Ezekiel J. Emanuel (
Health Aff (Millwood). 2019 Apr;38(4):604-612. doi: 10.1377/hlthaff.2018.05052.
The majority of Americans believe that lowering drug prices should be the top health care priority for the federal government. Yet drug costs as a proportion of the country's medical expenditures have increased substantially in recent years. Because drugs are basic necessities, and because how much society should contribute toward providing basic necessities is a question of justice, policies regarding drug prices must fulfill principles of justice, not just economic efficiency. In this article I define a standard for when the price of a drug is unjust, using a cross-disciplinary ethical approach. Based on four principles, I propose the average lifetime earnings standard for affordability. According to this standard, a drug price is unfair if it exceeds 11 percent of the average American's disposable income. This suggests that current prices for many drugs are excessive and unjust.
大多数美国人认为，降低药品价格应该是联邦政府医疗保健的首要任务。然而，近年来，药品成本在该国医疗支出中的占比大幅上升。由于药品是基本必需品，以及社会应为提供基本必需品做出多少贡献是一个正义问题，因此药品价格政策必须符合正义原则，而不仅仅是经济效率原则。在本文中，我使用跨学科的伦理方法来定义药品价格不公正的标准。基于四个原则，我提出了可负担性的平均终身收入标准。根据这一标准，如果药品价格超过美国人平均可支配收入的 11%，则该价格是不公平的。这表明目前许多药品的价格过高且不合理。
