What should be considered in valuing medicines in the U.S.?
The value of medicines includes the full range of benefits that innovative treatments provide, such as improved clinical outcomes, longer life expectancy, better quality of life and reduced caregiver burden.
A core principle of the U.S. healthcare system is that treatment decisions should be made through shared decision-making between patients and their physicians. Every patient is unique, and their medical status needs to be the key factor in determining treatment options. Because of this, evaluating the value of medicines requires a clinically nuanced and patient-centric approach.
Johnson & Johnson’s Issue Brief, The value of medicines in the U.S., explains why one-size-fits-all approaches are not suited for the U.S. healthcare system and underscores the need for patient-centered value assessment.
How does the U.S. approach to value assessment support patient choice?
Rather than relying on a single government authority to determine which treatments are worth covering, value is assessed locally, taking into consideration not only clinical evidence and physician judgment but also patient needs and market dynamics. This decentralized system of value assessment supports patients, in collaboration with their healthcare providers, in determining the best treatment option for their unique needs.
How do breakthrough medicines deliver value to patients and society?
They extend lives, improve quality of life and reduce burdens on patients, their caregivers and the healthcare system.
Innovative medicines can also help patients return to daily life and work and can provide hope for future treatments and cures. Additionally, the science of today’s treatments informs research for the next generation of therapies. Recognizing these multiple drivers of value is essential to capturing the full spectrum of benefits that medicines provide.
Why are one-size-fits-all value frameworks debated in healthcare policy?
Some current policy proposals suggest that the U.S. should adopt top-down value assessment models used in some parts of the world. These approaches often rely on a threshold (i.e., maximum amount that one additional year of life is worth) and a simplified, discriminatory metric of the impact that a treatment has on patients that does not fully reflect the complexity and diversity of patient needs. These approaches present several challenges:
- Rigid thresholds: Arbitrary and inconsistent rules can limit patient access to medicines that may be effective for specific individuals.
- Oversimplified metrics: Some frameworks rely on metrics that embed discriminatory assumptions.
- Focus on hypothetical “average” patients: Population-level models may overlook the needs of patients whose conditions or treatments differ from statistical averages.
What policy actions can strengthen the U.S. approach to value and access?
Johnson & Johnson supports value assessment that is patient-centered, locally relevant, deliberative, flexible, holistic and clinically driven. By employing these principles, value frameworks could continue to support rapid patient access to innovative medicines that can meet their unique needs.
To maintain the strengths of the U.S. system, policymakers should also support patients by:
- Increasing transparency in the drug supply chain, including prescription benefit manager (PBM) reforms to bolster patient access and lower patient costs.
- Ensuring that patient cost-sharing is based on net prices and that cost-sharing assistance is counted toward patient out-of-pocket contributions.
- Eliminating the ability of large health systems and for-profit middlemen to continue profiting from the 340B Drug Pricing Program while vulnerable patients see limited direct financial relief.
The brief, The value of medicine in the U.S., offers data and insights to help educate policymakers and stakeholders on the importance of patient-centered value assessment and the benefits of a market-based approach to innovation and access.
© Johnson & Johnson and its affiliates 2026 04/26 cp-550388v1