Biomedical Innovation and Equitable Access—Reply

In Reply We appreciate Dr Lindpaintner’s comments on our recent Viewpoint. We agree that high prices represent an important barrier to access, with drug pricing serving as one of the most salient examples of this issue. In fact, this challenge epitomizes what we term the health equity valley of death, wherein systemic factors—including those related to cost and access—hinder the equitable dissemination of medical innovation, particularly to the most vulnerable populations. Lindpaintner accurately quoted our passage regarding the “‘need to…reduce [the] cost of health care, improve access and affordability’ as ways to close the equity gap.” However, although he highlighted our discussion on “digital technology, big data, and artificial intelligence” as potential solutions, he did not acknowledge that we also emphasize a variety of important policy approaches, including the pursuit of universal health care, the strengthening of primary care systems, and the development of social programs and policies to improve access and affordability. Indeed, a major factor in affordability is drug price.