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The Evidence Standard Nov/Dec 2018
The Evidence Standard
Speech and Debate provides a meaningful and educational experience to all who are involved. We,
as educators in the community, believe that it is our responsibility to provide resources that
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multitude of perspectives and schools of thought.
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and vision of this activity.
These seven statements, while simple, represent the complex notion of what it means to
advance students’ understanding of the world around them, as is the purpose of educators.
Champion Briefs 4
Letter from the Editor Nov/Dec 2018

Letter from the Editor
Welcome to our first combined November/December edition of Champion Briefs! The

resolution for the next two months will be “Resolved: The United States federal government
should impose price controls on the pharmaceutical industry.”
The pharmaceutical industry has been under a microscope lately as the country
struggles with an ongoing opioid epidemic and rising medical expenditures on a national level.
Scandals, like Martin Shkreli increasing the price of live-saving Daraprim by 3000%, have
painted the industry in a dark light and led politicians to push for radical reforms. This topic will
be a fun one to research because it’s both highly relevant and straightforward in terms of
argumentation. Best of luck this month – I hope this brief is helpful in your preparation.
This topic may not be very broad, but it’s an excellent chance for debaters to dive
headfirst into the worlds of economics and healthcare. While every topic has discussions of
economics, and healthcare has appeared in other recent topics, this month will require you to
have a mastery of the subjects given their importance to this resolution. For many Americans,
however, these discussions are very sensitive. Be cautious in choosing your language, as
virtually every family across this country knows somebody who struggles with opioid addiction,
paying for prescription drugs, or another related issue.
At Champion Briefs, we’ve worked tirelessly this month to find the best arguments and
evidence for you to start your preparation with. As always, remember that our brief is an
excellent foundation for your preparations, but the best debaters should go above and beyond
in their own research and practicing as well.
Happy researching - I hope you enjoy the last topic of 2018!
Michael Norton
Editor-in-Chief
Champion Briefs 5
Table of Contents Nov/Dec 2018
Table of Contents
The Evidence Standard .......................................................................................4
Letter from the Editor .........................................................................................5
Table of Contents ...............................................................................................6
Topic Analyses ....................................................................................................8

Topic Analysis by Jakob Urda ......................................................................................................................... 9
Topic Analysis by Belén Mella ..................................................................................................................... 17
Topic Analysis by Zachary Ginsberg ......................................................................................................... 26
General Information ......................................................................................... 34
Pro Arguments with Con Responses ................................................................. 42

PRO – Price Controls Correct Market Failure ........................................................................................ 43
A/2 – Price Controls Correct Market Failure .................................................................................... 47
PRO – Price Controls Would Reduce Government Spending ......................................................... 50
A/2 – Price Controls Would Reduce Government Spending ..................................................... 54
PRO – Price Controls Necessary to Protect the Uninsured ............................................................. 58
A/2 – Price Controls Necessary to Protect the Uninsured .......................................................... 62
PRO – Price Controls Necessary to Control Patent Monopolies .................................................... 65
A/2 – Price Controls Necessary to Control Patent Monopolies ................................................ 69
PRO – Limiting Political Power of Pharmaceutical Companies ..................................................... 73
A/2 – Limiting Political Power of Pharmaceutical Companies ................................................. 78
PRO - Price controls prevent tradeoff of medicine/medical care ............................................... 82
A/2 - Price controls prevent tradeoff of medicine/medical care .............................................. 86
PRO – Price controls increase competition in the pharmaceutical industry ........................... 89
A/2 – Price controls increase competition in the pharmaceutical industry ....................... 93
PRO – Price controls would stop price discrimination ..................................................................... 96
A/2 – Price controls would stop price discrimination ............................................................... 100
PRO – Price controls would increase drug access for low income individuals ................... 103
A/2 – Price controls would increase drug access for low income individuals ................ 107
PRO – Price controls help fight the opioid epidemic ...................................................................... 110
A/2 – Price controls help fight the opioid epidemic ................................................................... 113
PRO – Price controls decrease hospital costs ..................................................................................... 117
A/2 - Price controls decrease hospital costs .................................................................................. 121
PRO – Price controls decrease insurance premiums ...................................................................... 125
A/2 - Price controls decrease insurance premiums ................................................................... 129
PRO – Price controls increase government medical coverage ................................................... 133
A/2 - Price controls increase government medical coverage ................................................. 137
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Table of Contents Nov/Dec 2018
PRO– High Drug Prices driving consumers to the black market ............................................... 141
A/2– High Drug Prices driving consumers to the black market ........................................... 145
PRO– High Drug Prices Strain State Budgets ..................................................................................... 148
A/2 - High Drug Prices Strain State Budgets ................................................................................. 151
Con Arguments with Pro Responses ............................................................... 153

CON – Price controls will limit research into vaccines .................................................................. 154
A/2 - Price controls will limit research into vaccines ................................................................ 158
CON – Price controls will limit research to treat new diseases .................................................. 162
A/2 - Price controls will limit research to treat new diseases ............................................... 166
CON – Cost of medicine is absorbed by insurance companies ................................................... 170
A/2 - Cost of medicine is absorbed by insurance companies ................................................. 174
CON - Price controls will cause political backlash ........................................................................... 178
A/2 - Price controls will cause political backlash ........................................................................ 182
CON – Price controls will result in lower quality assurance ....................................................... 186
A/2 - Price controls will result in lower quality assurance ..................................................... 190
CON – Price controls limit capital for research ................................................................................. 194
A/2 - Price controls limit capital for research ............................................................................... 198
CON – Price controls increase long term costs of medicine ......................................................... 202
A/2 - Price controls increase long term costs of medicine ...................................................... 206
CON – Price Controls would raise drug prices elsewhere ............................................................ 210
A/2 - Price Controls would raise drug prices elsewhere .......................................................... 213
CON – Drugs Account for Very Little of Healthcare Spending .................................................... 216
A/2 - Drugs Account for Very Little of Healthcare Spending .................................................. 219
CON – Price Controls Limit Research into Orphan Diseases ....................................................... 221
A/2 - Price Controls Limit Research into Orphan Diseases ..................................................... 224
CON – Most Americans use generic medicines that are already inexpensive ...................... 227
A/2 - Most Americans use generic medicines that are already inexpensive ................... 230
CON – Companies charge high prices to make up for failed products .................................... 233
A/2 - Companies charge high prices to make up for failed products .................................. 236
CON – Price Controls Disrupt Supply and Demand ......................................................................... 239
A/2 - Price Controls Disrupt Supply and Demand ....................................................................... 243
CON – Price Controls Encourage a Shift to the Black Market ...................................................... 246
A/2 - Price Controls Encourage a Shift to the Black Market .................................................. 250
CON – Price Controls Encourage a Shift to the Black Market ...................................................... 253
A/2 - Price Controls Encourage a Shift to the Black Market .................................................. 257
Champion Briefs 7
Topic Analysis by Jakob Urda Nov/Dec 2018
Topic Analysis by Jakob Urda
Resolved: The United States federal government should impose price controls on the
pharmaceutical industry.
Introduction
For the first time in Public Forum history, the November topic will also be used in
December. This might sound like a clerical change, but it will almost certainly make this part of
the school year far more competitive. This is because by merging the two topics, the NSDA has
made two ‘off-months’ (topics with less steep national competition) into a single topic which no
debater can afford to ignore. Combining the two months will have the effect of making
competition in both more intense, because doing research and practice will produce double the
return on investment.
This topic, like many November resolutions, pivots away from the international relations
tradition of September-October into current events domestic policy. Last year it was gun
control, this year it is healthcare. It is difficult to imagine a topic area more heavily politicized
than government intervention in the medical space—elections are regularly won and lost on
the issue, and it is the number one area of focus for many Americans. This topic is about as
political as they get, which means that debaters will have to tread lightly. It is impossible to
know what a judge’s bias is on a topic like this, and because of the highly sensitive and personal
nature of the topic it is possible that these biases are weighty. Almost every American has
personal experience with the healthcare industry and some political opinion about what should
be done about it. The trick to winning rounds on a topic such as this one will be to craft
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arguments which are broadly appealing, and being able to beat their opponents at their own
game. This type of topic brings out the finest in what PF has to offer by forcing debaters to
learn how to communicate with people who have real experiences with the issues at hand.
Tournament Considerations
The landscape of tournaments during the November-December topic is considerable.
The length of the topic and balance of competition make it advisable for teams to try and get in
as many rounds as possible early on, in order to gain an advantage later in the months. At the
same time, teams should be mindful that these tournaments can be incredibly competitive, and
that the extra length allocated to this topic will bring out fiercer competition. The length of the
topic means that few teams can afford to ignore these pivotal months.
Often referred to as the ‘Harvard of the First Semester’, Glenbrooks is undoubtably the
most intense tournament of the topic. Glenbrooks has a national draw and works hard to bring
in experienced judging. Therefore, one should expect the rounds to be intense and high quality.
Teams should focus on technical argumentation, practice speed, and take notes on lengthy
RFDs. The nation draw of the tournament will also expose debaters to different viewpoints that
they can adopt for later tournaments.
One should not make the mistake of assuming that strategies which work at Glenbrooks
will work at other tournaments. It is very possible that the judges at Glenbrooks—being debate
coaches and veterans—are better able to separate the discussion that goes on in-round from
their preexisting ideas about healthcare. For many other tournaments this may not be the case,
and more work will have to be done to make certain ideas palatable for laypeople.
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Counterintuitive arguments (about high prices being good, for instance) might work well at
Glenbrooks, but will certainly be a harder sell at other tournaments throughout the topic.
One of those other tournaments is the GMU invitational. GMU has historically been
massive, with hundreds of entries. The judging pool could also not be more dissimilar to that of
Glenbrooks. GMU has an east-coast draw, and has a substantially smaller portion of technical
judges in the judge pool. The tournament is also huge for speech, and the judges sometimes
circulate between events because schools bring odd numbers of teams, and need to fill their
judging requirements. This means that between non-traditional and lay judges, debaters need
to focus on the art of persuasion. I would recommend cases no longer than 650 words, and
arguments that are couched in intuitive logic. Winning the flow is less important than
communicating with your judge, and what flies in Glenbooks may not work out at GMU.
Strategy Considerations
Like any politics topic, the debate around price control revolves around inherency. What
is inherency? Inherency is the idea that there exist beliefs or attitudes which prevent altering
and shape the implementation of the resolution. In Public Forum, out topics are too narrow to
explore the full range of the subject without raising additional questions. For this one,
questions include: Where will the price controls fall in terms of the cost of medication, what
sectors of the industry will they fall on, and how will they be enforced? None of these questions
are answered in the wording of the topic, but all of them dramatically influence the debate-
space with their answers. In Public Forum, we lack the time and juridical authority to give plan
texts—which in other forms of debate deal away with the problem of inherency through fiat.
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Plan texts serve to carve out the exact parameters of the debate, specifying what changes in
the Aff world and what remains the same. Because PF lacks plan texts, we must resort to an
inherency debate. What is the most likely manifestation of affirming, given the current social
and political climate? Not all implementations are simultaneously possible, so teams must
argue about what is and is not likely to happen.
One of the most important questions is “What are pharmaceuticals?” That is to say,
what is the exact scope of the actor being targeted by price controls? This could have dramatic
implications for the round, for instance, is pharma research included in the scope of the price
controls? How about Insulin and generic medication? How will price protection deal with
patents? The answers to these questions determine the scope of the round, which can hand
large amounts of ground to the team that wins the inherency debate.
Another question of importance is “How high will the price controls be?” The inherency
of this question determines the scope of the impacts in the round. If the price ceiling for drugs
is 1 dollar, it would probably trigger many more impacts than if the price ceilings were
thousands of dollars. Yet another question is what will be the operationalization of the price
control plan? Will there be a commission to determine the price per drug, or perhaps a single
level of acceptable prices? This question could determine the type of impacts manifested in the
round, because some systems of price control will undoubtably lead to different consequences
than others.
The last and most important question of inherency is relates to the current political
climate. Debaters should study the ongoing debates around pharmaceuticals in order to glean
an understanding of how our legislature and electorate view this issue. The question here is
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‘How will the passage of price controls effect the balance of power in the American
government’. Many argue that political capital is zero sum, and that favors must be bought with
concessions. In this worldview, the ‘win’ of price controls could be offset by a series of political
concessions to private enterprise, or an electoral loss in the midterms (especially during the
first few tournaments in November, before the elections happen).
The inherency debate is a crucial part of politics topics, because it outlines the scope of
the policy which will be implemented. Debaters should spend ample time before serious
competition in order to establish a tactical understanding of what is the most likely
manifestation of the resolution. Remember that certain implementations can favor one side of
the debate over the other, and try to focus on an interpretation of the topic which leaves you
with the most room for argumentation. Being able to win the inherency debate sets a team up
to advantage themselves dramatically before the round has even begun.
Affirmative Argumentation
The affirmative has the advantage of being intuitive. Most judges will agree that drug
prices are far too high, and that the implications of an unaffordable medical system are socially
and morally intolerable. This limits the groundwork that aff teams need to do in order to build a
persuasive case, and makes many of the stock arguments on the topic the most appealing.
One argument that everyone should consider is a standard ‘increasing accessibility’
argument. The point of this contention would be to simply illustrate the massive gap that exists
in the status quo between the price of drugs and many Americans’ ability to pay for them. This
point is a strong one to consider for a few reasons. First, the impacts are large and non-tunable.
Champion Briefs 13
Millions of Americans lack the ability to pay for serious medication, and the inability to afford
essential pharmaceuticals has disastrous consequences—prolonged illness and death. These
impacts affect the most needy among us, and it seems logical and fair that society ought to help
people who’s situation is so dire.
Second, there are plenty of examples. From Martin Shkreli to the EpiPen, Americans are
already intimately familiar with, and aghast at, stories of big companies raising the prices of
essential health products above what is reasonable and fair. These scandals are well known and
popularized, and it will not take much effort to convince a judge that they need to be addressed
by the government. Teams should use statistics that indicate the degree to which drug
producers line their pockets with profits in order to corroborate their emotional assertion that
these industries do not actually need the revenue which they generate from high prices.
Teams that read these arguments should focus most of their time on frontlines,
preparing responses to responses. This is because as a stock argument, ‘increasing access’ is
sure to be blocked out by any team in the country. Now, this should not dissuade debaters from
running the argument, but it does warrant being prepared. Most of a team’s time should be
spent reading practice frontlines against many possible rebuttals, and perfecting extensions.
This point is intuitively appealing to judges, so you don’t want to mess it up by being
unprepared for predictable responses.
Negative Argumentation
Negative teams should think strongly about running arguments which center around
innovation. This is because the innovation impact acts as a link turn to most of the affirmative
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arguments which center around increasing access—because if fewer high quality drugs are
produced overall, the amount of useful medicine which people are able to consumer goes
down. In addition, innovation makes existing drugs cheaper by forcing existing producers to
lower their prices in order to compete with new alternatives. For instance, if there is a single
cure for cancer, the producer can charge whatever they want because they have a monopoly
on the market. However, if there are three producers, then the price falls to be closer to the
cost of production, because the manufacturers need to engage in a race to the bottom in order
to outbid their competitors for market-share. This point is also unlikely to be taken hostilely by
judges on any part of the political spectrum, because it concedes that the State’s overall goal is
to protect individuals from bad medical outcomes.
This argument is particularly strategic because you can use multiple links into the same
impact, giving a team the ability to collapse in different directions depending on the way the
round progresses. One link would be the direct effect that a decrease in profits would have on
the ability to reinvest money into research and development. With less cash on hand, most
companies would probably cut funding into looking for new drugs. This is especially true
because price controls would mean that the incentive to produce new drugs also goes down—
because the reward that a company can expect from producing a new drug also decreases.
Another link that negative teams could think about running for this argument could be
the effect that the political pressure of price controls could have on the drug market. The
American pharma industry has long been a free market in terms of price setting, so the
imposition of price controls would herald a fairly large departure from the status quo. This is
important because the breaching of these norms could spook pharma companies into scaling
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back long term investments in new projects, out of fear that they would not be able to profit
from those future products. It is important to remember that researching new cures can be
incredibly expensive, so increasing the legal uncertainty about the process is bound to decrease
the willingness of producers to be a part of the market.
Overall, this argument is strong because it couches the negative in relatable rhetoric and
has strategic links. Teams can spend less time fleshing out multiple impacts by concentrating on
the single impact of decreased research, and instead spend most of the case concentrating on
developing links. This is crucial because having multiple links spreads out the opponents ability
to respond to any one argument, and gives the negative the ability to collapse on a single
avenue of offense by the end of the round which has been only lightly responded to.
This topic promises to be exciting—both politically charged and well developed.
Teams will face both local and national competition, and see a full range of judging. Topics like
this bring out the best in the circuit. Good Luck!
About Jakob Urda
Jakob grew up in Brooklyn, New York. He attends the University of Chicago where he
hopes to receive a BA in Political Science in 2019, and is interested in security studies and
political economy. Jakob debate for Stuyvesant High School where he won Blake, GMU, Ridge,
Scarsdale, Columbia, the NCFL national championship, and amassed 11 bids. He coached the
winners of the NCFL national tournament, Harvard, and Blake.
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Topic Analysis by Belén Mella Nov/Dec 2018
Topic Analysis by Belén Mella
Introduction
Americans spend more per capita on pharmaceuticals than citizens of any other
country. This has prompted outrage across the political spectrum, with politicians from Bernie
Sanders1 to Donald Trump2 calling for solutions. This month, debaters will be considering
whether "the United States federal government should impose price controls on the
pharmaceutical industry," entering a decades-long national conversation. Proponents of price
controls will point out that most other developed countries use them, and that they're a critical
avenue for taking power out of the hands of monopolistic pharmaceutical companies and giving
it back to ailing consumers. Opponents will note that high costs are the necessary incentive for
pharmaceutical companies to engage in the slow and risky research that yields life-saving
medications. Debaters will have to navigate through these arguments, wielding rigorous
economic analysis as well as emotional appeals to the need for access to life-saving
medications.
Pro Arguments

1 “Sanders Calls for Price Controls.” CSP Daily News, 15 Aug. 2015, www.cspdailynews.com/fuels-news-prices-
analysis/fuels-news/articles/sanders-calls-price-controls.
2 Roy, Avik. “Trump's New Medicare Rule To Reduce Prescription Drug Prices Through Competition.” Forbes,
Forbes Magazine, 8 Aug. 2018, www.forbes.com/sites/theapothecary/2018/08/07/trumps-new-medicare-rule-to-
reduce-prescription-drug-prices-through-competition/#79dcdfcd7e88.
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Most judges will probably agree that Americans pay too much for pharmaceuticals. Indeed,
"Ninety-two percent of U.S. adults favor letting the federal government negotiate lower drug
prices for Medicare beneficiaries," and a majority believe the U.S. should be doing something to
curb drug costs overall.3 The heart of the debate lies in what to do. Pro teams will argue that
price controls are the right solution. The Pro advocacy stems from the argument that high
prices limit access to drugs, particularly for the socioeconomically disadvantaged, putting
human lives at stake. According to a 2016 survey, 14 percent of insured Americans and a third
of uninsured Americans failed to take prescribed medicines because the cost was too high.4
This problem is exacerbated for individuals with chronic conditions, who incur recurring costs
for their medication. Pro teams will argue that in one of the richest countries in the world, no
one should suffer from a treatable condition because they can’t afford the cure. They’ll also add
that it’s not just a question of increasing access to insurance. Health policy researcher Dana
Sarnak explains that “while insured U.S. patients often pay little or nothing for generic
prescriptions, they can be billed tens of thousands of dollars for certain high-priced medicines.”
She also notes that certain states have moved to change this, like Maryland, which has a $150
monthly cap for “specialty-tier drugs” and could be a good case study for teams to consider.
Reviewing the literature, debaters might find that many academic studies are on the
side of the Con, at least partially. Though debaters should comb through the literature to figure

3 Sarnak, Dana. “Paying for Prescription Drugs Around the World: Why Is the U.S. an Outlier?” Prescription Drug
Spending Why Is the U.S. an Outlier?, 5 Oct. 2017, www.commonwealthfund.org/publications/issue-
briefs/2017/oct/paying-prescription-drugs-around-world-why-us-outlier.
4 Ibid.
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out how the scholars on this topic come to their conclusions --what assumptions they rest on,
what values they prioritize, what data they consider, etc.-- the general argument seems to be
the following: in the short run, price controls reduce costs and increase access for consumers;
in the long run, they discourage innovation in the pharmaceutical sector, ultimately to the
detriment of consumers. Some studies go so far as to say that in the long run, costs and access
fail to improve for consumers, delivering a double whammy of bad news for advocates of price
controls.
This puts Pro teams in a tricky position. If it’s true that price controls would discourage
research into new medicine, then the Con gains a critical link into an impact on lives. One
advantage for the Pro team is that “price controls” is a relatively unspecific umbrella term.
While Public Forum debaters should never introduce a plan (that is, a specific articulation of
how price controls might look), debaters can certainly argue that a given price control scheme
is more likely because it’s more politically feasible, more backed by research, or just plain
better. With that flexibility, Pro teams can argue that price controls will be different in kind and
in degree from the worst-case implementation that the Con has in mind. Indeed, price controls
can take the form of price cuts, price caps, price freezes, or international price referencing
(where domestic prices are designed by looking at international prices).5 Furthermore, a price
control could be set around various metrics, including the “benefits conferred by drugs, the
costs of developing and distributing individual drugs, or some combination of the two.6”

5 Relakis, et al. “Systematic Review on the Impacts of Strict Pharmaceutical Price Controls-PHP199.” Value in
Health, vol. 16, no. 7, 2013, p. A486.
6 Calfee, J E. “Pharmaceutical Price Controls and Patient Welfare.” Annals of Internal Medicine, vol. 134, no. 11,
2001, pp. 1060–4.
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The crux of the Con argument is that if pharmaceutical companies don’t have a financial
incentive to make new drugs, they won’t, but Pro teams can advocate for a price control that
helps patients without cutting disastrously into pharmaceutical incentives. For example, some
experts have suggested that price controls be supplemented by measures to “restrict or
penalize advertising and promotion” of drugs, which many view as a waste of money that could
otherwise be going to research.7 (Opponents of this suggestion argue that advertisements for
drugs are socially beneficial, helping fill information gaps for consumers, even though ads for
medicine are pretty uncommon outside of the United States). Neera Tanden notes in the New
York Times that in 2014, "pharmaceutical costs grew 13.6 percent – faster than any other part
of the healthcare industry – and pharmaceutical company profits were nearly 20 percent in
2012, double the average profit margin for the S&P 500.8” The bottom line is that price controls
don’t need to be all or nothing; “big pharma” could stomach a hit to their profit margin without
losing the incentive to stay in the risky business of making medicine.
Pro teams could go further in defending themselves against the claim that price controls
will discourage research. For example, Jared Bernstein writes in the New York Times that the
government could expand the National Institutes of Health, subsidize private research, or
require that pharmaceuticals spend a given percentage on research.9 Pro teams shouldn't make

7 Ibid.
8 Tanden, Neera. “Encourage Drug Research Over Profiteering.” The New York Times, The New York Times, 23
Sept. 2015, www.nytimes.com/roomfordebate/2015/09/23/should-the-government-impose-drug-price-
controls/encourage-drug-research-over-profiteering-29.
9 Bernstein, Jared. “Drug Price Controls Are Vital in a Market That’s Not Free.” The New York Times, The New
York Times, 29 June 2016, www.nytimes.com/roomfordebate/2015/09/23/should-the-government-impose-drug-
price-controls/drug-price-controls-are-vital-in-a-market-thats-not-free.
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these proposals the key to their case, since these aren't built into the resolution, but they can
point out that a variety of options exists for mitigating the harms enumerated by the Con.
Pro teams should also point out that the United States is pretty alone in its lack of price
controls. Indeed, “many other countries employ centralized price negotiations, national
formularies, and comparative and cost-effectiveness research for determining price ceilings.10”
Meanwhile, the U.S. system is fragmented, with “numerous, separate negotiations between
drug manufacturers and payers and complex arrangements for various federal and state health
programs” as well as more lenience for “monopoly pricing of brand-name drugs than other
countries are willing to accept.”
If Pro teams can defend themselves against Con’s arguments, then lower prices for life-
saving drugs becomes pretty hard to beat. Pro teams should also be encouraged to be creative,
and consider the moral implications of putting a price on human life -- the de facto effect of
exorbitant pharmaceutical costs. Indeed, though markets are usually good at setting prices and
determining which products are worth making, it’s within reason to ask whether markets
should be deciding the price of drugs or even the types of drugs that are developed.
Con Arguments
Having already hinted extensively at the Con’s advocacy, let’s dig in. According to David
Francis at the National Bureau of Economic Research, "cutting prices by 40 to 50 percent in the
United States will lead to between 30 and 60 percent fewer [research and development]

10 Sarnak, Dana. “Paying for Prescription Drugs Around the World: Why Is the U.S. an Outlier?”
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projects being undertaken in the early stage of developing a new drug.11” Meanwhile,
“relatively modest price changes, such as 5 or 10 percent, are estimated to have relatively little
impact on the incentives for product development - perhaps a negative 5 percent.” He is not
alone in this conclusion. Relakis et al. conducted a meta-analysis of studies pertaining to price
controls, finding that they
“reduce company profits and have a detrimental effect on pharmaceutical research and
development, pipeline productivity and investment. They may also inhibit, reduce or
delay new product launches, increase parallel exports and diminish availability of
generics due to disincentives and, hence, may reduce product availability, increase
withdrawals and shortages... In terms of effects on patients, studies indicate in the short
term welfare gains due to lower cost and better access, but also losses due to drug
shortages and availability issues. Long-term effects appear to be welfare losses due to
reductions of discoveries, resulting from the disinvestment associated with the lower
revenues.12”
While this evidence is strong, Pro teams are going to know to anticipate it. That’s why it
will come down to which side has the better warranting, that is, the better reasoning for why
their arguments are true. Calfee offers solid warranting in “Pharmaceutical Price Controls and
Patient Welfare”: “Small-probability, high-payoff pharmaceutical research is motivated
primarily by the possibility of someday obtaining large profits from the rare success. This is

11 Francis, David. “The Effect of Price Controls on Pharmaceutical Research.” The Effect of Price Controls on
Pharmaceutical Research, www.nber.org/digest/may05/w11114.html.
12 Relakis, et al. “Systematic Review on the Impacts of Strict Pharmaceutical Price Controls-PHP199.”
Champion Briefs 22
reflected in the fact that even the largest pharmaceutical firms derive the bulk of their revenues
from one to three individual drugs.13” Calfee adds that “financial calculations suggest that after
accounting for risk and the role of research and development as an investment, pharmaceutical
industry profits have not persistently exceeded competitive levels,” contradicting the Pro
narrative that “big pharma” can take the hit and continue to innovate. Critically, the blow to
research would affect the development of new drugs, the beneficiaries of which are “unaware
of the stakes and thus unable to provide a countervailing force” in this debate.
There is empirical backing for these arguments. For example, Thomas writes that
“advanced nations with pervasive pharmaceutical price controls, such as Japan, have for
decades denied innovative drugs to their citizens even as domestic pharmaceutical firms
prosper by pursuing low-risk research on products of marginal value.14” Indeed, when price
controls were being debated in the mid-90s, “annual increases in domestic pharmaceutical
research budgets decreased to 4% before returning to normal levels of around 11%” as
companies adjusted their expectations.15 Calfee furthers that “also significant is the recent and
rapid shift in the locus of pharmaceutical research and development toward the United States
and away from the European Union, which was implementing ever stricter price controls. The
U.S. share of the 50 best-selling drugs worldwide increased from 19 in 1988 to 33 in 1998, when
the U.S. produced 8 of the 10 top-selling drugs.16”

13 Calfee, J E. “Pharmaceutical Price Controls and Patient Welfare.”
14 Thomas LG. “Implicit industrial policy: the triumph of Britain and failure of France in global pharmaceuticals.
Industrial and Corporate Changes.” 1994.
15 Calfee, J E. “Pharmaceutical Price Controls and Patient Welfare.”
16 Ibid.
Champion Briefs 23
Impacts on research and development are some of the strongest arguments available to the
Con, because of the incalculably large impact on human life and well being. Con teams should
consider the scale of these impacts, because even if drugs are being produced for the U.S.
market, life-saving medications will eventually make their way across the globe, and patents
will eventually expire allowing generic versions of the drug to improve accessibility.
There are other routes for Con argumentation, too. One route involves the fact that the actor
in this resolution is the United States federal government. This means that debaters must
consider the implications of the national government being the entity to implement price
controls and whether that is preferable to other entities like state governments. Another route,
also in the area of implementation, pertains to just how pharmaceutical price controls would be
determined. Calfee argues that "decisions would be dominated by political forces, including
managed care organizations, domestic versus foreign manufacturers, patient groups, insurance
firms, employee benefit managers, labor unions, and other advocacy groups, many of whom
would hope that pharmaceutical prices could be arranged so that other groups (or even citizens
of other nations) could bear a disproportionate share of the research costs. 17”
Conclusion
This Topic Analysis aimed to sketch the main arguments on both sides and begin to expose their
nuances, warrants, and empirical support. It's up to debaters to dive into the research and

17 Ibid.
Champion Briefs 24
come up with creative ways to defend their positions. As I mentioned earlier, debates on this
topic will come down to the warranting. Can you explain your study? Does it make sense?
Furthermore, debaters should practice their persuasive and analytical skills, drawing inpatient
narratives to strengthen their story.
Champion Briefs 25
Topic Analysis by Zachary Ginsberg Nov/Dec 2018
Topic Analysis by Zachary Ginsberg
Introduction
Despite its critical importance in everyone’s life, this is surprisingly the first topic about
healthcare to appear in public forum in a very long time. Personally, in all the years I have
competed and coached, I have never encountered a topic about healthcare. Healthcare is
something that everyone needs and it is always a contentious point of discussion in political
campaigns and on the media— from the gutting of Obamacare to the Martin Shkreli fiasco.
Thus, healthcare is a topic that many people are likely to have intense opinions about and many
personally important experiences with. This is important to consider when crafting an
argument because it means that debaters should be especially careful not to offend possible
judges or bring up arguments that many people might disregard on face.
Another important consideration brought into play because of this is a debate about
healthcare is that all impacts will likely pertain to the loss of life. This means debaters will not
be able to simply weigh by saying, “Lives matter most!” This is good because it will force teams
to shift away from a crutch many have relied on for years and move into more creative
argumentation that happens at the link level. The topic itself is rather small in scope and the
number of arguments available to make are limited as well, adding another layer of complexity
and challenge to the debate. This means teams must be especially cunning and strategic with
not only the content of the arguments, but the strategy of implementation and delivery as well.
Champion Briefs 26
Overall, I look forward to watching debates on this topic— the challenge is bound to bring out
the best in us.
Tournament Considerations
For the first time ever, November and December will share a topic. So, I will be going
into the tournaments that occur during each of those months. That being said, the scope and
variety in tournaments is pretty similar between November and December— both comprise
mostly of a scattered array of smaller, more local tournaments like Scarsdale and Ridge, with
the exception of a few large nationally competitive tournaments, namely the Glenbrooks.
At local tournaments, the judges are often more lay judges because of the limited
number of teams that attend. This means that it is especially important to explain your
arguments simply and cohesively so that any person taken off the street might be able to
understand. This means that every link of the argument should be explained fully. It also
means that weighing is more important than ever because teams will be unable to go for
multiple arguments in one round because that is quite hard to follow for a judge who is new to
debate. Thus, in order to differentiate yourself from the other side, you must be able to weigh
in a compelling and clear manner that explains how much more important your arguments is
than your opponent’s.
Let me make a brief note on the Glenbrooks, which is considered by many to be the
most important tournament of the first semester. This is for good reason. The Glenbrooks
attracts the best competition from both coasts, as it is well positioned in the middle of the
country, which means that the competition will be fierce and the judging pool is very
Champion Briefs 27
experienced. This means that debaters should be prepared to face a variety of different
approaches to the topic from teams with many different methodologies for approaching debate
and be prepared to hit all possible arguments one could think of. An extensive blockfile and
prepared weighing will prove crucial to do well at the Glenbrooks.
Given this spread of tournaments, there will likely also be a spread of judges meaning
that debaters should be prepared to adapt in their delivery depending on the judge sitting
across the room. I stress the fact that debaters should vary delivery because the arguments
themselves should not change much between judges. This is sometimes a good idea on
complicated topics, but on a fairly simple and limited topic such as this one, the best arguments
will work for both lay judges and tech judges. Thus, it is important to be able to have many
different ways of explaining and extending arguments, placing a premium on practice before
tournaments.
Strategy and Weighing
On this topic, each side is very predictable. The pro will almost certainly make
arguments about the affordability of medication and the con will almost certainly make
arguments about innovation. The best debaters will be those who sort through the weeds to
find the best and most nuanced versions of each of these arguments and prepare weighing that
can handily end the round by strategically preempting the other side’s weighing. This will also
require a lot of research to flesh out specific lines of logic more in depth with evidence that the
other side does not have access to.
Let’s go through a few different possibilities for how this can go down.
Champion Briefs 28
On the pro, weighing will probably take the form of arguing that none of the innovations
that the con could argue for will matter if people are simply unable to afford these newly
developed medicines in the absence of price controls. This is a very compelling line of logic
because it can essentially apply to any possible con impact of innovation. Whether the con is
talking about vaccines, better treatments that replace older ones, or any other sort of benefit
accrued from innovation, none of it will prove helpful unless people can afford it. Of the
different weighing categories, what I just described could be labeled as prerequisite weighing.
However, there is also room to outweigh on scope and magnitude as well. This avenue of
weighing will require more research but is just as viable. All the pro needs to do is prove that
the number of people at risk of death due to high prices is greater than the number of people
that could potentially be saved by new innovative drugs and technologies. This is likely a
better route to go down because it allows you to concede more of the con ground but still win
the round. The con could win their entire impact, implementation and all, but still lose because
they simply affect a smaller number of people.
On the con side, the weighing must be the opposite. However, for the con, much of the
weighing depends on the specifics of which kind of innovation they are arguing for. For
example, with vaccines, the con can argue that the cost of medicine does not matter because
vaccines are only taken once, but the effects last a life time. Or, the con could argue that new
innovative drugs could be made to cost less in the future, outweighing costs of access
arguments by proving costs will go down in the long run. However, the impact calculus still
follows the same overall format as it does on the pro. On the prerequisite level, the con can
argue that it does not matter if a drug is affordable if it does not do what is required of it. On
Champion Briefs 29
the magnitude and scope level, the con can argue that the number of people affected by bad or
nonexistent medicine is larger than the number of people who would not be able to afford
medicine that is too costly. This is likely an easy argument to make because the con impact here
is potentially unlimited. This is because new diseases may pop up as the years go on, and we
will need a treatment for them. The amount of unknown diseases likely to exist is impossible to
predict, but is certainly likely to be larger than the people the pro can prove are saved now with
medicine that costs less for people to purchase.
Affirmative Argumentation
The bulk of affirmative argumentation will be about the affordability of medicine, how
price controls affect it, and how much it matters. I already answered the latter half of this
concern up above in my weighing and strategy section. Here, I will go into different link stories
that can be told about how price controls affect the availability and price of healthcare.
The most obvious link into affordability is the price of the medicine itself. If a price cap
keeps the price of medicine low, this means that people paying out of pocket for medicine will
certainly have to pay less when they need it.
However, most people do not pay out of pocket for medication, and most people to not
buy medicines directly from distributers, so there are many other factors that are involved in
determining the cost of medical care that the patient pays.
For example, much of the cost of medicine is absorbed by insurance companies. All
people in the United States are required to have insurance by the Affordable Care Act, and
although some people still are not covered, the vast majority of people are. However, this does
Champion Briefs 30
not mean that patients are entirely insulated from the cost of price increases. Indeed,
insurance companies can raise the cost of insurance if the cost of medicine goes up. This
means that people will lose access not only to specific medicines but all of their healthcare in
general, and even if people are still able to afford health insurance after the price hike, it is
likely that they will have to downgrade their coverage to something less expansive that ends up
covering fewer of their needs. Another alternative is that insurance companies could simply
choose to pay for less of the drug as prices go up, meaning that consumers will be forced to
shell out extra money anyway.
Another middle man between pharmaceutical companies and the people is the
government. Many people get their healthcare covered by government programs like the
affordable care act, medicare, or medicaid. A mandated decrease in the cost of medicine might
increase the ability for the government to cover other expenses, or even better increase the
number of people they are able to cover under such programs. This is another way in which
the affordability of medicine may not necessarily impact people by means of the cost they pay.
Nevertheless, it still significantly increases the access to healthcare available to people,
especially the poor and the most vulnerable in society.
Negative Argumentation
On the con, most arguments will be about innovation. As with the affirmative
argumentation section, I will go into possible link stories and explanations for how exactly price
controls will decrease innovation and then the different ways this could manifest. It is
Champion Briefs 31
important to consider that there are many ways that price controls may impact innovation
because innovation costs a lot of money and involves a slew of logistical difficulties.
The easiest way price controls affect innovation is by reducing the revenue of
pharmaceutical companies. This directly limits capital available for research by the company.
This means that even if companies wanted to invest in new technologies, they would lack the
resources to do so. This matters a lot because there are many costs involved with developing a
new medicine, from hiring researchers in house or at universities, to buying materials, to
renting out space.
There are also links on the incentive level as well. Even if the capital is not depleted to a
point where companies are unable to conduct research, they might just not even want to —
even even with the capacity to do so. This is because one could argue that price controls
reduce the motivation to make new investments into innovation because there will be less
reward at the end of the line if companies are only able to charge a certain amount for their
product. This not only limits the incentive for companies themselves to invest in research, but
it also limits the incentive for outside investors to sink money into big projects by these
pharmaceutical companies, again limiting the capital necessary for such costly endeavors.
There are many different innovations that the con can argue are stifled by a lack of
research and development. There are essentially as many of these as there are areas of
medicine, meaning that the con has a lot of room to get creative with the specific impacts they
are going for here.
Let’s go through a few options that teams are likely to use. One might be the
development of better treatments. There are many diseases that have treatments already, but
Champion Briefs 32
the treatments either take too long or are often ineffective. Investing into research can solve
that problem by increasing the efficacy of such medication. Another route to go down could be
vaccines. Many pharmaceutical companies do great research into vaccines, which cure diseases
and prevent people from ever getting them. Another possibility is investment and research
into possible treatments which cost less than current treatments, allowing the con to win on
the pro’s weighing in addition to their own.
It is also important to note that there are many ways the con can mitigate any impact
that the pro goes for because there are so many middlemen involved in the distribution of
healthcare that it takes forever for the cost of medicine to actually impact the consumer. For
example, the con can argue that insurance companies will likely not change the cost of
insurance just because the price of medicine goes down. This is important because very few
people pay out of pocket for medicine anyway, meaning that the only cost they ever actually
face is the cost of insurance. If that is never meaningfully affected, then people will never see a
benefit of the lower prices.
About Zachary Ginsberg
Zachary Ginsberg is the Debate Coach for Trinity High School in New York City.
Throughout his high school debate career, Zach amassed a total of 15 bids to the Tournament
of Champions and was awarded a top 5 speaker award at Bronx, Harvard, and Columbia. He
has reached semifinals or further of Blake, GMU, Ridge, Bronx, the Glenbrooks, and Scarsdale.
In his senior year, Zach championed the Columbia Invitational and finished in the top ten at the
TOC, NCFL Nationals, and NSDA Nationals. Now, Zach is a sophomore at Columbia University,
looking to major in Visual Arts and Philosophy.
Champion Briefs 33
General Information Nov/Dec 2018
General Information
Foreword: We, at Champion Briefs, feel that having deep knowledge about a topic is just as
valuable as formulating the right arguments. Having general background knowledge about the
topic area helps debaters form more coherent arguments from their breadth of knowledge. As
such, we have compiled general information on the key concepts and general areas that we feel
will best suit you for in- and out-of-round use. Any strong strategy or argument must be built
from a strong foundation of information; we hope that you will utilize this section to help build
that foundation.
Champion Briefs 35
The Current Cost of Drugs
Name brand pharmaceutical products, like Humira, are the exact same drug no matter where it
is sold in the world.
The regulatory system
in the United States is
the main reason the
cost is higher
compared to, say,
Spain. The United
States federal
government currently
does not regulate or
negotiate the prices of
new prescription
drugs when they come
onto market, unlike
other countries will
task a government
agency to meet with
pharmaceutical
companies and
negotiate an appropriate price. These agencies will typically make decisions about whether
these new drugs represent any improvement over the old drugs — whether they’re even worth
bringing onto the market in the first place. They’ll conduct extensive research about the drug’s
potential risks and benefits. 18 The U.K.’s National Health Service has refused to pay for some
cancer drugs widely used in the U.S. on the grounds that they don’t constitute value for
money.19
In the United States, however, a pharmaceutical company can set its own prices and
bring a product to the market as long as it’s proven to be safe. As a result, consumers in the
United States are often forced to pay more than those in other countries around the world. The
average American spends over $1000 on prescription drugs a year, while people in places like
Sweden are paying half and people in Chile are paying a quarter.

18 Kliff, Sarah. “The True Story of America's Sky-High Prescription Drug Prices.” Vox, Vox, 10
May 2018, www.vox.com/science-and-health/2016/11/30/12945756/prescription-drug-

prices-explained.

19 Langreth, Robert. “Drug Prices.” Bloomberg.com, Bloomberg, 11 May 2018,
www.bloomberg.com/quicktake/drug-prices.

Champion Briefs 36
20

20
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Dr
ug
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ic
Champion Briefs 37
Why Do Companies Make the Drugs So Expensive?
“Pharmaceutical companies argue that they need robust profits to bankroll the
development of future medical advances and that restricting prices would harm innovation.
They highlight the benefits of medicines such as Sovaldi, which has a cure rate superior to
treatments that cost nearly as much.”21
Over the years, drug companies have also experienced significant increases in both the
costs of drug development leading to approval by the Food and Drug Administration (FDA) and
the risks of product failures. It costs over $2 billion to bring a drug to the market, 10% of drugs
that begin clinical trials are FDA approved. As the development costs for traditional drugs have
increased, drug manufacturers have shifted much of their research and development efforts
toward biologic products. Because of their high costs of development and production and lack
of competitors to control prices, biologic drugs are prohibitively expensive for many
consumers.22

e Scandal Won't Be Enough to Keep down Prices.” Fortune, Fortune, 26 Oct. 2015,
fortune.com/2015/10/26/drug-prices-daraprim-turing-scandal/.

21 Langreth, Robert. “Drug Prices.” Bloomberg.com, Bloomberg, 11 May 2018,
www.bloomberg.com/quicktake/drug-prices.

22 Shepherd J. The Prescription for Rising Drug Prices: Competition or Price Controls?
Health Matrix: Journal of Law-Medicine. 2017;27:315-346.

Champion Briefs 38
However, this is not always the reason prices increase. In a capitalist society, a
company’s ultimate goal is to make as much money as possible, and goals are no different in
the pharmaceutical industry. In 2015,
for example, Turing Pharmaceuticals
founder Martin Shkreli bought out the
rights to Daraprim, a drug used to treat
patients with AIDS and weak immune
systems. Overnight, the price of
Daraprim was increased from $13.50 to
$750 and thousands were no longer
able to afford the drug keeping them
alive.23 This is not an isolated example,
as the following graphic illustrates that
this happened multiple times between
the years 2013 and 2015 alone. These
drugs do not have generic
substitutions, which are often cheaper.
The case for drugs with generic
substitutes is very different, as drug
manufacturers have a lot less control
over prices.
Pharmacy Benefit Managers, or PBMs,

are third party pharmaceutical buyers
like Medicaid and private insurers. They “administer the prescription drug coverage for over
ninety-five percent of insured Americans, have adopted various benefit changes and tools to
reduce pharmaceutical prices and steer patients to less-expensive alternatives. For example,
PBMs have successfully reduced drug spending by requiring substitution of generic drugs for
brand name drugs when clinically appropriate. Many PBMs also offer mail-order pharmacy
services that lower drug prices by ensuring that consumers are dispensed the cheapest drug
within a therapeutic class, which is often a generic. PBMs also employ tiered formularies—a list
of approved or preferred drugs for the health plan—and direct consumers to the formulary
drugs with incentives, such as lower copayments. These and other innovative tools have saved
Americans billions of dollars each year. However, they have also dramatically changed the
landscape of the pharmaceutical market by lessening drug companies' influence over prices. In
the 1970s, most prescription drugs were prescribed by doctors that were largely insensitive to
price, methodically filled by pharmacists, and paid for by consumers or, less frequently, by

23 Mole, Beth. “The 5,000% Price Hike That Made Martin Shkreli Infamous Is No Longer
Paying Off.” Ars Technica, Ars Technica, 19 July 2018, arstechnica.com/tech-

policy/2018/07/shkrelis-former-company-is-now-losing-money-even-with-the-5000-
price-hike/.

Champion Briefs 39
third-party payers that had little influence over the drug chosen or the price paid. As a
consequence, drug manufacturers had enormous control over price. In contrast, the market for
prescription drugs in 2016 is one in which the PBMs and drug plans have harnessed the buying
clout of millions of consumers to negotiate discounted prescription drug prices. PBMs and drug
plans have harnessed the buying clout of millions of consumers to negotiate discounted prescription
drug prices. PBMs and drug plans now largely determine what consumers pay for drugs, which
pharmacies they use, and which drugs they take. As a result, PBMs and drug plans have replaced drug
manufacturers in the driver's seat when it comes to determining prices.”24
Political Support
v The Politicians. In the 2016 presidential election, candidates Trump, Clinton, Rubio,
Carson and Sanders all agreed on one thing: the cost of drugs in the United States was
too high and that price negotiations needed to happen with the biopharmaceutical
industry25. This was the first time in recent history where price controls on drugs had
bipartisan support.
v The People. Most Americans believe that the prices of brand-name prescription drugs
have become way too expensive. “About 7 out of 10 Americans, including two-thirds of
Republicans, said Medicare, the federal health insurance program for older and disabled
Americans, should be able to negotiate lower prices for all prescription drugs. Another
13 percent support negotiations for just high-cost drugs for illnesses such as hepatitis C
or cancer.”26

24 Shepherd J. The Prescription for Rising Drug Prices: Competition or Price Controls?
Health Matrix: Journal of Law-Medicine. 2017;27:315-346.

25 Mukherjee, Sy. “Trump Joins Clinton, Sanders, & Obama in Endorsing Medicare Drug
Price Negotiations.” BioPharma Dive, 27 Jan. 2016, www.biopharmadive.com/news/trump-

joins-clinton-sanders-obama-in-endorsing-medicare-drug-price-nego/412840/.

26 Nather, David. “STAT-Harvard Poll: Dismayed by Drug Prices, Public Supports
Democrats' Ideas.” Harvard University, www.harvard.edu/media-relations/stat-harvard-

poll-dismayed-by-drug-prices-public-supports-democrats-ideas.

Champion Briefs 40
v The Pharmaceutical Companies. “Even powerful members of Congress from both

parties have said that drug prices are too high, but any momentum to curtail
prescription drug costs — a problem that a large number of Americans now believe
government should solve — has been lost amid rancorous debates over replacing
Obamacare and stalled amid roadblocks erected via lobbying and industry cash.” 27 In
other words, the pharmaceutical companies, who spent $145 million lobbying congress
in just the first half of 2017 alone, are the biggest current roadblock to achieving price
controls.

27 Hancock, Jay. “Everyone Wants to Reduce Drug Prices. So Why Can't We Do It?” The New
York Times, The New York Times, 23 Sept. 2017, www.nytimes.com/2017/09/23/sunday-

review/prescription-drugs-prices.html.
Champion Briefs 41
Pro Arguments with Con Responses Nov/Dec 2018
PRO – Price Controls Correct Market Failure

Argument: Pharmaceutical companies have significant leverage over consumers, and price
controls are necessary to ensure that consumers aren’t being exploited.
Warrant: Pharmaceutical companies have enough market share generally that they have little
incentive to make their products affordable.
Bennett, Sara, Jonathan D. Quick, and German Velasquez. "Public-private roles in the
pharmaceutical sector: Implications for equitable access and racional drug use."
1997. http://apps.who.int/medicinedocs/en/d/Jwhozip27e/6.3.html
“When there are many buyers or sellers of a commodity the actions of any single actor
do not affect anyone else. However, if there are few buyers or sellers then these few
may be able to exercise market power. In the case of sellers this is called monopoly
power, in the case of buyers it is known as monopsony power. Market power enables
sellers to charge higher prices than they would in a situation of perfect competition. The
extent of market failure Unlike the overall health care sector, the pharmaceutical
sector suffers substantial problems related to the failure of competition. High initial
investment costs mean that average production costs reduce only when a large quantity
of a drug is produced. However, with international trade, it is rarely the case that a true
monopoly of this sort exists. Instead market power is created through: - patent
protection, which exists in order to encourage research and development; - brand
loyalty created through marketing which generates market power even after patents
expire; - market segmentation, especially by therapeutic subclass; - gaining control
over key inputs, thus preventing other firms from competing effectively; - implicit
collusion between firms through, for example, price-fixing. An alternative perspective
suggests that, due to the special characteristics of drugs, competition takes undesirable
forms. In particular, because of the life-saving nature of many drugs and the fact that
patients do not pay for them directly in many countries, there is unlikely to be
Champion Briefs 43
substantial price competition but rather competition in product quality, innovation and
brand awareness.”
Warrant: Pharmaceutical companies exist in a highly non-functional market that allows price
gouging and unfair prices.
Jared Bernstein, NY Times, “Drug Price Controls Are Vital in a Market That’s Not Free”,
June 29 2016, https://www.nytimes.com/roomfordebate/2015/09/23/should-
the-government-impose-drug-price-controls/drug-price-controls-are-vital-in-a-
market-thats-not-free
“The challenge is finding the public policies that will take pharmaceuticals from what
any objective person would view as a highly distorted market — prices don’t rise 5,500
percent overnight in a functioning market — to a more rational one. Hillary Clinton just
released a new proposal with various ideas that point in that direction: allowing
Medicare to bargain for lower drug prices, a monthly cap of $250 for patients with
chronic conditions, research and development investment requirements for highly
profitable drug companies, prohibition of delaying tactics that keep generics out of the
market, and more. All good ideas that incrementally push in the right direction. But to
go further will require two more aggressive steps: price controls and new incentives
for drug research. Price controls for drugs, which are common in other advanced
economies, increase affordability. But even when the mechanism is “cost-plus” pricing
— the government allows drug companies some degree of markup — their profits will
still decline from current levels.”
Warrant: Whenever one company chooses to gouge prices, other companies are able to follow
suit due to the imbalanced nature of the market.
Champion Briefs 44
University of Pennsylvania Wharton. “Preventing Price Gouging in the Pharmaceutical

Industry: A Comprehensive Policy Approach”. March 16 2018.
https://publicpolicy.wharton.upenn.edu/live/news/2390-preventing-price-
gouging-in-the-pharmaceutical/for-students/blog/news.php
“A price hike occurs when a large biopharmaceutical company can increase prices either
over a span of time, or in some cases, overnight, due to a single entity controlling much
the market share. Soon after, other companies with similar drugs follow suit, creating a
kind of “Shkreli effect,” named after the infamous CEO of Turing Pharmaceuticals, who
was responsible for the Daraprim price increase. Price gouging occurs because of
pharmaceutical company abuse of patent laws and the current model for drug discovery
and development previously mentioned. Although patent protections were created to
incentivize innovation, patents actually create “quasi-monopolies” in the pharmaceutical
sector by allowing companies loopholes to delay selling to competitors that produce
generic drugs. The prevalence of price hikes exemplifies the need to reform the
biopharmaceutical market, without disincentivizing innovation or risk-taking in research.”
Impact: Consumers suffer and are exploited by producers due to this market failure, resulting in
poor outcomes.
Berman, Aaron, et al. "Curbing unfair drug prices: A primer for states." (2017).
https://law.yale.edu/system/files/area/center/ghjp/documents/curbing_unfair_
drug_prices-policy_paper-080717.pdf
“The high cost of prescription drugs in the United States is unsustainable. Spending on
prescription drugs is increasing at a faster rate than any other component of health care
spending, and a growing number of Americans report difficulty affording their
medications. High drug prices are forcing some patients to skip doses of critical
medicines, and others to choose between their health and necessities like food and
Champion Briefs 45
rent. Meanwhile, the pharmaceutical industry continues to launch new drugs at

exorbitant prices, increase prices of many old drugs without justification, and reap record
profits. Evidence has unequivocally shown that high drug prices are not linked to the
actual costs of research, development and manufacturing. Instead, inflated drug prices
are a result of drug manufacturers’ power to charge whatever price the market will bear.
The need for legislative action is urgent.”
Analysis: This is a straightforward but powerful argument that teams can use in a number of
different ways. The most difficult part is proving that manufacturers raise prices arbitrarily, but
teams can use a number of examples to prove this is true. By pointing out the various ways that
the current set-up has resulted in market failure, teams can easily make the case that
government intervention is necessary.
Champion Briefs 46
A/2 – Price Controls Correct Market Failure

Answer: The high prices of drugs aren’t an example of market failure, they’re the result of the
costly, time-consuming, and intensive process of manufacturing and researching drugs.
Warrant: The upfront cost of making new pharmaceuticals is exceedingly high, and drug
companies need to be able to recoup that capital.
John Lamattina. “About Those Soaring Pharma Profits”, Forbes, 23 Jan 2018,
https://www.forbes.com/sites/johnlamattina/2018/01/23/about-those-soaring-
pharma-profits/#299331d53f9d
“It’s a critique often heard as pundits attack the costs of new drugs: the high price of
drugs is fueling unseemly Big Pharma profits. Typical is the headline, “Drug prices rise as
pharma profit soars”. There is no doubt that the high cost of new drugs is an important
issue, although arguments can be made that the prices charged for life-saving
medicines such as the cures for hepatitis C , childhood leukemia, and ALL can be more
than justified. However, pharma profits are not greatly increasing as a result. This
issue was hit hard by Pfizer CEO Ian Read at the recent Forbes Healthcare Summit. Is this
industry obscenely profitable? There is no evidence of that. If you look at our return on
investment, our return on capital, if you look at our P/E, if you look at anything inside
this industry – looking at the Bloomberg indices – we are in the middle. So I don’t see an
industry that you can say is profiteering. I see an industry that is taking its resources
and investing into a high risk business called ‘innovation’ and making modest returns
on the capital at risk. So, I think the societal issue is how do you afford access to
medicines that create great value, but require capital and risk to produce - the
medicines that may represent 12 – 14% of the total costs and have automatic price
adjustments in the form of loss of exclusivity? That’s a pretty good speech, but in an era
of fake news, how accurate are Read’s comments? Actually, available data* are pretty
supportive. The average return on equity for key industries from 2014 – 2016 shows
Champion Briefs 47
that biopharma’s profits stand at 16.2%, significantly lower than Computer Sciences
(31.6%), Beverages (27.4%), Aerospace/Defense (23.0%), and Trucking (19.1%) while
modestly higher than Software System/Applications (15.2%) and Healthcare Support
Services (14.4%).”
Warrant: American companies charge high prices for pharmaceuticals because they perform
the bulk of the R&D involved.
Jim Greenwood. “Impose Price Controls on Drug?”, The New York Times,
https://www.nytimes.com/2015/09/19/opinion/impose-price-controls-on-
drugs.html
“While Dr. Ezekiel J. Emanuel makes a few good points about the perils of expensive
drugs and their efficacy, he misses the big picture. The American drug industry is by far
the most successful and innovative in the world in addition to being the most
expensive because we are the only country that pays the true research and
development costs, not only for Americans, but for the rest of the world as well. Using
the Australian or the Swiss system here would result in Swiss or Australian limits on who
gets what. The easy route to talking about drug prices is to bash company profits.
Limiting profits may sound attractive but it will also be ineffective. The more honest
discussion is about what we as a society are willing to pay to improve or extend life.
And the answer is that we are willing to pay a lot, which is why reform is always
talked about but never accomplished.”
Impact: Price controls would make pharmaceuticals more expensive in the long-run by shifting
costs and reducing the efficiency of innovation.
Champion Briefs 48
Elizabeth Wright. “Pharmaceutical Price Controls: A Prescription for Disaster”,

Citizens Against Government Waste, October 2016,
https://www.cagw.org/sites/default/files/pdf/Pharmaceutical%20Price%20Contr
ols%20-%20A%20Prescription%20for%20Disaster.pdf
“Price control measures such as Medicaid rebates, the 340B program, and the VA
pricing structures have distorted the pharmaceutical market and caused price shifting.
In a November 4, 2010, letter to then-House Budget Committee Ranking Member Paul
Ryan (R-Wisc.), the CBO confirmed that Obamacare’s increased Medicaid discounts and
mandated new Medicare Part D discounts in the cover gap (more commonly referred to
as the “donut hole” between the end of initial coverage and the start of catastrophic
coverage), would likely cause manufacturers to raise prices to offset the costs of new
discounts.[50] Markets respond to pricing pressure as if it were an inflated balloon:
push down on one side and the other expands. It should come as no surprise that
some drug costs are being shifted to the private sector because of government price
controls.”
Analysis: These responses demonstrate that the pro is misrepresenting the nature of the
pharmaceutical market. While it may seem unfair to consumers, the reality is that prices are high
because companies are actively innovating and designing products. In the long run, price controls
would reduce innovation and cause other parts of medical spending to rise.
Champion Briefs 49
PRO – Price Controls Would Reduce Government Spending

Argument: Pharmaceutical prices factor heavily into Medicare and Medicaid spending, and price
controls would reduce costs.
Warrant: Rising pharmaceutical expenditures put substantial pressures on public healthcare

funds, causing a host of problems.
Bennett, Sara, Jonathan D. Quick, and German Velasquez. "Public-private roles in the
pharmaceutical sector: Implications for equitable access and racional drug use."
1997. http://apps.who.int/medicinedocs/en/d/Jwhozip27e/6.3.html
“Americans spend a lot on prescription drugs, more per capita than any other country
by far. Pharmaceuticals represent a significant—and growing—share of the country’s
health spending, both because new, and often costly, drugs are emerging from the lab
and because prices of many drugs are rising much faster than prices of other goods
and services. The Center for Medicare and Medicaid Services (CMS) estimates
prescription drug spending will grow an average of 6.3% per year over the 2016-2025
period. Highly publicized cases of very expensive new drugs as well as sharp increases in
the price of some older drugs has drawn widespread attention—and criticism—from the
public, members of Congress and President Donald Trump. Because the U.S.
government pays more than 40% of the retail prescription drug tab, rising spending on
drugs is putting pressure on the federal budget. It also contributes to rising health
insurance premiums.”
Warrant: Current government programs and insurance companies are unable to negotiate down
the prices of prescription drugs, resulting in high spending on pharmaceuticals.
Champion Briefs 50
Chris Lo, Pharmaceutical Technology, “Cost control: drug pricing policies around the
world”, 12 Feb 2018, https://www.pharmaceutical-
technology.com/features/cost-control-drug-pricing-policies-around-world/
“The US system of pharma reimbursement is multi-faceted and somewhat opaque, and

often results in different prices for different buyers. The US doesn’t directly regulate
drug prices, meaning that drug companies can set whatever sticker price they deem
fit, as Gilead did in 2013 when it set a price of $84,000 for a 12-week course of its
breakthrough hepatitis treatment Sovaldi, kicking off a sustained backlash on drug
pricing that rages on today. Medicaid, the federal programme to cover the medical costs
of low-income individuals, receives a mandated discount, but Medicare – which
provides insurance for Americans over 65 and is the pharma industry’s biggest single
customer, spending $137bn on prescription drugs in 2015 – is not allowed to negotiate
at the federal level. Insurance companies that have been contracted to administer
Medicare are able to negotiate, but with limitations such as having to cover all
treatments across six broad drug categories. The private insurance system, which covers
many Americans who are not on Medicare or Medicaid, is fragmented into hundreds of
different employers and insurance providers, limiting their ability to negotiate steep
discounts.”
Warrant: Health costs are compounded because patients who are unable to access the
prescription drugs they need end up having other health complications, increasing medical
spending.
Congressional Budget Office. “Offsetting Effects of Prescription Drug Use on Medicare’s

Spending for Medical Services”. November 2012.
http://www.cbo.gov/sites/default/files/cbofiles/attachments/43741-
MedicalOffsets-11-29-12.pdf
Champion Briefs 51
“Prescription drugs affect people’s health and their need for medical services.1
Therefore, policy changes that influence Medicare beneficiaries’ use of prescription
drugs, such as those altering the cost-sharing structure of the Part D prescription drug
benefit, probably affect federal spending on their medical services.2 After reviewing
recent research, the Congressional Budget Office (CBO) estimates that a 1 percent
increase in the number of prescriptions filled by beneficiaries would cause Medicare’s
spending on medical services to fall by roughly one-fifth of 1 percent. That estimate,
which applies only to policies that directly affect the quantity of prescriptions filled,
represents a change in the agency’s estimating methodology, which until now has not
incorporated such an effect. Previously, when estimating the budgetary effects of
legislation regarding prescription drugs, CBO found insufficient evidence of an
“offsetting” effect of prescription drug use on spending for medical services. But recently,
more analysis has been published that demonstrates a link between changes in
prescription drug use and changes in the use of and spending for medical services. This
report provides background information about that relationship; reviews the literature
on the size of the offset for the Medicare population; and describes how CBO synthesized
the recent research..”
Impact: Reducing the price of pharmaceuticals would transfer money away from pharmaceutical
companies and back toward consumers.
Alfred Engelberg, Health Affairs, “How Government Policy Promotes High Drug Prices”,
Oct 29 2015,
https://www.healthaffairs.org/do/10.1377/hblog20151029.051488/full/
“In 1984, I represented the Generic Pharmaceutical Industry Association in the

negotiations with Congress and PhRMA which sought to strike a balance between the
pharmaceutical industry’s demand for greater incentives to invest in innovation and the
public’s need for low-cost medicines. The deal which was struck then has not withstood
Champion Briefs 52
the test of time. The monopolies created by Hatch-Waxman and subsequent legislation
providing 12 years of exclusivity for biologic drugs clearly went too far in compensating
the pharmaceutical industry at the public’s expense. For decades, Congress has simply
been transferring wealth from ordinary citizens to the pharmaceutical industry. While
claiming to believe in free market capitalism, it has created a web of monopolies which
cause the United States to pay the world’s highest prices for drugs even though it is the
largest purchaser. The US would save $80 billion annually if its per capita drug costs
were only 50 percent higher ($750 per capita), rather than 100 percent higher, than
those of other developed countries. Investing some of those savings to accelerate the
development of cures for our most costly diseases could eventually reduce health care
costs and justify a high price for life-saving medicines.”
Analysis: This argument takes the simple but compelling approach that the pharmaceutical
industry isn’t just hurting medical consumers with their unfair tactics, but also directly robbing
taxpayers and the government. From here, teams can take a number of approaches to explain
why increasing government funds available for medical spending is a good thing. In particular,
teams could argue that the newly available funds could be used for medical research, other forms
of treatment, or expanding insurance coverage.
Champion Briefs 53
A/2 – Price Controls Would Reduce Government Spending

Answer: By reducing innovation and increasing consumption of pharmaceuticals, price controls
would increase government spending in the long-run.
Warrant: Setting price controls would reduce the incentive for pharmaceutical companies to
innovate, resulting in fewer and less effective new drugs.
“If price controls pressure the U.S. industry into a more conventional process industry
model, like that of the chemical industry, pharmaceutical R&D budgets would be
slashed. To achieve the chemical industry’s rate of R&D spending, as would be
required to achieve profitability competitive with the chemical industry, top
pharmaceutical companies would have to reduce their R&D budgets by 80 percent —
almost $50 billion in total. This reduction in spending would take a few years to realize,
but would be completely evident by 2023 or earlier. An important corollary is that, if
profitability and value creation opportunities for new drugs declined, the appetite of the
venture community for risky, long-term biopharmaceutical investments would shrink
exponentially. Price controls on drugs would have the surprising effect of accelerating
the flow of investment into high technology, where timelines to market are shorter, less
regulated, and less risky. The venture capital community is flush with cash and anxious
to invest where high returns can be achieved — ideally within a much shorter time than
is typically possible in the realm of drug R&D. As a society, if we force pharma into a
chemical industry model, where there is no biotech equivalent and no venture
investing, we will be trading better and sooner effective drugs for better and sooner
virtual reality devices and self-driving cars.”
Champion Briefs 54
Warrant: Making drugs artificially cheaper than they should be creates a moral hazard, where
people consume more prescription drugs, ultimately increasing public expenditures.
Sergio Prada, BioMed Central, “"Higher pharmaceutical public expenditure after direct
price control: improved access or induced demand? The Colombian case”, 2
March 2018, https://resource-
allocation.biomedcentral.com/articles/10.1186/s12962-018-0092-0
“Background High pharmaceutical expenditure is one of the main concerns for

policymakers worldwide. In Colombia, a middle-income country, outpatient prescription
represents over 10% of total health expenditure in the mandatory benefits package
(POS), and close to 90% in the complementary government fund (No POS). In order to
control expenditure, since 2011, the Ministry of Health introduced price caps on
inpatient drugs reimbursements by active ingredient. By 2013, more than 400 different
products, covering 80% of public pharmaceutical expenditure were controlled. This
paper investigates the effects of the Colombian policy efforts to control expenditure by
controlling prices. Methods Using SISMED data, the official database for prices and
quantities sold in the domestic market, we estimate a Laspeyres price index for 90
relevant markets in the period 2011–2015, and, then, we estimate real pharmaceutical
expenditure. Results Results show that, after direct price controls were enacted, price
inflation decreased almost − 43%, but real pharmaceutical expenditure almost
doubled due mainly to an increase in units sold. Such disproportionate increase in
units sold maybe attributable to better access to drugs due to lower prices, and/or to
an increase in marketing efforts by the pharmaceutical industry to maintain profits.”
Warrant: Because of the high upfront cost of developing new medicines, we should incentivize
research and development on drugs to reduce prices, rather than discouraging it.
Champion Briefs 55
John Graham. “Crisis In Pharma R&D: It Costs $2.6 Billion To Develop A New Medicine;
2.5 Times More Than In 2003”, Forbes, Nov 26 2014,
https://www.forbes.com/sites/theapothecary/2014/11/26/crisis-in-pharma-rd-
it-costs-2-6-billion-to-develop-a-new-medicine-2-5-times-more-than-in-
2003/#5a33cebe321c
“Given these facts, it may be understandable that the health-insurance industry is

campaigning against the high prices of specialty drugs. For its part, the brand-name
pharmaceutical industry emphasizes that health insurers (especially in Obamacare
exchanges) often put these specialty drugs on the most expensive tier of their
formularies. This requires patients to pay high out of pocket costs. While this is an
accurate description of the situation, a government policy simply forcing insurers to
cover a higher share of the price of a specialty drug does not reduce the price. It just
moves it from patients’ direct payment to premium. Reducing prices of specialty drugs
requires improving the productivity of R&D. On that front, the news is sobering. Last
December, Deloitte and Thomson Reuters TRI +0% examined newly introduced drugs
from the twelve pharmaceutical companies with the largest research and development
(R&D) budgets. It cost $1.3 billion to bring a newly discovered compound to market.
However, the average forecast for peak sales of an asset declined by 43%, dropping
from $816 million in 2010 to $466 million in 2013.”
Impact: Price controls distort the pharmaceutical market, ultimately resulting in higher medical
costs elsewhere and no real reduction in spending.
Elizabeth Wright. “Pharmaceutical Price Controls: A Prescription for Disaster”,

Citizens Against Government Waste, October 2016,
https://www.cagw.org/sites/default/files/pdf/Pharmaceutical%20Price%20Contr
ols%20-%20A%20Prescription%20for%20Disaster.pdf
Champion Briefs 56
controls.”
Analysis: These responses are effective because they attack the link within the pro’s argument
directly. By arguing that price controls increase pharmaceutical consumption in the short-term
and increase prices in the long-term, negative teams can effectively cast doubt on the assumption
that price controls would do anything to reduce public expenditures on pharmaceuticals.
Champion Briefs 57
PRO – Price Controls Necessary to Protect the Uninsured

Argument: The uninsured population is especially sensitive to the high prices of pharmaceuticals
and most acutely in need of those drugs.
Warrant: The uninsured population in America is large and continues to grow following actions
by the Trump administration.
Tami Luhby. "Millions more Americans were uninsured in 2017." CNN Business. Jan 26
2018. https://money.cnn.com/2018/01/16/news/economy/uninsured-
americans/index.html
“The uninsured rate rose 1.3 percentage points to 12.2% last year, according to the
Gallup-Sharecare Well-Being Index. That represents an increase of roughly 3.2 million
Americans. Under Obamacare, the uninsured rate plummeted to a low of 10.9% at the
end of 2016. Obamacare's exchanges opened in 2014, the same year Medicaid
expansion began and the individual mandate -- which required nearly all Americans to
have insurance or pay a penalty -- took effect. Those provisions helped reverse a soaring
uninsured rate, which hit a peak of 18% in the fall of 2013, fueled in part by the
aftermath of the Great Recession. Several factors likely contributed to the increase last
year. President Trump and congressional Republicans tried repeatedly, but
unsuccessfully, to repeal the landmark health reform law. That may have led some
Americans to question whether the administration would enforce the penalty for not
having insurance, according to Gallup-Sharecare. Also, many insurers withdrew from
the exchanges and the remaining carriers raised their rates, which may have
prompted some consumers to forgo coverage. Some 500,000 fewer Americans signed
up for 2017 coverage on the exchanges at the end of open enrollment a year ago. The
uninsured rate rose for all demographics last year, except for senior citizens, who all
qualify for Medicare. Young adults age 18 to 25 and Americans earning less than
$36,000 each saw a 2 percentage point increase. The rate for blacks soared 2.3
Champion Briefs 58
percentage points, while Hispanics saw a 2.2 percentage point jump. The annual
increase is the largest single-year jump since Gallup and Sharecare began tracking the
uninsured rate in 2008. The trend will likely continue this year. The Trump
administration pulled back on support and advertising for the 2018 open enrollment
season, which ended last month with 500,000 fewer people signing up on the federal
exchange.”
Warrant: The uninsured are nearly twice as likely to underuse their prescription drugs due to
cost concerns. Even among the insured, they often lack pharmaceutical drug benefits.
National Council on Patient Information and Education. “Understanding Prescription

Assistance Programs (PAPS)”. http://www.bemedwise.org/documents/paps.pdf
“Among those with health insurance, one out of 10 individuals 65 years old or
younger and one in three persons over age 65 of age do not have prescription drug
coverage. Not surprisingly, people with low incomes, older adults and those suffering
with chronic conditions that require multiple medications face the greatest economic
burden. These patients also tend to take less of their medication than has been
prescribed due to cost concerns. In fact, uninsured adults and their families are twice
as likely as insured adults to underuse their medications in order to lower drug costs.”
Warrant: This creates a cycle: the uninsured’s inability to afford expensive pharmaceuticals cause
prices of drugs for everyone to increase due to free-rider effects.
Dana Sarnak, “Paying for Prescription Drugs Around the World: Why Is the U.S. an
Outlier?” Oct 5 2017, The Commonwealth Fund,
https://www.commonwealthfund.org/publications/issue-
briefs/2017/oct/paying-prescription-drugs-around-world-why-us-outlier
Champion Briefs 59
“Various factors contribute to high per capita drug spending in the U.S. While drug
utilization appears to be similar in the U.S. and the nine other countries considered, the
prices at which drugs are sold in the U.S. are substantially higher. These price differences
appear to at least partly explain current and historical disparities in spending on
pharmaceutical drugs. U.S. consumers face particularly high out-of-pocket costs, both
because the U.S. has a large uninsured population and because cost-sharing
requirements for those with coverage are more burdensome than in other countries.
Most Americans support reducing pharmaceutical costs. International experience
demonstrates that policies like universal health coverage, insurance benefit design that
restricts out-of-pocket spending, and certain price control strategies, like centralized
price negotiations, can be effective.”
Impact: The uninsured and poor engage in cost-cutting measures by opting for inferior or no
pharmaceutical drugs, resulting in worse health outcomes.
Jeffrey Young, Health Affairs, “How Government Policy Promotes High Drug Prices”, Oct
29 2015,
https://www.healthaffairs.org/do/10.1377/hblog20151029.051488/full/
“Uninsured people and those with low incomes are the most likely to go without
prescription drugs they need because of cost — and it could be harming their health,
according to survey results published by the Centers for Disease Control and Prevention
Tuesday. The CDC found that one-fifth of American adults overall asked their doctors to
prescribe a medicine cheaper than their first choice. Thirteen percent of adults 18-64
didn’t take a prescribed drug because of cost compared to 6 percent of those over 65.
Rising health care prices are a big reason why more Americans aren’t getting treatments
they need. But the 45 million or more without health insurance are most vulnerable to
the high cost of prescription drugs in the United States. Nearly a quarter of people
without health insurance said they didn’t take a medicine their physicians prescribed,
Champion Briefs 60
according to the survey. A slightly larger percentage asked for a lower-priced substitute.
The poor and near-poor were much more apt than people with higher incomes to simply
go without the prescription drug they needed because of the cost. This isn’t merely an
academic exercise, the CDC emphasizes in its report: Some cost-reduction strategies
used by adults have been associated with negative health outcomes. For example,
adults who do not take prescription medication as prescribed have been shown to have
poorer health status and increased emergency room use, hospitalizations, and
cardiovascular events.”
Analysis: This argument can utilize the current political landscape of the United States to catch
opponents off-guard and potentially link into a big impact. What makes this argument effective
is that it doesn’t just effect the uninsured, although they suffer the most – when the uninsured
underpay for pharmaceuticals, that raises the price of healthcare for everybody. Additionally,
affirmative teams can pre-empt negative arguments about R&D by stating that R&D doesn’t help
the uninsured if they are unable to access the resulting pharmaceutical treatments.
Champion Briefs 61
A/2 – Price Controls Necessary to Protect the Uninsured

Answer: By reducing innovation, price controls ultimately reduce the range of drugs available
to the uninsured and ultimately increase prices.
Warrant: Price controls reduce the incentive for companies to innovate, ultimately resulting in a
longer-term problem where there are fewer drugs in the long-term.
Robert Easton. “Price controls would stifle innovation in the pharmaceutical industry”,
STAT News, 22 Jan 2018, https://www.statnews.com/2018/01/22/price-
controls-pharmaceutical-industry/
“If price controls pressure the U.S. industry into a more conventional process industry
model, like that of the chemical industry, pharmaceutical R&D budgets would be
slashed. To achieve the chemical industry’s rate of R&D spending, as would be required
to achieve profitability competitive with the chemical industry, top pharmaceutical
companies would have to reduce their R&D budgets by 80 percent — almost $50
billion in total. This reduction in spending would take a few years to realize, but would
be completely evident by 2023 or earlier. An important corollary is that, if profitability
and value creation opportunities for new drugs declined, the appetite of the venture
community for risky, long-term biopharmaceutical investments would shrink
exponentially. Price controls on drugs would have the surprising effect of accelerating
the flow of investment into high technology, where timelines to market are shorter, less
regulated, and less risky. The venture capital community is flush with cash and anxious
to invest where high returns can be achieved — ideally within a much shorter time than
is typically possible in the realm of drug R&D. As a society, if we force pharma into a
chemical industry model, where there is no biotech equivalent and no venture
investing, we will be trading better and sooner effective drugs for better and sooner
virtual reality devices and self-driving cars.”
Champion Briefs 62
Warrant: Introducing new pharmaceutical products is key to ensuring that the uninsured are
able to afford pharmaceuticals.
Cong, Ze. "Value of Pharmaceutical Innovation." (2009). Rand Corporation.

https://www.rand.org/content/dam/rand/pubs/rgs_dissertations/2009/RAND_R
GSD242.pdf
“By employing econometrics models with data from various data sources, we do find
statistically significant access effects of new drugs, in terms of increasing number of
drugs prescribed. Those effects are heterogeneous among different new drug
subgroups. More specifically, we find that more creative drugs (e.g., NCEs) tend to have
larger, more significant access effects, whereas less creative drugs (e.g., generic drugs,
nonNCEs) contribute smaller or even negative access effects. Non-NCE brand-name
drugs significantly increase the number of uninsured prescriptions, whereas no
significant effect is found for insured prescriptions. These findings confirm the
hypothesis that new drugs can impact population health not only with change in
clinical effectiveness on existing treatments, but also with change in the quantity of
prescriptions written and/or people treated”
Impact: Studies have demonstrated that, by dashing innovation, price controls ultimately
increase the price of drugs.
Paul Howard. “To Lower Drug Prices, Innovate, Don’t Regulate”,

The New York Times, Sep 23 2015,
https://www.nytimes.com/roomfordebate/2015/09/23/should-the-government-
impose-drug-price-controls/to-lower-drug-prices-innovate-dont-regulate
“Price control advocates argue that curtailing profits in the pharmaceutical industry
would save the country money without reducing innovation. There is, however, no such
Champion Briefs 63
thing as a free lunch. Bureaucratic price manipulation would only hurt the sickest
patients. Streamlining drug approvals would get more drugs on market, increasing
competition and lowering prices. Research shows that price controls in the United Sates
would powerfully dampen innovation. "Cutting prices by 40 to 50 percent in the U.S. will
lead to between 30 to 60 percent fewer R&D projects being undertaken," one study
found. A 2008 RAND study exploring the effect of U.S. price controls on those aged 55
to 59 in the United States and Europe similarly found that, on net, pharmaceutical
price controls would hurt patients. The idea that we “overspend” on drugs is also
misleading. In 2014, drug spending accounted for just 10 percent of U.S. health care
spending, and according to government actuaries, spending will increase by only 0.4
percentage points over the next decade. Hospitals, for comparison, account for more
than 30 percent of total health care spending. Countries that use price controls
advocated by industry critics actually spend a larger share on drugs and use fewer cost-
saving generics than the United States does.”
Analysis: Negative teams should question if artificially lowering the prices of drugs is likely to
ensure access for the uninsured, as out-of-pocket costs are likely to be high regardless. Instead,
allowing research and development to take place allows for new products to enter the market,
and that competition and diversity is empirically shown to improve the ability of the uninsured
to access pharmaceutical medicines.
Champion Briefs 64
PRO – Price Controls Necessary to Control Patent Monopolies

Argument: Due to the unique nature of the pharmaceutical industry, patent monopolies enable
companies to charge unfair prices.
Warrant: The current patent structure on pharmaceuticals is the most important factor keeping
the prices of pharmaceuticals high.
Sydney Lupkin. " Government-Protected ‘Monopolies’ Drive Drug Prices Higher, Study
Says" Kaiser Health News. August 23 2016. https://khn.org/news/government-
protected-monopolies-drive-drug-prices-higher-study-says/
“The “most important factor” that drives prescription drug prices higher in the United
States than anywhere else in the world is the existence of government-protected
“monopoly” rights for drug manufacturers, researchers at Harvard Medical School
report today. The researchers reviewed thousands of studies published from January
2005 through July 2016 in an attempt to simplify and explain what has caused America’s
drug price crisis and how to solve it. They found that the problem has deep and
complicated roots and published their findings in JAMA, the journal of the American
Medical Association. The study was funded by the Laura and John Arnold Foundation
with additional support provided by the Engelberg Foundation.”
Warrant: The primary ways to oppose the patent monopolies in the status quo are through
generic drugs and the power of the buyer, both of which have clear limitations.
Aaron Kesselheim. “The High Cost of Prescription Drugs in the United States Origins and
Prospects for Reform” JAMA Network. August 23/30 2016.
https://jamanetwork.com/journals/jama/article-abstract/2545691
Champion Briefs 65
“Per capita prescription drug spending in the United States exceeds that in all other
countries, largely driven by brand-name drug prices that have been increasing in recent
years at rates far beyond the consumer price index. In 2013, per capita spending on
prescription drugs was $858 compared with an average of $400 for 19 other
industrialized nations. In the United States, prescription medications now comprise an
estimated 17% of overall personal health care services. The most important factor that
allows manufacturers to set high drug prices is market exclusivity, protected by
monopoly rights awarded upon Food and Drug Administration approval and by
patents. The availability of generic drugs after this exclusivity period is the main
means of reducing prices in the United States, but access to them may be delayed by
numerous business and legal strategies. The primary counterweight against excessive
pricing during market exclusivity is the negotiating power of the payer, which is
currently constrained by several factors, including the requirement that most
government drug payment plans cover nearly all products. Another key contributor to
drug spending is physician prescribing choices when comparable alternatives are
available at different costs”
Warrant: Price controls would prevent powerful patent monopolies from exploiting their control
over the market in a number of nefarious ways.
Henry Mintzberg, “Patent nonsense: Evidence tells of an industry out of social control”
Aug 15 2006, US National Library of Medicine,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1534100/
“Beyond these problems of promotion lie a litany of stories revealed in the press in
recent years about immoral and sometimes corrupt behaviours of pharmaceutical
companies, including ostensibly the most reputable: about payoffs to generic producers
not to rush in with cheaper drugs; about tactics used to delay the expiry of patents;
about lawsuits and convictions, criminal and otherwise, concerning marketing fraud and
Champion Briefs 66
the overbilling of government agencies; about blatant misinformation; about the co-
optation and sometimes downright bribery of physicians, researchers and politicians.
Examples of these behaviours, from articles in the prominent press and some major
medical journals, are provided in Appendix 1. Together, they tell a story of an industry
that is out of social control. The problem of high pharmaceutical prices is not without
solutions. Many are obvious enough, and some have been implied in this article,
including firmer regulation of pricing, the use of independent clearinghouses for
balanced information on products, research efforts more widely spread across different
types of institutions, and a stop to direct-to-consumer advertising. However, there is a
lack of sufficient will to confront the problem directly, in part because of the power of the
industry and its influence on political processes. The current situation in the patent-
dependent pharmaceutical industry is not just unacceptable, it is shameful. It will remain
so until concerned citizens gather the energy to change it.”
Impact: This patent monopoly is unacceptable because it directly puts human lives at risk by
allowing companies to charge unfairly high prices.
Robert Pearl, Forbes, “Why Patent Protection In The Drug Industry Is Out Of Control”,
Jan 19 2017, https://www.forbes.com/sites/robertpearl/2017/01/19/why-
patent-protection-in-the-drug-industry-is-out-of-control/#25a7a30478ca
“Patent protection was never intended for use in a situation when human life would be
endangered through its use. In other areas of society, broad legal prohibitions exist to
protect human life and the well-being of citizens. For example, individuals are prohibited
from yelling "Fire!" in a theater, and utility monopolies that control all of the electricity
for a city are prohibited from price gouging. Patents make sense in a retail or
manufacturing context. If you don't want to purchase Venetian glass, you can decide it’s
too expensive. In contrast, if your child is born with a genetic defect, you have no choice
but to obtain the medication available for treatment regardless of price. Patent
Champion Briefs 67
protection effectively grants the pharmaceutical industry a monopoly, regardless of the

human consequences. For a patient with a particular disease and a single solution
available in the form of a sole-source drug, allowing exorbitant pricing that prevents
access for individuals to the medication runs counter to the expectation of Congress to
protect the health of its citizens.”
Analysis: This argument shows the clear downsides to the inherent market structure of the
pharmaceutical industry. Teams should use this perspective to interact with arguments that
negative teams make about research and development; patents may encourage research and
development, yet patent monopolies were never intended for situations where life is at stake
and price controls are an effective way to ensure that pharmaceutical companies aren’t milking
excessive product from their products.
Champion Briefs 68
A/2 – Price Controls Necessary to Control Patent Monopolies

Answer: In the absence of thorough patent protections for pharmaceutical companies, the
incentive for innovation would decline significantly.
Warrant: Patents are necessary for pharmaceutical companies, both in terms of spurring
innovation and getting new products onto the market.
Global CCS Institute. “How patents encourage innovation in technological development

and deployment”, June 2013,
https://hub.globalccsinstitute.com/publications/intellectual-property-rights-
role-patents-renewable-energy-technology-innovation/1-how-patents-
encourage-innovation-technological-development-and-deployment
“Advocates of patenting argue that patents act as a strong incentive for innovation,
while others are concerned that they restrain innovation. To some extent the role and
impact of patents depend on the specific technology involved. While some patents may
temporarily limit the use of specific technologies to the patent's owner and licensees
in some jurisdictions, such innovations often spur the development of competing
technologies. For technologies requiring considerable financial and technical
resources, and a long period to develop marketable products that are then relatively
inexpensive to reproduce, patent protection is critical. For pharmaceuticals, for
example, patents are important both in terms of spurring innovation of new medicines
and ensuring access to new medical technologies. National and regional patent offices,
such as the United States Patent and Trademark Office (USPTO), the Japan Patent
Office (JPO), EPO, the Korean Intellectual Property Office (KIPO) and the State
Intellectual Property Office of the People's Republic of China (SIPO) play a critical role in
ensuring that patents are granted only to inventions that are genuine contributions to
the state of the art and comply with procedural, as well as substantive requirements
prescribed under the applicable patent law of the country or region in question..”
Champion Briefs 69
Warrant: Pharmaceutical companies, despite supposed monopolies, are not capturing

exceedingly high profits.
“It’s a critique often heard as pundits attack the costs of new drugs: the high price of
drugs is fueling unseemly Big Pharma profits. Typical is the headline, “Drug prices rise as
pharma profit soars”. There is no doubt that the high cost of new drugs is an important
issue, although arguments can be made that the prices charged for life-saving
medicines such as the cures for hepatitis C , childhood leukemia, and ALL can be more
than justified. However, pharma profits are not greatly increasing as a result. This
issue was hit hard by Pfizer CEO Ian Read at the recent Forbes Healthcare Summit. Is this
industry obscenely profitable? There is no evidence of that. If you look at our return on
investment, our return on capital, if you look at our P/E, if you look at anything inside
this industry – looking at the Bloomberg indices – we are in the middle. So I don’t see an
industry that you can say is profiteering. I see an industry that is taking its resources
and investing into a high risk business called ‘innovation’ and making modest returns
on the capital at risk. So, I think the societal issue is how do you afford access to
medicines that create great value, but require capital and risk to produce - the
medicines that may represent 12 – 14% of the total costs and have automatic price
adjustments in the form of loss of exclusivity? That’s a pretty good speech, but in an
era of fake news, how accurate are Read’s comments? Actually, available data* are
pretty supportive. The average return on equity for key industries from 2014 – 2016
shows that biopharma’s profits stand at 16.2%, significantly lower than Computer
Sciences (31.6%), Beverages (27.4%), Aerospace/Defense (23.0%), and Trucking
(19.1%) while modestly higher than Software System/Applications (15.2%) and
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Healthcare Support Services (14.4%).”
Impact: Thorough patent systems encourage the introduction of products to the market
sooner, whereas price controls discourage the introduction of new products.
Lanjouw, Jean O. Patents, price controls and access to new drugs: how policy affects
global market entry. No. w11321. Cambridge (MA): National Bureau of Economic
Research, 2005.
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.610.965&rep=rep1&
type=pdf
“The first two columns of Table 7 present the main results for estimates when additional
variables are included in the random effects specification. The first adds a country’s R&D
share and its level of tariff protection (which together lead to a sizable drop in the
number of observations due to missing data). We again find that having a long process
patent regime significantly encourages rapid drug launch. A new finding is that
countries with a high technical capacity as measured by R&D expenditure are far less
likely to see new pharmaceuticals in the market quickly. Starting from no R&D and then
increasing R&D to the mean level of one-half of one percent of GDP drops the
probability of rapid launch by an estimated 13.6 percentage points. This negative effect
of local capacity, however, is significantly offset if a country offers the strongest level
of patent protection. Although the effect of a higher R&D share remains negative even
when interacted with strong patent protection, its marginal effect is diminished by a
third (joint marginal effect = -0.19, p-value = 0.01, versus -0.28). As in the simpler
specification, extensive price control has a significant negative effect on the
probability of rapid launch. Moderate regulation of prices is also found to have a
negative effect now that the specification allows for its interaction with GDP per capita.”
Champion Briefs 71
Analysis: The above pieces of evidence prove that patent protections, rather than harming
consumers, protect producers and researchers. Although the patent monopolies may seem
egregious at first glance, pharmaceutical companies are still only making a modest profit due to
the intense requirements of upfront capital for developing new medicines. The final piece of
evidence demonstrates that price controls would delay the entry of products onto the market,
signifying that consumers would be worse off in a world where pharmaceutical companies did
not have the same profit incentive to produce.
Champion Briefs 72
PRO – Limiting Political Power of Pharmaceutical Companies

Argument: Pharmaceutical companies in the status quo have too much political and lobbying
power, and limiting their profits would minimize their influence over politics.
Warrant: Pharmaceutical companies put more money into influencing politics than any other
industry.
Chris McGreal. "How big pharma's money – and its politicians – feed the US opioid
crisis" The Guardian. 19 Oct 2017. https://www.theguardian.com/us-
news/2017/oct/19/big-pharma-money-lobbying-us-opioid-crisis
“Trump was right on both counts. Pharmaceutical companies spend far more than any
other industry to influence politicians. Drugmakers have poured close to $2.5bn into
lobbying and funding members of Congress over the past decade. Hundreds of
thousands of dollars have gone to McConnell – although he is hardly alone. Nine out
of 10 members of the House of Representatives and all but three of the US’s 100
senators have taken campaign contributions from pharmaceutical companies seeking
to affect legislation on everything from the cost of drugs to how new medicines are
approved. Trump’s nominee for drug czar, the US congressman Tom Marino, was forced
to withdraw after a report by the Washington Post and CBS’s 60 Minutes highlighted his
role in forging legislation that hinders the DEA’s ability to move against drug distributors
or pharmacies recklessly dispensing the opioid painkillers at the heart of the epidemic,
which claims more than 100 lives a day.”
Warrant: The immense power of the pharmaceutical lobbying industry allows them to shut down
virtually any attempt to reduce pharmaceutical prices.
Champion Briefs 73
Henry Mintzberg, “Patent nonsense: Evidence tells of an industry out of social control”
Aug 15 2006, US National Library of Medicine,
“Beyond these problems of promotion lie a litany of stories revealed in the press in
recent years about immoral and sometimes corrupt behaviours of pharmaceutical
companies, including ostensibly the most reputable: about payoffs to generic producers
not to rush in with cheaper drugs; about tactics used to delay the expiry of patents;
about lawsuits and convictions, criminal and otherwise, concerning marketing fraud
and the overbilling of government agencies; about blatant misinformation; about the
co-optation and sometimes downright bribery of physicians, researchers and
politicians. Examples of these behaviours, from articles in the prominent press and some
major medical journals, are provided in Appendix 1. Together, they tell a story of an
industry that is out of social control. The problem of high pharmaceutical prices is not
without solutions. Many are obvious enough, and some have been implied in this article,
including firmer regulation of pricing, the use of independent clearinghouses for balanced
information on products, research efforts more widely spread across different types of
institutions, and a stop to direct-to-consumer advertising. However, there is a lack of
sufficient will to confront the problem directly, in part because of the power of the
industry and its influence on political processes. The current situation in the patent-
dependent pharmaceutical industry is not just unacceptable, it is shameful. It will remain
so until concerned citizens gather the energy to change it.”
Warrant: Price controls would cut into the profits of the pharmaceutical industry, reeling in their
excessive political power.
Neeraj Sood, “The effect of regulation on pharmaceutical revenues: experience in

nineteen countries”, National Institute for Health, Dec 16 2008,
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“Several important patterns emerge from our analysis. First, we find that a majority of
regulations reduce pharmaceutical revenues significantly. Second, we find that most
countries that adopted new regulations since 1994 already had some regulations in place
for controlling costs. We find that such additional regulation had smaller impact on
further controlling costs, though this is an average effect across all regulations introduced
since 1994, including both enforced and poorly or un-enforced policies. However, we find
that introducing new regulations in a largely unregulated market, for example the US,
could reduce pharmaceutical revenues significantly. Finally, we show that the effects of
price controls increase over time – price controls not only reduce the level of
pharmaceutical revenues but also reduce the rate of growth of pharmaceutical
revenues.”
Impact: The pharmaceutical lobby’s immense power has contributed significantly to the opioid
crisis in America.
Robert Pearl, Forbes, “Why Patent Protection In The Drug Industry Is Out Of Control”,
Jan 19 2017, https://www.forbes.com/sites/robertpearl/2017/01/19/why-
patent-protection-in-the-drug-industry-is-out-of-control/#25a7a30478ca
“For more than a decade, members of a little-known group called the Pain Care Forum
have blanketed Washington with messages touting prescription painkillers’ vital role in
the lives of millions of Americans, creating an echo chamber that has quietly derailed
efforts to curb U.S. consumption of the drugs, which accounts for two-thirds of the
world’s usage. In 2012, drugmakers and their affiliates in the forum sent a letter to U.S.
senators promoting a hearing about an influential report on a “crisis of epidemic
proportions”: pain in America. Few knew the report stemmed from legislation drafted
and pushed by forum members and that their experts had helped author it. The report
estimated more than 100 million Americans — roughly 40 percent of adults — suffered
from chronic pain, an eye-popping statistic that some researchers call deeply problematic.
Champion Briefs 75
The letter made no reference to another health issue that had been declared an
epidemic by federal authorities: drug overdoses tied to prescription painkillers. Deaths
linked to addictive drugs like OxyContin, Vicodin and Percocet had increased more than
fourfold since 1999, accounting for more fatal overdoses in 2012 than heroin and
cocaine combined.”
Impact: Pharmaceutical lobbying shapes government healthcare policy in negative ways to

perpetuate pharmaceutical profits.
Laurie Powell, “The Danger Of Big Pharma ’s Silent Hold Over The US Government”, May
2 2016, Focus For Health, https://www.focusforhealth.org/big-pharma-silent-
hold-us-government/
“Pharmaceutical companies are some of the richest, most profitable companies in the
world. Besides using profits to advertise products and influence prescription-writing
target markets, Pharma spends extraordinary amounts of money on patents to protect
their profit margins. Some cancer treatments can cost 600 times more in the U.S. than
in other countries — and this form of price gouging remains legal in the U.S.1
Unfortunately for consumers, the game is rigged in Pharma’s favour, as they buy this
privilege by lobbying government representatives. Lobbying expenditures by the
pharmaceutical industry have been increasing every year and hit an all-time high of $273
million in 2009. Monies are used successfully to influence lawmakers and politicians and
shape pending legislature. Since 2003, Medicare, the biggest drug purchaser in the US,
cannot negotiate drug pricing. As a result, some of the most disenfranchised patients
pay high co-pays, and tax payers are forced to cough up billions in taxes to subsidize
Medicare drug spending. Another example of how pharmaceutical companies spend
their money to influence government, thanks to legislation passed in 1988. If a suit is
won in the government-funded ‘vaccine court,’3 those cases are sealed so the public
cannot see judgements or payouts to victims.4”
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Analysis: This is a powerful argument that can be argued in a number of different ways – the
impacts listed above are naught but a few examples of how the pharmaceutical industry can
nefariously influence the political sphere. Teams can make the argument that this feeds into a
cycle; pharmaceutical companies lobby to keep their profits high, and they can continue lobbying
as long as their profits remain high. From there, teams can demonstrate that pharmaceutical
companies’ interests are at-odds with that of citizens, and can impact this argument out in a
variety of different ways.
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A/2 – Limiting Political Power of Pharmaceutical Companies

Answer: The affirmative is overstating the political power of pharmaceutical companies, and
price controls would do little to limit pharmaceutical revenues anyways.
Warrant: Pharmaceutical companies aren’t actually bringing in outrageous profits – their

political industries are more specific to their industry interests than to their levels of revenue.
“It’s a critique often heard as pundits attack the costs of new drugs: the high price of drugs
is fueling unseemly Big Pharma profits. Typical is the headline, “Drug prices rise as pharma
profit soars”. There is no doubt that the high cost of new drugs is an important issue,
although arguments can be made that the prices charged for life-saving medicines such
as the cures for hepatitis C , childhood leukemia, and ALL can be more than justified.
However, pharma profits are not greatly increasing as a result. This issue was hit hard by
Pfizer CEO Ian Read at the recent Forbes Healthcare Summit. Is this industry obscenely
profitable? There is no evidence of that. If you look at our return on investment, our
return on capital, if you look at our P/E, if you look at anything inside this industry –
looking at the Bloomberg indices – we are in the middle. So I don’t see an industry that
you can say is profiteering. I see an industry that is taking its resources and investing
into a high risk business called ‘innovation’ and making modest returns on the capital
at risk. So, I think the societal issue is how do you afford access to medicines that create
great value, but require capital and risk to produce - the medicines that may represent 12
– 14% of the total costs and have automatic price adjustments in the form of loss of
exclusivity? That’s a pretty good speech, but in an era of fake news, how accurate are
Read’s comments? Actually, available data* are pretty supportive. The average return on
equity for key industries from 2014 – 2016 shows that biopharma’s profits stand at
Champion Briefs 78
16.2%, significantly lower than Computer Sciences (31.6%), Beverages (27.4%),

Aerospace/Defense (23.0%), and Trucking (19.1%) while modestly higher than Software
System/Applications (15.2%) and Healthcare Support Services (14.4%).”
Warrant: Even in the event of reducing drug prices, that would not necessarily reduce
pharmaceutical profits, as consumers would purchase more pharmaceutical products,
offsetting decreases in revenue.
Sergio Prada, BioMed Central, “Higher pharmaceutical public expenditure after direct
price control: improved access or induced demand? The Colombian case”, 2
March 2018, https://resource-
allocation.biomedcentral.com/articles/10.1186/s12962-018-0092-0
“The Colombian experience clearly shows that price controls do not necessarily
decrease overall real pharmaceutical expenditures. Pharmaceutical expenditure is
determined by variation in prices and quantities.2 A drug price regulation that does not
consider a set of measures to strictly monitor (and eventually investigate and further
control) quantities sold, is likely to fail in its objective of halting expenditure. This is a
crucial finding in the context of middle income countries like Colombia that still face
challenges to guarantee financially sustainable universal healthcare coverage. While
ERP may lower pharmaceutical prices, it may also spur an increase in the demand of
regulated products, defying the cost control objective that motivated price regulation
in the first place.”
Impact: Pharmaceutical companies are losing political power currently despite the amount of
lobbying they perform because their methods of lobbying are ineffective.
Champion Briefs 79
John Jones. The Hill. “Big Pharma's lobbyists are losing despite their 'pass the buck'
campaigns”, March 5 2018, https://thehill.com/opinion/healthcare/376699-big-
pharmas-lobbyist-are-losing-despite-their-pass-the-buck-campaigns
“This isn’t surprising and certainly not unpredictable, but ignores the basic challenge
facing drug companies: no amount of money can change the fact that Republicans and
Democrats know the problem is high drug prices and that drugmakers alone set those
prices. So despite all this overwhelming lobbying and financial firepower, the question
remains: Why are drugmakers losing? In the recent budget bill, drugmakers were
singled out by both parties to pay billions more in discounts to help seniors in the
Medicare prescription drug benefit “donut hole.” This comes as states across the
country are taking a harder look at drugmaker pricing schemes and passing legislation in
California and Nevada that faced significant pushback fr m drug companies (and their
surrogates). Like the emperor who wore no clothes, drugmakers have confused
politician’s fear of speaking out against them with support for their pricing practices. It
appears that most politicians will tolerate, but not believe in the drug lobby's messages
or goals. Drug manufacturers have a number of options to alter public perception of
their pricing strategies. They can assert that their products are a great value at any price
but there is definitely a level where that argument fails. They can also compete on price
and refrain from automatic pricing increases that obviously impact healthcare
affordability. Instead, they peddle distracting narratives and government mandates
that undermine federal programs and result in huge industry profit windfalls.”
Analysis: The first piece of evidence above questions a critical piece of the affirmative
argument. Pharmaceutical companies aren’t actually bringing in huge levels of profit compared
to other industries: their political influence owes more to their persistence in lobbying, rather
than high levels of revenue. The second piece of evidence demonstrates that price controls may
not even significantly reduce the revenues flowing into pharmaceutical companies, as people
simply start buying more prescription drugs. Finally, the last piece of evidence demonstrates
Champion Briefs 80
that public and partisan opinions are beginning to oppose pharmaceutical tactics, calling into
question the necessity of addressing pharmaceutical lobbying in the first place.
Champion Briefs 81
PRO - Price controls prevent tradeoff of medicine/medical

care
Argument: Due to the rising cost of drugs in the United States, people often have to choose
between prescription medications and medical care. With price controls, people would be able
to afford both.
Warrant: Drug prices are increasing
Hackett, Brittany. “Prescription Drug Costs Continue to Skyrocket.” AARP, 7 Dec. 2017,
www.aarp.org/health/drugs-supplements/info-2017/prescription-drug-costs-
fd.html.
Retail prices for prescription drugs continue to rise at significantly higher rates than
inflation, which may make it difficult for many Americans, especially Medicare
beneficiaries, to afford their medications, warns a new report from AARP’s Public Policy
Institute (PPI). According to the report, retail prices for 768 prescription drugs
commonly used by older Americans rose by an average of 6.4 percent in 2015, the
latest year for which data are available. The report also found that for 528 medications
many older adults take every day to control chronic conditions like diabetes and high
blood pressure, the average retail price was $12,951 in 2015, more than three times the
average price for such drugs in 2006. Most people do not pay the retail price for their
medications because they either have private insurance or are covered by a government
program such as Medicare, which pays most of a drug’s costs. But there are a growing
number of patients whose prescription plan requires them to pay a percentage of a
medication’s retail price, instead of a flat copay.
Warrant: The amount of people using prescription drugs is only increasing
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Iuga, Aurel O, and Maura J McGuire. “Adherence and Health Care Costs.” Current
Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2014,
www.ncbi.nlm.nih.gov/pmc/articles/PMC3934668/.
In 2010 spending for prescription drugs in the US was US$259 billion.26 Considering the
prevalent rates of nonadherence, drug-related expenses could increase substantially if
adherence improved. Medication nonadherence is widespread and varied by disease,
patient characteristics, and insurance coverage, with nonadherence rates ranging from
25% to 50%. In the US, nearly half of all adults have at least one chronic disease28 and
the percentage of Americans taking at least one prescription drug increased from 38%
in the period 1988–1994 to 49% in the period 2007–2010; during the same time the
number of adults taking three or more prescription drugs doubled.26 rescription
medication use will increase as the population ages. Based on these statistics, increasing
adherence from current levels could increase medication expenses by billions of dollars.
Strategies to enhance adherence should consider the impact on overall health care
costs, weighing increased drug expenditures against savings from improved outcomes.
The majority of the costs attributed to medication nonadherence result from avoidable
hospitalization.
Warrant: Medical care and prescription drugs are substitute products.
Santerre, Rexford E. and John A. Vernon. "Assessing Consumer Gains From A Drug Price
Control Policy In The United States," Southern Economic Journal, 2006,
v73(1,Jul), 233-245.
The positive and statistically significant cross-price elasticity estimates suggest that
medical care and prescription drugs are substitute products. For example, our results
indicate that a 10 percent increase in the price of medical care is associated with a 4.5
to 5.6 percent increase in the quantity of prescription drugs demanded. The direct
Champion Briefs 83
relation between the price of medical care and the quantity of prescription drugs
demanded suggests that decision-makers have some ability to substitute one good for
the other in the production of good health when relative prices change. This finding is
consistent with Lichtenberg’s (1996) research, which found that increased
expenditures on pharmaceuticals lead to reduced expenditures on hospitalizations,
ambulatory care, and physician services. Net income elasticity estimates are positive
and statistically significant, indicating that pharmaceutical products can, collectively, be
treated as normal goods. The income elasticities are fairly sizable and suggest that a 10
percent increase in real income per capita produces a 5 percentage increase in the
quantity of drugs demanded. Studies tend to suggest that health care represents a
normal good (Santerre and Neun, 2004).
Warrant: High drug prices cause people to take unhealthy measures.
“Is There a Cure for High Drug Prices?” Product Reviews and Ratings - Consumer Reports,
Consumer Reports, 29 July 2016, www.consumerreports.org/drugs/cure-for-
high-drug-prices/.
The practice of raising drug prices on new—and old—medications is common and

widespread. From a nationally representative telephone poll conducted by Consumer
Reports Best Buy Drugs in March, we learned that three in 10 Americans (about 32
million people) were hit with price hikes within the previous 12 months, costing them
an average of $63 more for a drug they routinely take—and a few paid $500 or more.
We also found price increases on everything from longtime generics used to treat
common conditions such as diabetes, high blood pressure, and high cholesterol to new
treatments for diseases such as hepatitis C. Our poll shows that when people were hit
with higher drug costs, they were more likely to take unhealthy measures such as
skipping doctor appointments, tests, or procedures, or not filling their prescriptions or
taking them as directed. Take the case of Marlene Condon, a nature writer living in
Champion Briefs 84
Crozet, Va. Two years ago she paid about $32 for 180 tablets of hydroxychloroquine (a
generic available for almost two decades) to treat her rheumatoid arthritis. When the
drug’s price more than doubled to $75, Condon says she was annoyed but paid the bill
anyway.
Analysis: This argument is strategic because it gives you a path to save lives and lets you weigh
on timeframe. If we keep waiting and watch drug prices rise, more and more people are forced
to choose between their medicine and medical care. However, affirming the resolution allows
for people to afford both, and avoid taking costly measures.
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A/2 - Price controls prevent tradeoff of medicine/medical care
Response: Innovation in a world without price controls solve back for the tradeoff.
Warrant: People spend less at hospitals because they have fewer reasons to go
Lichtenberg, Frank R. “The Benefits of Pharmaceutical Innovation: Health, Longevity,

and Savings.” Montreal Economic Institute, Montreal Economic Institute, June
2016, www.iedm.org/files/cahier0216_en.pdf.
Although the costs of new pharmaceuticals are often the subject of critical media
coverage, they are rarely juxtaposed with the benefi ts that these new drugs bring.
Between 1995 and 2012, life expectancy at birth in Canada increased by more than
three years and curative care hospital discharges per 100,000 population (a measure of
hospital utilization) decreased by 25%. While these improvements naturally have
multiple sources, a substantial and growing number of studies have demonstrated that
pharmaceutical innovation is responsible for a large part of such long-term
improvements in health and longevity. Furthermore, although new drugs can appear
expensive when considered in isolation, pharmaceutical innovation leads to cost
savings elsewhere in the system through the reduced use of health services like
hospitals and nursing homes. Studies have also shown that pricing drugs appropriately
is important in sustaining a robust rate of pharmaceutical innovation.
Warrant: We wouldn’t have drugs as effective in a pro world because there is less innovation.
Santerre, Rexford E. and John A. Vernon. "Assessing Consumer Gains From A Drug Price
Control Policy In The United States," Southern Economic Journal, 2006,
v73(1,Jul), 233-245.
Champion Briefs 86
However, over this same time period, Giaccotto, Santerre, and Vernon (2005) estimated
that this same price control regime would have caused firms to reduce pharmaceutical
R&D expenditures (in $2000) by between $264.5 and $293.1 billion, because of lower
profit expectations and possibly reduced levels of internal funds (which are the
primary source of R&D finance) 10 . This reduced investment in R&D would have led to
approximately 38 percent fewer new drugs being brought to market in the global
economy. If this 38 percent figure is applied to the total number of new chemical
entities approved for marketing during this period in the U.S., we can use our simulation
results to calculate the average social opportunity cost per new drug.
Analysis: This response could be extremely effective, especially if you’re reading some form of
the innovation argument. With the medical innovation we have in the status quo, long term
spending on hospital care could decrease due to the effectiveness of the drugs.
Response: The tradeoff isn’t direct, and price controls wouldn’t solve for it.
Warrant: Healthcare in the United States is expensive in general.
Blumberg, Yoni. “Here's the Real Reason Health Care Costs so Much More in the
US.” CNBC, CNBC, 3 Sept. 2018, www.cnbc.com/2018/03/22/the-real-reason-
medical-care-costs-so-much-more-in-the-us.html.
The U.S. is famous for over-spending on health care. The nation spent 17.8 percent
of its GDP on health care in 2016. Meanwhile, the average spending of 11 high-income
countries assessed in a new report published in the Journal of the American
Medical Association — Canada, Germany, Australia, the U.K,. Japan, Sweden,

France, the Netherlands, Switzerland, Denmark and the U.S. — was only 11.5 percent.
Per capita, the U.S. spent $9,403. That's nearly double what the others spent. This
Champion Briefs 87
finding offers a new explanation as to why America's spending is so excessive. According

to the researchers at the Harvard Chan School, what sets the U.S. apart may be inflated
prices across the board. In the U.S., they point out, drugs are more expensive. Doctors
get paid more. Hospital services and diagnostic tests cost more. And a lot more money
goes to planning, regulating and managing medical services at the administrative
level.
Warrant: There are more factors than just drug costs that contribute to high healthcare prices.
Blumberg, Yoni. “Here's the Real Reason Health Care Costs so Much More in the
US.” CNBC, CNBC, 3 Sept. 2018, www.cnbc.com/2018/03/22/the-real-reason-
medical-care-costs-so-much-more-in-the-us.html.
The real difference between the American health care system and systems abroad is
pricing. Specialists, nurses and primary care doctors all earn significantly more in the
U.S. compared to other countries. General physicians in America made an average of
$218,173 in 2016, the report notes, which was double the average of generalists in the
other countries, where pay ranged from $86,607 in Sweden to $154,126 in Germany.
Administrative costs, meanwhile, accounted for 8 percent of total national health
expenditures in the U.S. For the other countries, they ranged from 1 percent to 3
percent. Health care professionals in America also reported a higher level of
"administrative burden." A survey showed that a significant portion of doctors call the
time they lose to issues surrounding insurance claims and reporting clinical data a major
problem.
Analysis: The purpose of this response is to take away your opponent’s uniqueness. Price
controls wouldn’t have that big of an impact on hospital services, so even if drugs are more
affordable medical care is extremely expensive.
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PRO – Price controls increase competition in the
pharmaceutical industry
Argument: The pharmaceutical industry is currently dominated by large corporations. Setting

price controls would significantly reduce the profits gained by these large corporations and
allow for a more competitive market.
Warrant: Large pharmaceutical companies have a stranglehold on the market that allows for
excessive charges.
Varian, Hal “Examining Differences in Drug Prices”, The New York Times, 21 Sept. 2000,
https://www.nytimes.com/2000/09/21/business/examining-differences-in-drug-
prices.html
“Americans pay the highest health-care prices in the world, including the highest for
drugs, medical devices, and other health-care services and products. Our fragmented
system produces many opportunities for excessive charges. But one lesser-known
reason for those high prices is the stranglehold that a few giant intermediaries have
secured over distribution. The antitrust laws are supposed to provide protection against
just this kind of concentrated economic power. But in one area after another in today’s
economy, federal antitrust authorities and the courts have failed to intervene. In this
case, PBMs are sucking money out of the health-care system—and our wallets—with
hardly any public awareness of what they are doing. Even some Republicans criticize
PBMs for pursuing profit at the public’s expense. “They show no interest in playing fair,
no interest in the end user,” says Representative Doug Collins of Georgia, one of the
industry’s loudest critics. “They act as monopolistic terrorists on this market.” Collins
and a bipartisan group in Congress want to rein in the PBM industry, setting up a titanic
battle between competing corporate interests. The question is whether President
Champion Briefs 89
Donald Trump will join that effort to fulfill his frequent promises to bring down drug
prices.”
Warrant: The pharmaceutical industry is dominated by a few giant companies that have even
merged with smaller competitors.
Varian, Hal “Big, bad pharma: Why our relationship with the Pharmaceutical industry
matters”, The Independent, 21 Dec. 2012,
prices.html
“Over the past few decades, the pharmaceutical industry has dramatically changed
shape. And as a society, our relationship with it has altered alongside. The
pharmaceutical industry is dominated now by a few giant companies which merged
with smaller competitors giving us the likes of Novartis, Wyeth, Glaxo Smith Kline and
Bristol Myers Squibb. The majority of the pharmaceutical market in the United States
and the UK, as well as globally, is controlled by a handful of companies. There is
obviously good reason for such a business model. In an industry whose upfront costs are
enormous, (it costs on average around $1 billion to develop a new compound), it is not
hard to see that economy of scale would be a sensible strategy to adopt. So why should
we care about our relationship with pharma or how runs it itself?”
Warrant: Large drug manufacturers commonly pay generic brand companies to keep their
products off the market.
Fox, Erin “How Pharma Companies Game the System to Keep Drugs Expensive”, Harvard
Business Review, 6 April 2017, https://hbr.org/2017/04/how-pharma-
companies-game-the-system-to-keep-drugs-expensive
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“Not anymore. The system intended to reward drug companies for their innovations,
but eventually protect consumers, is systematically being broken. Drug companies are
thwarting competition through a number of tactics, and the result is high prices, little
to no competition, and drug quality problems. One of the ways branded drug
manufacturers prevent competition is simple: cash. In so-called “pay for delay”
agreements, a brand drug company simply pays a generic company not to launch a
version of a drug. The Federal Trade Commission estimates these pacts cost U.S.
consumers and taxpayers $3.5 billion in higher drug costs each year. “Citizen petitions”
offer drug companies another way to delay generics from being approved. These ask the
Food and Drug Administration to delay action on a pending generic drug application. By
law, the FDA is required to prioritize these petitions. However, the citizens filing
concerns are not individuals, they’re corporations.
Impact: Regulating drug prices empirically reduces market power and increases the market
share of generic drugs
Morten Dalen, Dag “Price regulation and generic competition in the pharmaceutical
market ”, University of Oslo, 25 Nov 2005,
https://www.researchgate.net/publication/6944913_Price_regulation_and_gen
eric_competition_in_the_pharmaceutical_market
“In March 2003 the Norwegian government implemented yardstick based price
regulation schemes on a selection of drugs experiencing generic competition. The
retail price cap, termed “index price”, on a drug (chemical substance) was set equal to
the average of the three lowest producer prices on that drug, plus a fixed wholesale and
retail margin. This is supposed to lower barriers of entry for generic drugs and to reduce
market power. Using monthly data over the period 1998-2004 for the 6 drugs
(chemical entities) subjected to the index price regulation, we estimate a structural
model enabling us to examine the impact of the reform on both demand and market
Champion Briefs 91
power. Our results suggest that the index price helped to increase the market shares
of generic drugs and succeeded in reducing overall market power.”
Analysis: Large pharmaceutical companies currently have a stranglehold on the market and are
responsible for high prices, by implementing price controls large corporations’ profits will
decrease substantially limiting their ability to bully smaller companies. Further, this argument
has been proven in Norway, a country with price controls, allowing the Pro to access an
empirical example.
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A/2 – Price controls increase competition in the

pharmaceutical industry
Response: Large pharmaceutical companies have several other methods of preventing generic
brands from reaching the market.
Warrant: Large pharmaceutical companies file false citizen petitions, and even market the same
drug under another name in order to prolong their monopoly.
“Citizen petitions” offer drug companies another way to delay generics from being
approved. These ask the Food and Drug Administration to delay action on a pending
generic drug application. By law, the FDA is required to prioritize these petitions.
However, the citizens filing concerns are not individuals, they’re corporations. The FDA
recently said branded drug manufacturers submitted 92% of all citizen petitions. Many
of these petitions are filed near the date of patent expiration, effectively limiting
potential competition for another 150 days. “Authorized generics” are another tactic to
limit competition. These aren’t really generic products at all; they are the same product
sold under a generic name by the company that sells the branded drug. Why? By law,
the first generic company to market a drug gets an exclusivity period of 180 days.
During this time, no other companies can market a generic product. But the company
with the expiring patent is not barred from launching an “authorized generic.” By selling
a drug they’re already making under a different name, pharmaceutical firms are
effectively extending their monopoly for another six months.”
Warrant: Product hopping allows large corporations to slightly change their products and file
new patents, keeping competition away.
Champion Briefs 93
Jones, Gregory “Strategies that delay or prevent the timely availability of affordable
generic drugs in the United States”, NCBI, 27 Jan 2016,
“Product hopping, also called “forced switching” or “evergreening,” involves a brand-

name company switching the market for a drug, prior to its patent expiration date, to
a reformulated version that has a later-expiring patent, but which offers little or no
therapeutic advantages. The newer version, for example, could have a slightly different
tablet or capsule dose or a slow-release formulation (given once a day rather than twice
daily). In conjunction with this change, the company spends heavily to convince doctors
and/or patients to switch to the new drug and may even withdraw the (often profitable)
older drug from the market before its patent expiration date. When the generic version
of the drug becomes available, pharmacists cannot substitute it for the new (branded)
version because state laws allow drug substitution only if the dosage strength and
other characteristics remain the same.”
Analysis: While decreasing large corporation’s profits may limit their ability to pay generic
companies to delay their company, there are several other methods for preventing
competition. The Con can argue that the Pro needs to prove that all these mechanisms will
disappear before generic companies can truly compete with Big Pharma.
Response: Generic drug companies cannot effectively compete with big corporations because
their products are not as effective
Warrant: Generic medications are frequently recalled due to issues with their quality
Champion Briefs 94
“Although makers of a branded drug are using a variety of tactics to create barriers to
healthy competition, generic drug companies are often not helping their own case. In
2015, there were 267 recalls of generic drug products—more than one every other
day. These recalls are for quality issues such as products not dissolving properly,
becoming contaminated, or even being outright counterfeits. A few high-profile recalls
have shaken the belief that generic drugs are truly the same. In 2014, the FDA withdrew
approval of Budeprion XL 300 — Teva’s generic version of GlaxoSmithKline’s Wellbutrin
XL. Testing showed the drug did not properly release its key ingredient, substantiating
consumers’ claims that the generic was not equivalent. In addition, concerns about
contaminated generic Lipitor caused the FDA to launch a $20 million initiative to test
generic products to ensure they are truly therapeutically equivalent.”
Analysis: Regardless of the power that large pharmaceutical companies have to stop generic
medicines from being sold, generic companies face their own challenges when reaching the
market. The Con can effectively argue that the problems existing within generic companies will
exist regardless of price controls, thus preventing competition in the market.
Champion Briefs 95
PRO – Price controls would stop price discrimination
Argument: Large pharmaceutical companies are often condemned for discriminating prices
between different markets. Setting price controls in the U.S. where they are allowed to charge
any price they want, would severely hinder this process.
Warrant: Pharmaceutical companies use price discrimination to charge higher prices in the
United States
Varian, Hal “Examining Differences in Drug Prices”, The New York Times, 21 Sept. 2000,
prices.html
“The natural strategy is to selectively cut prices and set different prices for different
markets. Drugs sold for humans generally sell for more than drugs sold for animals.
Drugs in rich countries tend to cost more than drugs in poor countries. A daily dose of
the AIDS drug PLC sells for $18 in the United States and $9 in Uganda, while a generic
equivalent sells for $1.50 a day in Brazil. Even at $9 a dose, the drug company makes a
profit on incremental sales. But if the drug were sold at $9 to everyone, profits would be
substantially lower than they would be under differential pricing. The United States
ends up paying more for drugs since it is much richer than the rest of the world and
tends to spend a large fraction of that wealth on health care. Furthermore, in most
countries, a single governmental health care provider bargains over drug prices.
America's health care system is much more fragmented, which tends to reduce the
bargaining power of health care providers in negotiating drug prices. Price
discrimination is not popular with consumers, especially those paying the higher price.
What does economics say about whether this kind of differential pricing is good or bad?
To answer this question, we have to ask what price would prevail if only one price could
be charged.”
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Warrant: Price Discrimination is used to vary prices within the United States.
Thomas, Katie “What Does a Drug Cost? It Depends on Where You Live”, The New York
Times, 6 July 2018, https://www.nytimes.com/2018/07/06/health/drug-prices-
cities.html
“What you pay at the pharmacy for generic drugs can vary widely based on where you
live, according to a new analysis by the consumer website GoodRx. The study, which
looked at 500 commonly used drugs in 30 American cities, highlights just how
unpredictable drug prices can be. The cost of common drugs like the generic version of
the cholesterol drug Zocor, or the diabetes drug metformin, differ significantly from
coast to coast. GoodRx looked at the average cash price of the drug at a pharmacy —
something not every consumer will have to pay. Most people have insurance coverage
for their prescriptions, and consumers can often take advantage of discount programs.
But a growing number of people are being asked to pay for a greater share, sometimes
with a deductible. Some disparities obviously result from a higher cost of living — New
York and San Francisco were the most expensive cities in the country for drugs. But
prices can vary widely even between similar cities in the same state: Cleveland’s
pharmacy prices were 2.5 percent above the national average, while not far away,
Columbus had prices that were nearly 22 percent below average. In Cleveland, the
generic version of Paxil, the antidepressant, costs about $46.94, while in Columbus,
someone would pay $20.87.”
Warrant: U.S. patients bear the greatest burden of pharmaceutical price discrimination.
Bate, Roger “Drug Pricing and Its Discontents”, American Enterprise Institute, 9 Aug
2007, http://www.aei.org/publication/drug-pricing-and-its-discontents/
The reality is that U.S. patients bear the greatest burden for R&D costs even when
middle-income countries contribute their share. Americans would certainly like to see
Champion Briefs 97
reduced drug prices. Senator Byron L. Dorgan (D-N.D.), sponsor of a Senate bill that
would allow Americans to reimport cheaper drugs from Canada, said that “lifesaving
prescription drugs save no lives if you cannot afford to purchase them.” Dorgan makes
an important point: even wealthy countries like the United States have to deal with
pricing pressures of their own, and their citizens may be getting fed up with paying the
lion’s share of global R&D costs. Although the correct price of a pharmaceutical is a
debatable topic, middle-income countries have some responsibility to contribute to
R&D, yet they do not generally acknowledge that role.”
Impact: Price controls prevent pharmaceutical firms from charging high prices in high income
nations.
Atella, Vincenzo “Pharmaceutical Price Controls and Minimum Efficacy Regulation:

Evidence from the United States and Italy”, Health Services Research, 18 Oct.
2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447248/
“The extent of price controls on drugs also differs considerably across countries.
Countries such as Germany allow price freedom only for innovative drugs. In the United
States prices are free, but Health Maintenance Organizations (HMOs) and other
Pharmacy Benefit Managers (PBMs) create formularies of “preferred” drugs that
physicians and patients are encouraged to use via price incentives. Countries such as
Italy, France, and Spain provide examples of regulatory frameworks that deter
pharmaceutical companies from charging high prices. Drug prices are set through
negotiation between the government and industry; firms must agree to the final price to
obtain reimbursement from public health insurance.
Analysis: Because there are no limits on drug prices in the U.S., pharmaceutical companies
charge Americans with disproportionately high prices. By looking at examples of wealthy
Champion Briefs 98
countries who have price controls such as France and Italy, it is evident that price controls are
effective at stopping companies from charging these unfair prices.
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A/2 – Price controls would stop price discrimination
Response: Price discrimination is necessary for pharmaceutical companies to ensure profits and
maximize social well-being.
Warrant: Price discrimination occurs due to the high cost of drug research and development.
Bhanji, Shaira “Price Discrimination in Pharmaceutical Companies: The Method to the

‘Madness’”, Harvard College Global Health Review, 2 April 2012,
https://www.hcs.harvard.edu/hghr/online/price-discrimination-method/
“One of the primary reasons for price discrimination is the astronomical cost of drug
research and development. The total average cost of developing a new drug is more
than $1 billion over the course of 15 years of research and testing. Many drugs fail in
clinical trials and do not even make it to the market, resulting in sunk costs. A recent
study conducted by the Centre for Medicine Research (CMR) on 16 pharmaceutical
companies that account for 60% of the world’s research and development spending
estimates that Phase II trial success rates have fallen by 10 percentage points to just
18% from 2006 to 2009. Furthermore, only half of drugs make it through Phase III trials.
All this is to say that drug development is a high-risk, high-reward game. When the
game is won, the rewards have the potential to benefit many lives around the globe in
addition to generating the profits that pharmaceutical companies may reap. Price
discrimination can be thought of as a way for pharmaceutical companies to hedge
against this huge inherent risk by allowing them to take advantage of the entire
market. An August 2011 Health Affairs article affirms that the strategy promotes
production of new and existing products by providing money for research and
development in the future. Thus, some believe that the long-term benefits of continued
innovation outweigh the short-term benefits of more standard pricing.”
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Warrant: Price discrimination can increase the number of products that are profitable to
manufacture and increase social welfare.
Lichtenberg, Frank “Pharmaceutical Companies’ Variation of Drug Prices Within and

Among Countries Can Improve Long-Term Social Well-Being”, Health Affairs,
Aug. 2011, https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010.0891
“Price discrimination may make some products profitable to manufacture and sell that
otherwise would not be. One reason is the existence of substantial fixed costs of
production. A manufacturer whose goal is to maximize profits will not develop and
produce a product whose fixed costs are high—even though it would be socially
desirable to do so (in the sense that the total benefits of production would exceed the
total costs)—because the manufacturer pays all of the costs but does not capture all of
the benefits. Price discrimination increases the manufacturer’s benefits by allowing it to
charge higher prices where demand is less elastic. Hence, price discrimination makes it
less likely that high fixed costs would prevent manufacturers from pursuing socially
desirable investment opportunities, and thus increases social welfare. In the presence
of high fixed costs, social welfare can therefore be higher under price discrimination
than it would be under uniform pricing. The pharmaceutical industry has much higher
fixed costs—especially the expenses involved in research and development (R&D)—as a
percentage of sales than most other industries.”
Analysis: These responses establish that pharmaceutical companies engage in price

discrimination within and among countries due to high fixed costs, such as research and
development. Further, it can be proven that price discrimination results in long term benefits to
society as more products enter the market.
Response: Price discrimination is necessary to make medicine affordable in developing nations.
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Warrant: Price Discrimination ensure lower cost in countries with lower incomes than the
United States.
Schweitzer, Stuart. “Prices of Pharmaceuticals in Poor Countries are Much Lower Than in
Wealthy Countries”, Health Affairs, Aug. 2011,
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.0923
“For patented drugs, middle-income countries pay on average 52 percent of what

industrialized countries pay, while developing countries pay 27 percent of the prices
charged in industrialized countries. For drugs that are no longer patented, middle-
income countries pay 71 percent and developing countries 41 percent of what
industrialized countries pay, while for products on the World Health Organization’s list
of essential drugs, the figures are 28 percent and 6 percent. Thus, the average prices
charged in developing countries for all three categories of drugs are much lower than
those charged elsewhere.”
Analysis: This response is strategic when weighing it against the pro team’s argument on scope.
While the U.S. may see higher prices, there are more countries who are benefitted by price
discrimination, as on net all developing nations pay significantly less for medicine.
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PRO – Price controls would increase drug access for low

income individuals
Argument: Currently drug prices are so high that many Americans struggle to afford them. This
is especially true for low income individuals who may not have the means to purchase these
life- saving drugs. Price controls would lower the price of drugs and allow more low-income
individuals to gain access to them.
Warrant: Prescription drugs are more expensive in the United States than in any other country.
Hirschler, Ben “Transatlantic divide: how U.S. pays three times more for drugs”, 12
Oct. 2015, https://www.reuters.com/article/us-pharmaceuticals-usa-
comparison/exclusive-transatlantic-divide-how-u-s-pays-three-times-more-for-
drugs-idUSKCN0S61KU20151012
“U.S. prices for the world’s 20 top-selling medicines are, on average, three times
higher than in Britain, according to an analysis carried out for Reuters. The finding
underscores a transatlantic gulf between the price of treatments for a range of diseases
and follows demands for lower drug costs in America from industry critics such as
Democratic presidential candidate Hillary Clinton. Researchers from Britain’s University
of Liverpool also found U.S. prices were consistently higher than in other European
markets. Elsewhere, U.S. prices were six times higher than in Brazil and 16 times
higher than the average in the lowest-price country, which was usually India. The
United States, which leaves pricing to market competition, has higher drug prices than
other countries where governments directly or indirectly control medicine costs. That
makes it by far the most profitable market for pharmaceutical companies, leading to
complaints that Americans are effectively subsidizing health systems elsewhere.”
Warrant: A third of low income individuals find it difficult to afford prescription drugs.
Champion Briefs 103

Smith, Katie. “Most Say They Can Afford Their Prescription Drugs, but One in Four Say
Paying is Difficult, Including More than Four in Ten People Who are Sick”, Kaiser
Family Foundation, 20 Aug. 2015, https://www.kff.org/health-costs/press-
release/most-say-they-can-afford-their-prescription-drugs-but-one-in-four-say-
paying-is-difficult-and-more-than-four-in-ten-for-people-who-are-sick/
“About half of Americans (54%) report currently taking a prescription drug, and a large
majority of them (72%) say their prescriptions are very or somewhat easy to afford.
However, about a quarter (24%) say paying for their drugs is difficult, and the share
facing difficulties rises among those with low incomes (33%) or currently taking four or
more prescription drugs (38%), and is highest for those in fair or poor health (43%).
These are among the findings from the August Kaiser Health Tracking Poll, which
expands on findings from earlier this year looking at prescription drug costs. The new
poll finds strong majorities of the public support a wide range of policy actions to lower
the costs of prescription drugs. At least seven in 10 support each of these four potential
policy changes:”
Warrant: One in ten Americans cannot afford their prescriptions
Reinberg, Stevne. “Nearly 1 in 10 Adults Skip Meds Due to Cost, CDC Says,” HealthDay,
29 Jan 2015, https://consumer.healthday.com/senior-citizen-information-
31/misc-aging-news-10/nearly-1-in-10-adults-skips-meds-due-to-cost-cdc-says-
695925.html
“Nearly one in 10 American adults don't take their medications as prescribed because
they can't afford to, health officials reported Thursday. High drug costs in the United
States may be hurting the very people the medications are meant to help, the new
report from the U.S. Centers for Disease Control and Prevention suggests. About 15
Champion Briefs 104

percent of U.S. adults have asked their doctor for a lower-cost alternative, the
researchers found. Moreover, almost 2 percent have bought prescription drugs from
another country -- where medications may or may not be regulated -- and more than 4
percent have tried alternative therapies. "These people are skipping doses, taking less
medication or delaying filling prescriptions," said report author Robin Cohen, a health
statistician at CDC's National Center for Health Statistics (NCHS).”
Warrant: The poorest individuals in America are the most likely to skip medication due to
financial barriers.
Reinberg, Stevne. “Nearly 1 in 10 Adults Skip Meds Due to Cost, CDC Says,” HealthDay,
29 Jan 2015, https://consumer.healthday.com/senior-citizen-information-
31/misc-aging-news-10/nearly-1-in-10-adults-skips-meds-due-to-cost-cdc-says-
695925.html
“Insurance was a key factor in whether patients took their medications as prescribed,
the researchers found. Among adults younger than 64, about 6 percent with private
insurance skipped medications to save money, compared with 10.4 percent of those
with Medicaid and 14 percent of uninsured patients. The poorest adults -- those with
incomes below 139 percent of the poverty level (about $27,300 for a family of three
last year) -- were most likely to not take medication as prescribed because of limited
finances, the researchers said. "Poor adherence to prescribed medication use is a
significant problem with potentially serious consequences," agreed Dr. David Katz,
director of the Yale University Prevention Research Center. For many medications, it
makes sense for public and private insurers to remove all barriers to access and, if
anything, add incentives, Katz said.”
Impact: Hundreds of thousands of Americans cannot afford prescribed medications for cancer
treatment
Champion Briefs 105

Short, April. “Americans Are Dying Because They Can’t Afford Medicine” The National
Memo, 13 Feb 2018, http://www.nationalmemo.com/americans-dying-cant-
afford-medicine/
“At least 1.5 million Americans will receive a cancer diagnosis in 2018, and hundreds of
thousands of them won’t be able to afford their prescribed medications. One fairly
common cancer drug called Alecensa costs more than $159,000 a year. Many others
hover around that price range. A 2014 study published in The Oncologist showed a
quarter of all cancer patients opted not to fill a prescription due to the cost and nearly
20 percent only filled their prescriptions partway or took less than the prescribed
dosage. As a Kaiser Health News article which ran on NPR reported in March 2017, “the
high cost of cancer medications can burden patients for years even after they finish
treatment….one-third of Medicare patients who were expected to use Gleevec — a
life-saving leukemia medication that costs up to $146,000 a year — failed to fill
prescriptions within six months of diagnosis, according to a December study in the
Journal of Clinical Oncology.”
Analysis: This argument is strategic as it demonstrates a significant harm that is faced by a large
percentage of Americans. By focusing on low income individuals, it is clear that this group is
harmed the most by high drug prices, and that price controls would offer a solution to increase
drug access.
Champion Briefs 106

A/2 – Price controls would increase drug access for low

income individuals
Response: Price controls would not affect the price of the majority of the U.S.’s drugs
Warrant: 90 percent of drugs dispensed in the U.S. are inexpensive generics
Winegarden, Wayne. “Price Controls Will Reduce Innovation and Health Outcomes”,
Forbes, 12 Oct 2017,
https://www.forbes.com/sites/econostats/2017/10/12/price-controls-will-
reduce-innovation-and-health-outcomes/#64083a1863a6
“To start, the price controls would be irrelevant for most patients. Nearly 90
percent of all drugs dispensed in the U.S. in 2016 were generic medicines, according to
IMS Health. Therefore, any price control scheme would not apply to the majority of
patients who are using inexpensive generics, not more expensive patented products. It
is also important to note that generic medicines are significantly cheaper in the U.S.
compared to the other major industrialized countries. In fact, total pharmaceutical
spending as a percentage of total health care spending is lower in the U.S. (12.2 percent)
than the average for the 30 nations that comprise the Organization for Economic
Cooperation and Development, or OECD, (16.9 percent). This is due to, in part, the
prevalence of generic medicines that are more affordable here than in other OECD
nations.”
Analysis: This response emphasizes that the majority of drugs in the U.S. are actually less
expensive than in other countries and thus affordable for low income Americans. This can be
used to severely mitigate the pro team’s claims on increasing access to drugs.
Response: Price controls would create drug shortages which limit drug access
Champion Briefs 107

Warrant: Price controls have historically created drug shortages, exemplified by flu vaccines.
Tate, Edward. “Government Price Controls On Prescription Drugs May be More Than
Patients Bargain For”, HealthCare Institute of New Jersey, 7 Oct 2002,
http://hinj.org/government-price-controls-on-prescription-drugs-may-be-more-
than-patients-bargain-for/
Another even more important consideration is that price controls stifle innovation and
can lead to supply shortages in both the quality and quantity of medications. Consider
the recent flu vaccine shortage. The largest purchaser of the vaccine is the federal
Vaccines for Children Program. The program buys up nearly 70 percent of all childhood
vaccines at government-set prices and then distributes them to states according to a
federally-set formula. The end result is that vaccines have been distributed to states
where there is no epidemic often leaving a shortage where it is needed. Because the
government controls the price, the vaccine makers are discouraged from producing
more than what the government orders. Vaccine prices have remained stagnant since
1994. Thanks to these price controls, there now are only four developers of childhood
vaccines. That’s down from 20 companies just a few years ago.”
Warrant: Price controls incentivize pharmaceutical companies to leave the market for generic
drugs in search of profit elsewhere.
Sullivan, Thomas. “Increasing Generic Drug Shortages Linked to Government Price

Controls”, Policy & Medicine, 6 May 2018, http://hinj.org/government-price-
controls-on-prescription-drugs-may-be-more-than-patients-bargain-for/
“First, the number of suppliers of generic drugs has dwindled. There were 26 U.S.
vaccine makers in 1967; today there are only six. Supply disruptions are common,
Champion Briefs 108

including the possibility that a facility completely shuts down for a protracted time
because of quality or safety problems. Second, unlike in most consumer-goods
industries, many pharmaceutical manufacturers have failed to invest in the technology
and quality-control improvements that would reduce the risks of partial or complete
facility shutdowns—and this despite the FDA’s regularly issued current guidelines for
good manufacturing practices. Behind both problems are the government’s tight price
controls for generic drugs, especially when purchased by Medicare and Medicaid. Low
prices induce drug makers to exit various markets, or at least to reallocate their
manufacturing capacity toward more profitable, patented pharmaceuticals. Low prices
also tend to eliminate the rationale for investments in better manufacturing
technologies and processes, as shown in a 2009 study conducted by the author and
published in the Journal of Management Science.”
Analysis: These responses serve to demonstrate that when price controls are implemented
pharmaceutical companies often choose to leave the generic drug market in search of a more
profitable field. When considering that most people in America rely on generic drugs, per the
first response, it can be argued that price controls will only decrease access for low income
individuals by creating vast shortages of generic drugs.
Champion Briefs 109

PRO – Price controls help fight the opioid epidemic
Argument: Scientists have found an effective treatment fight the opioid epidemic. However,
accessing Buprenorphine is often too expensive because most insurance companies do not
cover opioid addiction. Controlling the price of this treatment is vital to stopping the opioid
epidemic.
Warrant: The best way to fight opioid addiction is through medication-assisted treatment, and
monthly injections will be ready soon.
Fischer, Kristen. “Opioid Addiction Treatments That May Surface in 2018.” Healthline, 4
Jan. 2018, www.healthline.com/health-news/opioid-addiction-treatments-
surface-in-2018#1.
Remedying opioid addiction with medication-assisted treatment is the most promising

avenue, says Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at
Brandeis University in Massachusetts. First, he notes, the country must prevent people
from becoming addicted. That requires being more cautious in prescribing opioids.
“Prescribing practices have to change,” Kolodny told Healthline. Second, it may be
necessary to treat people who are already addicted with other drugs. The country as a
whole, Kolodny said, isn’t making it easy to access these addiction-defeating drugs.
Buprenorphine remains the best treatment for opioid addiction. It’ll soon be available
as a monthly injection so people don’t have to remember to take a pill daily.
Warrant: Although effective and accessible, most insurance companies don’t cover this
treatment.
Champion Briefs 110

Fischer, Kristen. “Opioid Addiction Treatments That May Surface in 2018.” Healthline, 4
Jan. 2018, www.healthline.com/health-news/opioid-addiction-treatments-
surface-in-2018#1.
Physicians must complete an eight-hour training to apply for permission to prescribe

buprenorphine under The Drug Addiction Treatment Act of 2000. The law grants a
Drug Enforcement Agency (DEA) waiver to doctors who complete training to prescribe
buprenorphine to treat opioid use disorder. There are limits on the numbers of patients
a doctor can treat, though. Most of the doctors doing this don’t take insurance, so
funding the treatment has to come out of pocket. Another challenge to getting
treatment is that many people with an opioid addiction don’t know that buprenorphine
is an effective treatment, Kolodny said.
Warrant: Injection based treatment costs $1000 a month, limiting access to most people.
Bebinger, Martha, and WBUR. “FDA Considering Pricey Implant As Treatment For Opioid
Addiction.” Kaiser Health News, Kaiser Health News, 26 Jan. 2017,
khn.org/news/fda-considering-pricey-implant-as-treatment-for-opioid-
addiction/.
“Anything that might help people beat their opioid addiction is a good idea,” said Dr.
Barbara Herbert, president of the Massachusetts Society of Addiction Medicine. But she
said she also has reservations about this method of delivering treatment. The main one
is price. The company says it will price the implants to be competitive with other
injectable treatments used to battle opioid addiction, including a shot that costs about
$1,000 a month. Buprenorphine pills, in comparison, typically cost $130 to $190 for a
month’s supply. Herbert said a high price may force providers to turn patients away —
or cut back on other services.
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Impact: The opioid epidemic in our country kills 115 people a day and hurts our economy.
“Opioid Overdose Crisis.” NIDA, National Institute on Drug Abuse, 6 Mar. 2018,
www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.
Every day, more than 115 people in the United States die after overdosing on
opioids The misuse of and addiction to opioids—including prescription pain
relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that
affects public health as well as social and economic welfare. The Centers for Disease
Control and Prevention estimates that the total "economic burden" of prescription
opioid misuse alone in the United States is $78.5 billion a year, including the costs of
healthcare, lost productivity, addiction treatment, and criminal justice involvement.
Analysis: This argument is strategic because the opioid epidemic is one of the biggest problems
our country faces today, and affirming the resolution could help fight it. Saving over 100 lives
daily is extremely convincing and easily outweighs any economic impact.
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A/2 – Price controls help fight the opioid epidemic
Response: Steps are already being taken to fight the opioid crisis.
Warrant: Legislation is being passed right now to fight addiction in the long term.
Sotomayor, Marianna. “Senate Passes Sweeping Legislation to Combat Opioid

Epidemic.” NBCNews.com, NBCUniversal News Group, 17 Sept. 2018,
www.nbcnews.com/politics/politics-news/senate-passes-sweeping-legislation-
combat-opioid-epidemic-n908901.
Similar to the House package passed in June, the Senate's Opioid Crisis Response Act of
2018 (OCRA) directs funding to federal agencies to establish or expand programs
dealing with prevention, treatment and recovery. Highlights from the 70 bills in the
package include funding that requires the Food and Drug Administration to dole out
prescription opioid pills in smaller quantities and money that offers an incentive to the
National Institutes of Health to prioritize the development of non-addictive
painkillers, two solutions medical experts believe could help decrease opioid addiction
in the long run. The package also includes Ohio Republican Sen. Rob Portman's
Synthetics Trafficking and Overdose Prevention Act "STOP" Act, a bill endorsed by
President Donald Trump because it establishes parameters to crack down on shipments
of fentanyl, a synthetic opioid, from entering the U.S.
Warrant: Steps are being taken to reduce the manufacturing of frequently misused opioids.
Hellmann, Jessie. “Trump Administration Cracking down on Production of Prescription

Opioids.” TheHill, The Hill, 16 Aug. 2018, thehill.com/policy/healthcare/402157-
trump-administration-cracking-down-on-production-of-prescription-opioids.
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The Trump administration is using new powers to propose a significant decrease in how
many opioids drug companies can manufacture in the U.S. in 2019. The Justice
Department and Drug Enforcement Administration (DEA) are proposing an average 10
percent decrease next year in the manufacturing quotas for six frequently misused
opioids. “We’ve lost too many lives to the opioid epidemic and families and
communities suffer tragic consequences every day,” said acting DEA Administrator
Uttam Dhillon.“This significant drop in prescriptions by doctors and DEA’s production
quota adjustment will continue to reduce the amount of drugs available for illicit
diversion and abuse while ensuring that patients will continue to have access to proper
medicine.”
Analysis: This response takes the uniqueness to price controls out of your opponent’s
argument. Right now, there is bipartisan support to fight the opioid crisis and over 70 bills have
passed to curb it. If the problem is solving itself in either world, price controls are not
necessary.
Response: Price controls would decrease the amount of the drugs available to fight opioid
addiction.
Warrant: Price controls create drug shortages. We have seen this in the past with flu vaccines.
Tate, Edward. “Government Price Controls On Prescription Drugs May be More Than
Patients Bargain For”, HealthCare Institute of New Jersey, 7 Oct 2002,
than-patients-bargain-for/
Another even more important consideration is that price controls stifle innovation and
can lead to supply shortages in both the quality and quantity of medications. Consider
the recent flu vaccine shortage. The largest purchaser of the vaccine is the federal
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Vaccines for Children Program. The program buys up nearly 70 percent of all childhood
vaccines at government-set prices and then distributes them to states according to a
federally-set formula. The end result is that vaccines have been distributed to states
where there is no epidemic often leaving a shortage where it is needed. Because the
government controls the price, the vaccine makers are discouraged from producing
more than what the government orders. Vaccine prices have remained stagnant since
1994. Thanks to these price controls, there now are only four developers of childhood
vaccines. That’s down from 20 companies just a few years ago.”
Warrant: Price controls incentivize pharmaceutical companies to leave the market for generic
drugs in search of profit elsewhere.
Sullivan, Thomas. “Increasing Generic Drug Shortages Linked to Government Price

Controls”, Policy & Medicine, 6 May 2018, http://hinj.org/government-price-
controls-on-prescription-drugs-may-be-more-than-patients-bargain-for/
“First, the number of suppliers of generic drugs has dwindled. There were 26 U.S.
vaccine makers in 1967; today there are only six. Supply disruptions are common,
including the possibility that a facility completely shuts down for a protracted time
because of quality or safety problems. Second, unlike in most consumer-goods
industries, many pharmaceutical manufacturers have failed to invest in the technology
and quality-control improvements that would reduce the risks of partial or complete
facility shutdowns—and this despite the FDA’s regularly issued current guidelines for
good manufacturing practices. Behind both problems are the government’s tight price
controls for generic drugs, especially when purchased by Medicare and Medicaid. Low
prices induce drug makers to exit various markets, or at least to reallocate their
manufacturing capacity toward more profitable, patented pharmaceuticals. Low prices
also tend to eliminate the rationale for investments in better manufacturing
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technologies and processes, as shown in a 2009 study conducted by the author and
published in the Journal of Management Science.”
Analysis: This response helps weaken the probability of your opponent’s argument. If there are
fewer companies making the treatment for opioid addiction, fewer people get treated. As such,
fewer people have access to it on net.
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PRO – Price controls decrease hospital costs
Argument: Because hospitals spend so much money on
Warrant: Medicine prices are going up
Howard, Jacqueline Howard. “EpiPen Cost Soars, but It’s Not the Only Drug To.” CNN, 25
Aug. 2016, https://www.cnn.com/2016/08/23/health/epipen-price-mylan-
prescription-drugs-increase/index.html.
Net spending on prescription drugs by consumers in the United States has increased
about 20% between 2013 and 2015, according to a new paper published in the Journal
of the American Medical Association on Tuesday. Prescription drugs also cost about
twice as much in the United States compared to other advanced nations. In other
words, EpiPens are not the only prescription drugs with steep price hikes. For instance,
when Turing Pharmaceuticals increased the cost of Daraprim, a drug used by some
cancer and AIDS patients, from $13.50 to $750 last year, it sparked outrage. The
pharmaceutical company's former CEO was Martin Shkreli, known as "pharma bro."
Albuterol, an asthma medicine, has also increased in price in recent years. A House of
Representatives report found in 2014 that 10 generic drugs experienced price
increases just a year prior, ranging from a 420% hike to more than 8,000%. Now, the
new study suggests that a combination of market exclusivity provisions granted to drug
manufacturers, and coverage requirements imposed on government-funded drug
benefits, are both driving the high costs of prescription drugs nationwide.
Warrant: Rising medicine costs hurt hospitals’ abilities to operate
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Kacik, Alex. “Surging Price of Branded Drugs Squeezing Healthcare Providers’ Bottom
Lines.” Modern Healthcare, 4 May 2017,
http://www.modernhealthcare.com/article/20170504/NEWS/170509935.
Drug prices often increase because there aren't enough manufacturers making
alternatives. Specialty drugs such as Enbrel, Gilenya, Harvoni and Humira will not have
low-cost generics enter the market anytime soon, the study said. It cited reasons
including complex and complicated approval processes and patents that translate to
difficult and expensive development as well as existing patents that are valid for five
years or longer. "It's not only because the drugs are expensive to make, these
pharmaceutical companies are excellent litigators," said Knoer, adding that
pharmaceutical companies have paid manufacturers not to develop generics. "They will
fiercely litigate to protect and keep their patents.” In a related 2016 study sponsored by
the American Hospital Association, 57% of hospital administrators reported that
higher drug prices have had a moderate impact on their budgets, while 33.8% said the
impact was severe. Hospitals have changed employee compensation models and
delayed upgrades in facilities and technology due to increases in drug costs, the CEOs of
the American Hospital Association and the Federation of American Hospitals said in
another 2016 report.
Warrant: Price controls will decrease healthcare costs
Langwell, Kathryn. “Price Controls: On the One Hand… And on the Other.” Health Care
Financing Review, vol. 14, no. 3, 1993, pp. 5–10.
Adopting a nationwide system of price controls, such as the use of Medicare payment
rules under an all-payer system (which is the topic of this issue of the Review), would
avoid some, but not all, of these potential effects. In particular, price controls would
have greater potential for reducing health care costs when applied uniformly to the
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whole health care system, because cost shifting among services and payers is less
likely to be an issue. Thus, a Medicare-based all-payer system that extends to all
consumers and covers both hospital and physician services would probably reduce
spending by more than an all-payer system for physicians only. In addition, access to
care would be less likely to be differentially affected if price controls were applied
uniformly within a geographic region. Volume responses, however, would still be
possible, even within a national system of controlled prices. Further, such responses
could be large enough to reduce potential savings substantially, unless price controls
were combined with systematic utilization monitoring and review of all providers. A
recent study by Sandra Christensen (1993) of the U.S. Congressional Budget Office
(CBO) suggests that, if providers offset 55 percent of the potential savings under a
Medicare-based all-payer system for hospitals and physicians, significant savings in
health spending for these services could still be achieved.
Impact: A decrease in hospital expenses helps patients
Russo, PIERANTONIO. “Health Care Efficiency: Measuring the Cost Associated With
Quality.” Managed Care Magazine, 26 July 2015,
https://www.managedcaremag.com/archives/2015/7/health-care-efficiency-
measuring-cost-associated-quality.
A more complex method, stochastic frontier analysis (SFA) (Rosko 2008), compares an
individual hospital’s performance with an ideal “frontier” of best performance.
However, most of the earlier SFA studies have produced analyses of operational
efficiency and don’t address the quality of care. For example, Valdmanis, Rosko, and
Mutter found that most efficient hospitals have lower cost per case mix-adjusted
admission, fewer full-time equivalents per case mix-adjusted admission, and higher
operating margins (Valdmanis 2008). Recently, though, SFA studies have included
measures of true health care efficiency by adjusting for outcomes and risk (Mutter
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2008). For example, Deily and McKay demonstrated that a higher risk-adjusted
mortality rate in Florida hospitals was associated with higher hospital cost and
reduced hospital operational efficiency (McKay 2008). SFA analyses hold the promise
of being able to adjust the cost of care for quality indicators, including hospital
readmission and access to ambulatory care, and for risk factors such as patient
demographics and burden of illness (Rosko 2010).
Analysis: This is a good argument because an overall increase in the efficiency of hospitals will
help everyone with medical problems, regardless of whether they are related to drugs with
rising prices. This makes the argument easy to weigh because the scope is much larger than
anything the con could impact to.
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A/2 - Price controls decrease hospital costs
Response: Hospitals are inefficient
Warrant: 30 percent of spending is wasted
Graban, Mark. Cut Costs by Reducing Redundant or Inefficient Activity. 9 Aug. 2011,
https://www.hhnmag.com/articles/4753-cut-costs-by-reducing-redundant-or-
inefficient-activity.
Many hospital CEOs, including John Toussaint, M.D., the former CEO of ThedaCare,
and thought leaders, including Donald Berwick, M.D., M.P.P., administrator for the
Centers for Medicare & Medicaid Services, estimate that 30 to 50 percent of all health
care spending can be described as waste — activity that provides no benefit to
patients. This adds up to more than $1 trillion a year in the United States. Instead of
merely slashing reimbursements or providing less care, there is a clear opportunity to do
more — and provide the right care — with less waste and less spending. The word
"waste," or muda in Japanese, is one of the most commonly used terms in Lean
management, which is based on the Toyota Production System. According to Toyota,
there are eight types of waste, each of which can be translated directly into health care:
Warrant: There are many types of waste
Bentley, Tanya G. K., et al. “Waste in the U.S. Health Care System: A Conceptual
Framework.” The Milbank Quarterly, vol. 86, no. 4, Dec. 2008, pp. 629–59.
PubMed Central, doi:10.1111/j.1468-0009.2008.00537.x.
In order to help reduce waste in the U.S. health care system, we first must understand
the sources of the problem. While many studies have examined different types of
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waste, there has been, to date, no comprehensive conceptual framework to guide

researchers and policymakers in categorizing and developing specific strategies to
address different types of waste. We propose such a framework in this article. This
framework builds on the traditional understanding of waste as a measure of
inefficiency. Conceptually, economists distinguish between two types of inefficiencies:
productive inefficiencies, which create waste in the form of excess costs in producing a
given output, and allocative inefficiencies, which produce the wrong output. Waste in
production is the difference between the cost of producing the item or service under
the current system and the cost of producing it efficiently. Waste in misallocated
outputs is the difference between the cost of the item or service and its actual value.
While these types of inefficiencies differ in theory, they overlap significantly in reality.
For example, additional imaging tests of low value to the patient could be considered a
productive inefficiency, because the output (a diagnosis, in this case) could have been
made with fewer tests and at lower cost.
Analysis: This is a good response because even if the pro can prove that hospitals will free up
more money by spending less on medicine, they will still not be able to spend this new money
efficiently because of how inefficient spending is in general. This means the pro team has no
impact off this argument.
Response: Patients are not affected by hospital expenses
Warrant: Insurance companies insulate patients from high costs
Langwell, Kathryn. “Price Controls: On the One Hand… And on the Other.” Health Care
Financing Review, vol. 14, no. 3, 1993, pp. 5–10.
Cost containment using mechanisms that affect prices could be achieved through
several differing policy approaches. Although direct regulation of prices through
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government intervention has most often been the focus of policy deliberations, market-
oriented health reform proposals also would, if successful, affect prices charged by
providers. For example, under managed competition, which involves considerable
government intervention in the health insurance and health care markets, insurers
would have greater market power to negotiate with providers over price and quantity.
Those who favor market-based approaches argue that relying on the market to
determine fees would allow for greater flexibility in pricing and provide for variations in
quality of care. Proponents of direct price controls believe that the market for health
services is irretrievably flawed. The presence of extensive health insurance renders
consumers insensitive to the price of services. And the inability of consumers, under
many circumstances, to make informed decisions leads to delegation of
decisionmaking to providers who have little incentive to consider costs.
Warrant: Hospitals often overcharge insurance companies
Belk, David. “Hospital Billing.” True Cost of Heathcare, 2017,

http://truecostofhealthcare.org/hospitalization/.
Hospitals see no problem in sending bills to insurance companies for five to ten times
the amount that they actually expect, because they are simply playing the game that
the insurance companies fashioned. But remember, they only produce one kind of bill,
and it’s designed to send to someone who holds all the cards (an insurance company),
and so can just refuse to pay anything they didn’t already agree to pay. That’s their
game. But what happens when you have to play the game with the hospital alone (if you
don’t have insurance, or if your insurance doesn’t cover that stay for some reason).
Then you’re on the hook for the entire amount. Most hospitals have a policy that allows
people to negotiate for a lower amount, but most people don’t know this. And don’t
expect the hospital to tell you about it, let alone help out. So even if you can remember
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to negotiate while you’re convalescing from a long hospital stay, good luck trying to get
the deal the insurance company gets.
Analysis: This is a good argument because even if hospitals have to spend less money on
medicines, this doesn’t necessarily mean that the patients are the ones who benefit. Often,
this only means lower costs for the government or insurance companies, while the people see
no better outcomes. This takes out the whole impact.
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PRO – Price controls decrease insurance premiums
Argument: As the prices of drugs inevitably rise without price controls, the cost of insurance
will go up in order to compensate for that. As a result, price controls will stem these increases.
Warrant: The cost of insurance is rising dramatically
Colarossi, Tony. How the U.S. Can Lower out-of-Control Health-Insurance Premiums -
MarketWatch. 9 May 2016, https://www.marketwatch.com/story/how-the-us-
can-lower-out-of-control-health-insurance-premiums-2016-05-09.
They say in life you can only be certain of two things: death and taxes. But these days
you can add rising health-insurance premiums to that list. Annual health-insurance
premiums for the average family are 4.4% higher in 2016 compared with last year,
now above $16,800. Those increases are hard to take because they advance much
faster than the average paycheck. Between 1999 and 2009, the average U.S. salary
rose 38%, but health-care premiums jumped an incredible 131%. Today, health care
operates on an outdated business model, focused on boosting the volume of patients
and customer satisfaction rather than ensuring better health outcomes. However, a
consumer-centric approach, underpinned by an agreement between the individual and
a health manager, would radically alter how health systems operate.
Warrant: Insurance companies raise premiums because of increasing drug costs
Fielding, Jonathan. “The High Cost of Rising Drug Prices.” US News & World Report, 21
Dec. 2017, https://www.usnews.com/opinion/policy-dose/articles/2017-12-
21/the-high-cost-of-rising-drug-prices.
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Consider insulin, critical to more than 6 million Americans with Type 1 diabetes.
Between 2002 and 2013, drug makers Sanofi, Novo Nordisk and Eli Lilly (under Azar's
leadership) raised prices in lockstep. Their insulin more than tripled in price to as much
as $300 per patient, per month. Closed-door negotiations between drug makers,
insurance companies and middlemen pharmacy benefit managers, which came to light
earlier this year, contributed to these outsize price increases. When list prices rise,
many with health insurance still see their out-of-pocket costs go up. Increasingly high
patient co-payments, which require them to pay a portion of their drug costs, are
based on whether the drugs are generic, preferred branded, other branded or
specialty. The result: costs of some commonly prescribed drugs have become
unaffordable for many patients.Even prices for unproven medications or those with
dubious benefit have skyrocketed. A study conducted before Food and Drug
Administration approval recommended that necitumumab, a lung-cancer drug, ought to
cost between $500 and $1,300 per treatment. Study authors based cost projection on
the drug's likely benefit: giving patients only a few weeks of quality life. Now approved,
necitumumab commands a hefty $11,450 per treatment cycle.
Warrant: Price controls will stop the constant rise in drug prices
Jagaska, Arnav. “Preventing Price Gouging in the Pharmaceutical Industry: A

Comprehensive Policy Approach.” Penn Wharton Public Policy Initative, 16 Mar.
2018, http://publicpolicy.wharton.upenn.edu/live/news/2390-preventing-price-
gouging-in-the-pharmaceutical/for-students/blog/news.php.
Amidst heavy public scrutiny, Chao regained the manufacturing rights from Rodelis and
reduced the price, but the price remained double the original price [21]. However, in the
United States, patents are transferable goods because this allows for flexibility in
research and manufacturing and recognizes the fact that a creator may not be the entity
to bring a product to market [22]. Making patent transfers more regimented may
Champion Briefs 126

consequently make it more difficult to ensure the continued production of a compound.

Currently, bio-pharmaceutical companies in the United States are already required to
provide notice of plans to discontinue the production of a potentially life-saving drug
[23]. The addition of price ceiling in transfer agreements will result in more mindful
and calculated transfer of drugs, which can confer stability to the market in the future.
It will legally preempt price hikes in the industry.
Impact: Rising premiums decrease access to medical care
Davis, Matthew. Effects of Rising Health Insurance Premiums. 2016,

http://www.nber.org/digest/aug05/w11063.html.
Overall, Baicker and Chandra believe "it is possible that a significant portion of the
increase in the uninsured population may be a consequence of employers shedding this
benefit as health insurance premiums rise." They point out that a 34 percent rise in
premiums during the 1990s is probably the reason why, despite strong economic
growth in the decade, the number of uninsured grew 3 percentage points to 15.7
percent of the population. In Wage and Benefit Changes in Response to Rising Health
Insurance Costs (NBER Working Paper No. 11063), co-authors Dana Goldman, Neeraj
Sood, and Arleen Leibowitz offer further evidence of the far-reaching effects of health
insurance inflation. They show that rising health costs are forcing many employees who
want to retain coverage to surrender both income and benefits. These authors
examined the response to health insurance costs among almost 3000 employees at a
single large firm. Like a growing number of workers today, these employees are offered
what are known as "defined-contribution benefit plans." Such plans offer a base
amount of coverage for a variety of areas, such as health, life insurance, disability, and
retirement. If employees want additional coverage in any area, they can either pay for
it outright from their pre-tax earnings or reduce benefits in one area and shift them to
another.
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Analysis: This is a good argument because losing access to insurance means that not only will
people not have access to the drugs that see price increases, but they will also not have access
to all other medical care as well. This easily outweighs all con arguments because those likely
only have to do with the medicines themselves.
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A/2 - Price controls decrease insurance premiums
Response: Insurance premiums take too long to go down
Warrant: Insurance companies will take their time to adjust
O’brian, Elizabeth. “Several of the Biggest Pharma Giants Are Freezing Drug Prices.
Here’s How It Will Affect You.” Money, 25 July 2018,
http://time.com/money/5347360/drug-prices-freezes-costs-big-pharma/.
Even if the recently announced drug price freezes or cuts translate into some savings
for insurers, it’s not at all a given that insurers will pass along those savings directly to
patients taking that particular drug, Purvis cautions. For starters, many health plans
don’t make changes to their formulary — that’s their list of covered drugs and pricing
schemes — mid-year. And even if your drug is getting a price cut, insurers could choose
to pass savings along more broadly next year, by limiting price hikes for all covered
consumers, Purvis says. That’s because insurers usually pass high drug costs on to
customers in the form of higher copayments, coinsurance, premiums and deductibles.
So while more modest price increases for your medications could benefit everyone on
your plan, they won’t necessarily mean a huge change for you, Purvis notes. Experts
argue that — rather than relying on one-off actions by manufacturers — the health
care system actually needs structural changes to meaningfully lower drug prices.
Warrant: The price of drugs is a drop in the bucket
Sisson, Paul. “Why Our Health Care Costs so Much — and Why Fixes Aren’t Likely.”
Sandiegouniontribune.Com, 18 Mar. 2017,
http://www.sandiegouniontribune.com/news/health/sd-me-healthcare-costs-
20170318-story.html.
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“The biggest reason is that we have higher prices for health-care services in the U.S.
than other countries have,” said Cynthia Cox, associate director of the Program for the
Study of Health Reform and Private Insurance at the nonpartisan Kaiser Family
Foundation. “We pay our doctors more, we pay our hospitals more, we pay more for
our drugs,” said Geoffrey Joyce, a health-care economist with the Schaeffer Center for
Health Policy and Economics at the University of Southern California. The
Commonwealth study found that among industrialized nations, there were significant
pricing differences for many medical procedures. An MRI scan in the U.S. cost $1,145
on average in 2013, compared with $138 in Switzerland, $350 in Australia and $461 in
the Netherlands. An appendectomy cost $6,645 in New Zealand and $13,910 in
America. The U.S. has experimented with many ways to reduce skyrocketing medical
costs, including moving to the health management organization model — HMOS — in
the 1980s and ’90s and, more recently under Obamacare, to systems that allow health
providers to keep part of the money they save as long as the quality of patient care
remains high.
Analysis: This is a good response because it functionally delays the impact of the pro’s
argument indefinitely. Since insurance companies want to make money, it makes sense that
they will only decrease premiums if they absolutely have to. Thus, it would take too long for
this impact to materialize, by which point the price cap may have been raised anyway. This
makes the argument much easier to weigh against because the impact is so far in the future.
Response: Insurance companies will keep premiums high
Warrant: Price controls will increase the cost of insurance
Miller, Tracy. Obamacare Repeal Can’t Ignore Price Controls | RealClearHealth. 2 May
2017,
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https://www.realclearhealth.com/articles/2017/05/02/obamacare_repeal_cant_
ignore_price_controls_110574.html.
But requiring insurance companies to charge the same premium to everyone has
made selling coverage through the exchanges unprofitable for many of them. Healthy
people have little incentive to buy coverage that costs them much more than it
should, and the penalties for being uninsured are relatively small. This creates a cycle
in which, without those healthy participants, the average health of the insured
population declines. Costs go up, making it harder for insurance companies to keep
premiums affordable and still make a profit. Instead of requiring insurance companies
to charge the same premium on the individual market for people with pre-existing
conditions as everyone else, the federal government could fund reinsurance to keep
premiums down for those who have maintained continuous coverage. Doing this—
while also allowing insurance companies to lower prices for healthier people—would
require another source of revenue. It might be necessary to maintain one or more of the
types of taxes within the ACA, such as the Cadillac tax, which gradually reduces the tax
deduction for employer-sponsored insurance plans.
Warrant: The problem is with monopolization, not drug prices
Alex, Kacik. “Monopolized Healthcare Market Reduces Quality, Increases Costs.”

Modern Healthcare, 13 Apr. 2017,
http://www.modernhealthcare.com/article/20170413/NEWS/170419935.
Consolidation will continue to drive up healthcare costs and reduce quality of care
unless lawmakers and regulators push policy reforms and rules aimed at increasing
competition, according to new research. As providers increasingly look to consolidate
in order to lower operating costs and create economies of scale, the Center for Health
Policy at the Brookings Institution and Carnegie Mellon University's Heinz College on
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Thursday said the trend has led to a dearth of competition. That's why the healthcare
industry sees rising prices, price variation and uneven quality of care, according to the
groups' white paper. The past 15 years have seen significant consolidation in hospital,
physician and insurance markets, and that trend is expected to continue.
Analysis: Insurance companies will likely never decrease premiums even if the cost of medicine
goes down. This means that even if the pro is able to prove that in a perfect world, the cost of
insurance would fall, that does not necessarily follow through in the real world.
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PRO – Price controls increase government medical coverage
Argument: Because price controls lower the cost that the government spends on medicines for
people on government medical programs, they will free up money to be allocated toward other
important aspects of the program.
Warrant: Healthcare costs are rising because of government programs
Amadeo, Kimberly. “See for Yourself If Obamacare Increased Health Care Costs.” The
Balance, 15 Sept. 2018, https://www.thebalance.com/causes-of-rising-
healthcare-costs-4064878.
In 2016, U.S. health care costs were $3.3 trillion. That makes health care one of the
country's largest industries. It equals 17.9 percent of gross domestic product. In
comparison, health care cost $27.2 billion in 1960, just 5 percent of GDP. That
translates to an annual health care cost of $10,348 per person in 2016 versus just $146
per person in 1960. Health care costs have risen faster than the average annual
income.Health care consumed 4 percent of income in 1960 compared to 6 percent in
2013. There were two causes of this massive increase: government policy and lifestyle
changes. First, the United States relies on company-sponsored private health
insurance. The government created programs like Medicare and Medicaid to help
those without insurance. These programs spurred demand for health care services.
That gave providers the ability to raise prices. A Princeton University study found that
Americans use the same amount of health care as residents of other nations. They just
pay more for them. For example, U.S. hospital prices are 60 percent higher than those
in Europe. Government efforts to reform health care and cut costs raised them instead.
Warrant: Medicine covered by medicare is increasing in cost
Champion Briefs 133

Drash, Wayne. “Medicare Drug Prices Soar at 10 Times Rate of Inflation, Report Says.”
CNN, 26 Mar. 2018, https://www.cnn.com/2018/03/26/health/report-medicare-
drug-prices-soaring/index.html.
The report examined the costs of the 20 most-prescribed drugs under the Medicare
Part D program from 2012 to 2017. It found that the drug Nitrostat, used to relieve
chest pain, had increased the most: a percentage change of 477%. Zostavax, prescribed
for shingles among seniors, had the lowest percentage increase but was still high: 31%
over five years. Twelve of the 20 drugs saw their prices increase by more than 50%
over the five-year period and six had price increases of over 100%, the report found.
Although 48 million fewer prescriptions were written for the top 20 most commonly
prescribed brand-name drugs from 2012 to 2017, the report found that total sales
revenue from these prescriptions increased by almost $8.5 billion during that period.
The Pharmaceutical Research and Manufacturers of America, an industry group that
represents leading pharmaceutical companies, sharply criticized the report. "This is yet
another misleading report that ignores the robust negotiation that occurs between
Medicare Part D plans, middlemen and biopharmaceutical companies," Juliet Johnson, a
spokeswoman for PhRMA, said in a written statement. "Negotiated rebates can reduce
list prices by as much as 30 to 70 percent for medicines used to treat diabetes, high
cholesterol, and chronic respiratory illnesses. Notably, half of the 20 brand medicines in
this report are used to treat these chronic conditions.
Warrant: Rising prices are hurting Medicaid
Lupkin, Sydney. Rising Price of Old Drugs Costs Medicaid Billions. 11 Aug. 2017,
https://www.thedailybeast.com/rising-price-of-old-drugs-costs-medicaid-
billions.
Champion Briefs 134

Skyrocketing price tags for new drugs to treat rare diseases have stoked outrage
nationwide. But hundreds of old, commonly used drugs cost the Medicaid program
billions of extra dollars in 2016 vs. 2015, a Kaiser Health News data analysis shows.
Eighty of the drugs—some generic and some still carrying brand names—proved more
than two decades old. Rising costs for 313 brand-name drugs lifted Medicaid’s
spending by as much as $3.2 billion in 2016, the analysis shows. Nine of these brand-
name drugs have been on the market since before 1970. In addition, the data reveal
that Medicaid’s outlays for 67 generics and other non-branded drugs cost taxpayers an
extra $258 million last year. Even after a medicine has gone generic, the branded
version often remains on the market. Medicaid recipients might choose to purchase it
because they’re brand loyalists or because state laws prevent pharmacists from
automatically substituting generics. Drugs driving Medicaid spending increases ranged
from common asthma medicines like Ventolin to over-the-counter painkillers, like the
generic form of Aleve, to generic antidepressants and heartburn medicines.
Impact: Increased Medicaid spending helps the poorest Americans
Wagnerman, Karina. “Research Update: Medicaid Pulls Americans Out Of Poverty.”

Center For Children and Families, 20 Nov. 2017,
https://ccf.georgetown.edu/2017/11/20/research-update-medicaid-pulls-
americans-out-of-poverty/.
The authors developed the first health-inclusive poverty measure that factors in both
the need for health insurance and the value of health benefits as resources to meet that
need. They compare the impacts of different health insurance programs to non-health
programs, such as social insurance, means-tested cash, and in-kind benefits and
refundable tax credits. They examine the population under age 65. Medicaid is among
the most effective antipoverty programs. Medicaid reduced the health inclusive
poverty measure by 3.8 percentage points. This is comparable to the combined effect
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of all social insurance programs and greater than the effects of means-tested benefits
and refundable tax credits. (See Exhibit 2 copied at the bottom. Medicaid had a larger
effect on child poverty than all non-health means tested benefits combined. It is
estimated to reduce child poverty by 5.3 percentage points. Medicaid is particularly
important for people of color. It reduced the poverty rates of Hispanics by 6.1
percentage points and African Americans by 4.9 percentage points (in households with
no disability recipients). Health insurance benefits are important to families who receive
them. Medicaid reduced poverty among its beneficiaries by 17.1 percentage points.
This is higher than other types of insurance: ESI reduced poverty by 5 percentage points
for those it covered and premium subsidies reduced poverty by 6.6 percentage points
for those it covered.
Analysis: This is a good argument because it impacts to the most vulnerable sectors of society.
This makes it easy to weigh against any neg argument because you can simply say that even if
they are able to benefit all of society by a larger amount, a smaller magnitude felt by those
most in need actually has a bigger impact because they had less to begin with.
Champion Briefs 136

A/2 - Price controls increase government medical coverage
Response: Government medical programs are inefficient
Warrant: Price controls reduce quality of care
Nix, Kathryn. “Government Price Controls for Health Care: A Deficit-Reduction Strategy
to Avoid.” The Heritage Foundation, 30 Nov. 2011, /health-care-
reform/report/government-price-controls-health-care-deficit-reduction-
strategy-avoid.
The federal government sets prices for services paid for by Medicare, Medicaid, and
the Veterans Administration (VA) employing a variety of mechanisms, with a variety
of consequences. Medicare’s complex fee schedules overpay providers for some
services, underpay them for others, and therefore do not reflect the value of medical
goods and services accurately. As a result, providers who treat Medicare beneficiaries
are encouraged by perverse financial incentives to offer inefficient, less-effective care.
Seniors receive unnecessary tests and treatments, have less time with their physicians,
and face mounting barriers to access to physicians’ services. Price controls for drug
coverage have been just as damaging. Low payment for prescription drug coverage by
Medicaid and the VA increases costs for other purchasers and bars access to effective
treatments using restrictive formularies. Across the board, price-setting in health care
has failed to produce expected savings, meanwhile devastating the quality of, as well
as access to, health care. The only way to undo the damage wrought by decades of
government price controls is to address the true causes of the problems of America’s
health care system with market-oriented reforms.
Warrant: Medicaid wastes money and increases costs relative to private insurance
Champion Briefs 137

Donlan, Thomas G. A Funding Mess in the Medicaid Program. 19 Mar. 2016,

http://www.barrons.com/articles/a-funding-mess-in-the-medicaid-program-
1458363194.
Medicaid is also inefficient: Even though it pays less for a given procedure than the
average for private health insurance, the providers make it up on volume. Medicaid
spending per beneficiary is 40% greater than spending per beneficiary of private
insurance. After several major expansions of eligibility, the Medicaid program now has
more than 70 million beneficiaries, which is more than 20% of the U.S. population.
About a quarter of all states’ spending goes to their Medicaid programs, although
every state’s program is different, and most states cover more people and services
than the federal mandatory minimums. Free money from the feds looks like the most
likely reason that states are so generous.
Analysis: This is a good response because even if the pro can prove that price controls free up
money for government programs, there is no guarantee that money will be spent efficiently. In
fact, it likely will not because of how inefficient the government is, meaning their impact is
nonexistent.
Response: Other problems will get in the way
Warrant: The overall increase in cost of medicaid is caused by nursing home expenses
Holahan, John, et al. “Explaining The Recent Growth In Medicaid Spending.” Health
Affairs, vol. 12, no. 3, Jan. 1993, pp. 177–93. healthaffairs.org (Atypon),
doi:10.1377/hlthaff.12.3.177.
Exhibit 5 displays increases in prices nationally for Medicaid-covered services. Average

annual price growth for inpatient hospital services and nursing homes was slower
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than for most other services in the 1988-1992 period. However, price increases for
these two sectors contributed the most to Medicaid expenditure increases. This share
reflects the overall predominance of these services in Medicaid spending, rather than
particularly high price increases. Payments to hospitals and nursing homes accounted
for more than half of total Medicaid expenditures in 1992. Prescription drug prices
had the highest rate of growth and alone accounted for 2.7 percent (or $1.7 billion) of
Medicaid spending growth despite being a relatively small item in Medicaid budgets.
The important conclusion here is that rapid escalation in health care prices is largely
outside of Medicaid's control, assuming the program seeks to maintain access. Clearly,
Medicaid spending will continue to increase along with overall health cost increases.
Warrant: Price controls will worsen care that is offered
Winegarden, Wayne. Pacific Research Institute | The Price Control Hammer Will Break
the Health Care System. 17 Oct. 2017, https://www.pacificresearch.org/the-
price-control-hammer-will-break-the-health-care-system/.
To start, price controls are irrelevant for most patients. Nearly 90 percent of all drugs
dispensed are generic medicines. Not only are generics significantly cheaper in the U.S.,
the prevalence of cheap generics helps explain why total pharmaceutical spending as a
percentage of total health care spending is lower in the U.S. (12.2 percent) compared to
the average OECD country (16.9 percent). Price controls will harm patients who benefit
from patented medicines, however. To see why, imagine the consequences if the
government capped the salary of doctors at the U.S. median income level. Surely
many doctors would cease practicing, causing a doctor shortage to arise. Over time,
this doctor shortage would worsen as more young people would be discouraged from
entering the field. Ultimately, the quality of health care would decline, and total costs
would increase as untreated minor afflictions would become more expensive
ailments.
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Analysis: This is a good response because it functionally gives the negative team more offense
in the round by giving additional reasons price controls are bad, which complicate the impact of
the pro. If other factors are causing prices to rise and if the care that will be provided will be of
low quality anyway, then surely an increase in access to care will neither result from price
controls nor help if it did.
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PRO– High Drug Prices driving consumers to the black market
Argument: High drug prices means that consumers are left to find similar, more affordable
medicine elsewhere. The black market and other secondary markets serve as avenues to do so.
Warrant: High drug prices make drugs unaffordable
Fielding, Jonathan. “The High Cost of Rising Drug Prices.” U.S. News & World Report,
U.S. News & World Report, 21 Dec. 2017, <www.usnews.com/opinion/policy-
dose/articles/2017-12-21/the-high-cost-of-rising-drug -prices.>
Lowering drug prices is long overdue, but this report shows what patients are up
against. Right now, spending on prescription drugs rises at a rate faster than any other
health care cost. Growing numbers of Americans can't afford their medications,
forcing too many to skip them altogether. Alex Azar, President Donald Trump's pick for
health and human services secretary, told a Senate Committee last month that bringing
drug prices down would be his top priority, confirming this is the president's priority as
well. Encouraging words, but choosing Azar as a change agent is ironic. Consider insulin,
critical to more than 6 million Americans with Type 1 diabetes. Between 2002 and 2013,
drug makers Sanofi, Novo Nordisk and Eli Lilly (under
Azar's leadership) raised prices in lockstep. Their insulin more than tripled in price to as
much as
$300 per patient, per month. Closed-door negotiations between drug makers, insurance
companies and middlemen pharmacy benefit managers, which came to light earlier this
year, contributed to these outsize price increases. When list prices rise, many with
health insurance still see their out-of-pocket costs go up. Increasingly high patient co-
payments, which require them to pay a portion of their drug costs, are based on
whether the drugs are generic, preferred branded, other branded or specialty. The
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result: costs of some commonly prescribed drugs have become unaffordable for many
patients.
Warrant: High prices incentivizes a shift to the black market
Edwards, Sam. “Interest in Black-Market Medications Climbs with Rising Pharmaceutical

Prices.” Online Allied Health and Medical School Education Courses by Orion
College, 14 June 2017, <orioncollege.org/blog/interest-in-black-market-
medications-climbs-with-rising-pharmac eutical-prices/.>
“However, it’s also more common than you probably think. As prices for life-saving
drugs hit an all-time high, patients have begun to seek black-market medications in
their desperate attempts to stay healthy. The risks of trading and buying drugs on the
black market are pretty obvious. The FDA has no way to regulate these
pharmaceuticals. There’s also the risk of substance abuse. You could be trading with
drug addicts, which is dangerous for you and for them. Thus, the practice is illegal and
strongly ill-advised. The government has made some efforts to tighten the drug supply
chain, but the solution is not necessarily simple. Making arrests and shutting down illicit
online groups is often ineffective and consumes more resources than government
institutions can spare. Most people who turn to the black market are fully aware of the
risks, but do it anyway. They see no other option when drug prices are rising and
health insurance doesn’t cover what they need.”
Impact: Medicines sold on the black market are often lower-quality. Lower quality drugs hurt
patients
Bate, Roger. “Bad Medicine.” Foreign Policy,

<https://foreignpolicy.com/2013/10/04/bad-medicine/>. Accessed 7 Oct. 2018.
Champion Briefs 142

Frighteningly, the problems with Ranbaxy are not isolated incidents. Over the past six
years, my research group has sampled thousands of medicines used to treat
tuberculosis, malaria, and major bacterial infections in emerging markets. Of these
medicines, 3,695 were allegedly made by Indian companies. We tested them for
quality and published the results in peer-reviewed publications. In short, the results
were not good. Pulling all the data together, I wanted to see whether the problems
occurring at Ranbaxy were repeated by other Indian producers. After removing falsified
samples, which were obviously counterfeited (they had no active ingredients, and the
packaging was flawed), just over 5 percent of products failed quality-control tests. There
is no evidence to suggest these samples were not made in India by the supposedly
reputable firms identified on the labels. (More detailed data analysis can be found
here.) To put this finding in human terms: Given that probably over 100 million people
around the world take Indian drugs every week, if one in 20 of those drugs doesn’t
work, millions of patients are not taking the medicines they need.
Impact: Black market medicine can be deadly. Patients with diabetes are notably at risk
Black Market Insulin: Life-Saving Medication or Major Health Risk?” The Center for Safe
Internet Pharmacies (CSIP), 13 Nov. 2017, <safemedsonline.org/2017/08/black-
market-insulin-life-saving-medication-or-maj or-health-risk/.>.
"Individuals are countering this high price by turning to black market trading and
purchasing of insulin via online sources that may or may not be legitimate. According
to a 2017 NBC News article, “soaring insulin prices and inflexible insurance prices” are
forcing parents to purchase or make deals via the Black Market for needed insulin for
their children. But how do you know you are getting the medication you need?
Counterfeit insulin pens, and test strips have been found on the marketplace and can
result in injury or death if a patient who needs insulin, ends up dosing incorrectly or
has an insulin pen that is fake and doesn’t work.”
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Analysis: Given the amount of literature that exists surrounding the black market, this could be
a really cool argument to run. I think the strategy comes in identifying the fact that medicine is
an inelastic good, meaning that people will pay whatever they need to just to have the
medicine. If there is a medicine that can save your life, people aren’t really going to think twice
about the cost. Therefore, the link that high prices is leading people to find risky alternatives
makes a lot of sense intuitively and can appeal to both lay and flow judges.
Champion Briefs 144

A/2– High Drug Prices driving consumers to the black market
Answer: Most consumer medicine is cheap and affordable already
Warrant: 90% of all consumer medicines are generic and relatively cheap
Winegarden, Wayne. “Price Controls Will Reduce Innovation and Health Outcomes.”
Forbes, Forbes Magazine, 12 Oct. 2017,
<www.forbes.com/sites/econostats/2017/10/12/price-controls-will-reduce-
innovat ion-and-health-outcomes/#32f4201363a6.>
“To start, the price controls would be irrelevant for most patients. Nearly 90 percent
of all drugs dispensed in the U.S. in 2016 were generic medicines, according to IMS
Health. Therefore, any price control scheme would not apply to the majority of
patients who are using inexpensive generics, not more expensive patented products.
It is also important to note that generic medicines are significantly cheaper in the U.S.
spending as a percentage of total health care spendingis lower in the U.S. (12.2 percent)
nations.”
Response: Price controls would create drug shortages which limit drug access, only incentivizing
more people to turn to the black market
Warrant: Price controls cause shortages
Champion Briefs 145

Reisman, George. “Price Controls and Shortages | George Reisman.” FEE, Foundation for
Economic Education, 1 Feb. 1980, <fee.org/articles/price-controls-and-
shortages/.>
“The one consequence of price controls that is the most central and the most
fundamental and important from the point of view of explaining all of the others is
the fact that price controls cause shortages. A shortage is an excess of the quantity of
a good buyers are seeking to buy over the quantity sellers are willing and able to sell.
In a shortage, there are people willing and able to pay the controlled price of a good,
but they cannot obtain it. The good is simply not available to them. Experience of the
gasoline shortage of the winter of 1974 should make the concept real to everyone. The
drivers of the long lines of cars all had the money that was being asked for gasoline and
were willing, indeed, eager, to spend it for gasoline. Their problem was that they simply
could not obtain the gasoline. They were trying to buy more gasoline than was available.
The concept of a shortage is not the same thing as the concept of a scarcity. An item can
be extremely scarce, like diamonds, Rembrandt paintings, and so on, and yet no
shortage exist. In a free market the effect of such a scarcity is a high price. At the high
price, the quantity of the good demanded is levelled down to equality with the supply
available, and no shortage exists. Anyone willing and able to pay the free-market price
can buy whatever part of the supply he wishes; the height of the market price
guarantees it, because it eliminates his competitors. It follows that however scarce a
good may be, the only thing that can explain a shortage of it is a price control, not a
scarcity. It is a price control that prevents the price of a scarce good from being raised
by the self-interest of the buyers and sellers to its free-market level and thus reducing
the quantity of the good demanded to equality with the supply of the good available.
Of course, if a price control on something exists, and a scarcity of it develops or grows
worse, the effect will be a shortage, or a worsening of the shortage. Scarcities can
cause shortages, or worsen them, but only in the context of price controls. If no price
Champion Briefs 146

control existed, the development or worsening of a scarcity would not contribute to any
shortage; it would simply send the price higher..”
Warrant: Shortages and artificially adjusted prices incentivize a shift to the black market
Coyne, Christopher, and Rachel Coyne. “Price Controls and the Damage They Cause.”
IEA, Institute of Economic Affairs, 2015, <iea.org.uk/wp-
content/uploads/2016/07/Coyne-Interactive.pdf.>
“The emergence of crime and black markets are another indirect negative effect of
price controls. Unable to adjust prices legally, producers and buyers may move into
the extralegal market to engage in exchange. Others, desperate to obtain goods for
which there is a shortage, may engage in theft to obtain goods. To provide one
illustration of black market activities, consider the case of farmers in the UK in World
War II. Facing wartime meat rationing, many farmers under-reported animal births to
the Ministry of Food and then sold the additional meat in the black market.”
Analysis: While the first response is inherently mitigatory, the second response functions as a
pretty neat turn. By showing that the amount of drugs on the market will go down, it is a pretty
easy path to prove that there will be shortages in the market, only creating more of a need for
people to turn to the black market.
Champion Briefs 147

PRO– High Drug Prices Strain State Budgets
Argument: High drug prices put a strain on state budgets, which in turn means higher costs for
things like Medicaid.
Warrant: High drug prices strain state budgets
Nguyen, Quynh Chi, and Michael Miller. “Addressing Out Of Control Prescription Drug
Prices Federal and State Strategies.” Community Catalyst, Community Catalyst,
May 2018,
<www.communitycatalyst.org/resources/publications/document/2018/CC-
PrescripDrugPrices-Report-FINAL.pdf.>
“Escalating drug prices are also straining state budgets. Between 2013 and 2014,
Medicaid prescription drug spending rose more than 24 percent. This large increase in
spending creates a challenge for policymakers. With few tools for addressing spending
growth, a number of states have taken harmful measures such as cutting prescription
drug benefits, imposing prescription drug copays and curtailing the use of new
medicines that many people depend on.”
Warrant: States buy a lot of prescription drugs
Lowering Drug Costs: Transparency Legislation Sets Off Flurry of New State
Approaches.” NASHP, 7 May 2018,
<nashp.org/lowering-drug-costs-transparency-legislation-sets-off-flurry-of-new-
state-app roaches/>
“States are large purchasers of prescription drugs for a number of programs and
agencies, such as Medicaid, prisons, and state employee benefits. Escalating drug
Champion Briefs 148

prices have put pressure on states to create legislation to improve the sustainability of
their budgets and ensure health care access for their residents. Some of the more
ambitious proposed legislation requires manufacturers to justify prices, particularly for
new drugs or for large year-after-year increases for older drugs that strain state
budgets. Other states plan to use their authority to take action under long-standing
“unfair business practices” laws. By increasing the transparency of prescription drug
prices, lawmakers hope to be better equipped to manage costs and lower the burden on
taxpayers and health care consumers. Here are brief highlights of state transparency
proposals.”
Impact: Rising prices has devastating effects
Lupkin, Sydney. “Climbing Cost Of Decades-Old Drugs Threatens To Break Medicaid

Bank.” Kaiser Health News, Kaiser Health News, 14 Aug. 2017,
<khn.org/news/climbing-cost-of-decades-old-drugs-threatens-to-break-
medicaid-bank/>
Skyrocketing price tags for new drugs to treat rare diseases have stoked outrage
nationwide. But hundreds of old, commonly used drugs cost the Medicaid program
billions of extra dollars in 2016 vs. 2015, a Kaiser Health News data analysis shows.
Eighty of the drugs — some generic and some still carrying brand names — proved
more than two decades old. Rising costs for 313 brand-name drugs lifted Medicaid’s
spending by as much as $3.2 billion in 2016, the analysis shows. Nine of these brand-
name drugs have been on the market since before 1970. In addition, the data reveal
that Medicaid outlays for 67 generics and other non-branded drugs cost taxpayers an
extra $258 million last year. Even after a medicine has gone generic, the branded
version often remains on the market. Medicaid recipients might choose to purchase it
because they’re brand loyalists or because state laws prevent pharmacists from
automatically substituting generics. Drugs driving Medicaid spending increases ranged
Champion Briefs 149

from common asthma medicines like Ventolin to over-the-counter painkillers like the
generic form of Aleve to generic antidepressants and heartburn medicines.
Impact: Any threat to Medicaid poses major consequences
Craig, Gregory. “Why Medicaid Is More Important Than Ever.” Capitol Beat, 2016,
<anacapitolbeat.org/2018/04/05/why-medicaid-is-more-important-than-ever/.>.
"Too often overlooked in recent debates is the role that Medicaid plays in children’s
healthcare coverage. Of the 74 million Americans covered by Medicaid, nearly 36
million are children enrolled in Medicaid and the Children’s Health Insurance Program
(CHIP) – which was enacted in 1997 to ensure affordable and accessible healthcare
coverage for low-income children. Roughly 38 percent of American children receive
healthcare services through these two programs, and they have been critical in
increasing the percentage of American children with health insurance coverage to a
historic high of 95.5 percent in 2016. Medicaid and CHIP are particularly important to
some of the nation’s most vulnerable children – 76 percent of children living in
poverty, 48 percent of children with special health needs, and 48.8 percent of children
ages three and under are covered under Medicaid and CHIP. Furthermore, 49 percent
of births are covered by Medicaid. Without these two programs, millions of children
would go without crucial healthcare services, positioning them for a lower quality of life
further down the road.”
Analysis: This argument is pretty strategic just because you can blow up the importance of
medicaid which is one of the most vital government programs we have to date. Especially in
today’s society, where so many people rely on medicaid, any threat could have dangerous
consequences for a good deal of people.
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A/2 - High Drug Prices Strain State Budgets
Answer: Medicaid cuts are already on the way
Warrant: Republican administration already planning to slash medicaid budget
Werner, Erica. “House GOP Plan Would Cut Medicare, Medicaid to Balance Budget.” The
Washington Post, WP Company, 19 June 2018,
<www.washingtonpost.com/news/business/wp/2018/06/19/house-gop-plan-
would-cut-medicare-social-security-to-balance-
budget/?noredirect=on&utm_term=.7a1c 1bea5971.>
“The House Republican budget, titled “A Brighter American Future,” would remake
Medicare by giving seniors the option of enrolling in private plans that compete with
traditional Medicare, a system of competition designed to keep costs down but
dismissed by critics as an effort to privatize the program. Along with other changes,
the budget proposes to squeeze $537 billion out of Medicare over the next decade.
The budget would transform Medicaid, the federal-state health-care program for the
poor, by limiting per capita payments or allowing states to turn it into a block-grant
program — the same approach House Republicans took in their legislation that passed
last year to repeal the Affordable Care Act (the repeal effort died in the Senate, but the
GOP budget assumes that the repeal takes place). It also proposes adding work
requirements for certain adults enrolled in Medicaid. Changes to Medicaid and other
health programs would account for $1.5 trillion in savings.”
Response: High drug prices aren’t an example of market failure, they’re the result of the costly and
intensive process of manufacturing and researching drugs.
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Warrant: Price controls would make pharmaceuticals more expensive in the long-run by shifting
costs and reducing the efficiency of innovation.
Elizabeth Wright. “Pharmaceutical Price Controls: A Prescription for Disaster”, Citizens

Against Government Waste, October 2016,
<https://www.cagw.org/sites/default/files/pdf/Pharmaceutical%20Price%20Con
trols%20-%20A %20Prescription%20for%20Disaster.pdf>
controls.”
Analysis: The first response pretty easily non-uniques the argument on face. Given the Trump
administration’s plans to slash a good portion of medicare and medicaid, the effect of
constraining the state budget would be pretty marginal if anything. Moreover, proving that
drug prices would actually increase in the PRO world turns the argument because it means the
budget will only be strained more.
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Con Arguments with Pro Responses Nov/Dec 2018
CON – Price controls will limit research into vaccines
Argument: Limiting the revenue that goes to pharmaceutical companies by capping prices will
limit capital necessary for developing vaccines.
Warrant: It costs a lot to develop vaccines
Plotkin, Stanley, et al. “The Complexity and Cost of Vaccine Manufacturing – An

Overview.” Vaccine, vol. 35, no. 33, July 2017, pp. 4064–71. PubMed Central,
doi:10.1016/j.vaccine.2017.06.003.
As companies, countries, and governments consider investments in vaccine

production for routine immunization and outbreak response, understanding the
complexity and cost drivers associated with vaccine production will help to inform
business decisions. Leading multinational corporations have good understanding of
the complex manufacturing processes, high technological and R&D barriers to entry,
and the costs associated with vaccine production. However, decision makers in
developing countries, donors and investors may not be aware of the factors that
continue to limit the number of new manufacturers and have caused attrition and
consolidation among existing manufacturers. This paper describes the processes and
cost drivers in acquiring and maintaining licensure of childhood vaccines. In addition,
when export is the goal, we describe the requirements to supply those vaccines at
affordable prices to low-resource markets, including the process of World Health
Organization (WHO) prequalification and supporting policy recommendation. By
providing a generalized and consolidated view of these requirements we seek to build
awareness in the global community of the benefits and costs associated with vaccine
manufacturing and the challenges associated with maintaining consistent supply. We
show that while vaccine manufacture may prima facie seem an economic growth
opportunity, the complexity and high fixed costs of vaccine manufacturing limit
Champion Briefs 154

potential profit. Further, for most lower and middle income countries a large majority
of the equipment, personnel and consumables will need to be imported for years,
further limiting benefits to the local economy.
Warrant: Price controls limit vaccine research
Tate, Edward. Government Price Controls on Prescription Drugs May Be More than
Patients Bargain For - HealthCare Institute of New Jersey. 7 Oct. 2002,
than-patients-bargain-for/.
Consider the recent flu vaccine shortage. The largest purchaser of the vaccine is the
federal Vaccines for Children Program. The program buys up nearly 70 percent of all
childhood vaccines at government-set prices and then distributes them to states
according to a federally-set formula. The end result is that vaccines have been
distributed to states where there is no epidemic often leaving a shortage where it is
needed. Because the government controls the price, the vaccine makers are
discouraged from producing more than what the government orders. Vaccine prices
have remained stagnant since 1994. Thanks to these price controls, there now are
only four developers of childhood vaccines. That’s down from 20 companies just a
few years ago. Even the U.S. Department of Health and Human Services recognizes the
consequences to medical innovation if the federal government should choose to impose
price controls. In a recent study the Department stated, “There are potentially serious
consequences to medical innovation with the implementation of government controls
that are inevitably arbitrary and out of touch with the diversity of patients needs and
consequences.
Warrant: Price controls reduce research and development by 80 percent
Champion Briefs 155

Easton, Robert. “Price Controls Would Stifle Innovation in the Pharmaceutical Industry.”
STAT, 22 Jan. 2018, https://www.statnews.com/2018/01/22/price-controls-
pharmaceutical-industry/.
But if U.S. drug prices come under bureaucratic control, as they have in most of Europe
and Japan, it will be a different story. Little pharmaceutical innovation occurs in price-
control jurisdictions. The United States has always, by a large margin, led the world as a
source of new drugs, and that lead has widened as Japan and Germany have imposed
price controls over the past few decades. All major international pharmaceutical
companies, without exception, have instituted R&D and commercial operations in the
U.S. to take advantage of its pricing environment. If price controls pressure the U.S.
industry into a more conventional process industry model, like that of the chemical
industry, pharmaceutical R&D budgets would be slashed. To achieve the chemical
industry’s rate of R&D spending, as would be required to achieve profitability
competitive with the chemical industry, top pharmaceutical companies would have to
reduce their R&D budgets by 80 percent — almost $50 billion in total. This reduction in
spending would take a few years to realize, but would be completely evident by 2023 or
earlier.
Impact: Vaccines have saved millions of lives
Researchers at the University of North Carolina at Chapel Hill. “Vaccines Save 20 Million
Lives, $350 Billion in Poor Countries since 2001.” ScienceDaily, 1 Sept. 2017,
https://www.sciencedaily.com/releases/2017/09/170901101035.htm.
Researchers led by Sachiko Ozawa, Ph.D., an associate professor at the UNC Eshelman
School of Pharmacy, studied the economic impact of Gavi, the global vaccine alliance
launched in 2000 to provide vaccines to children in the world's poorest countries. Gavi
support has contributed to the immunization of 580 million children, and it has
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operated primarily in the 73 countries covered by the team's analysis, which was
published in the Bulletin of the World Health Organization. "Vaccination is generally
regarded to be one of the most cost-effective interventions in public health," Ozawa
said. "Decision-makers need to appreciate the full potential economic benefits that are
likely to result from the introduction and sustained use of any vaccine or vaccination
program.” Researchers looked at both short- and long-term costs that could be saved
preventing illness. The costs -- expressed in 2010 U.S. dollars -- include averted
treatment, transportation costs, productivity losses of caregivers and productivity losses
due to disability and death. They used the value-of-a-life-year method to estimate the
broader economic and social value of living longer, in better health, as a result of
immunization.
Analysis: This is a good argument because even if the costs of vaccines are high, they are not a
recurring cost. Once someone pays for a vaccine once, they never need it again because it will
prevent them from ever getting the disease. If there are more vaccines, then high cost
medicines will not even be used anymore, thus outweighing any pro argument about costs for
patients. Furthermore, these vaccines can then be exported to the developing world for use
there.
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A/2 - Price controls will limit research into vaccines
Response: New vaccines are often unaffordable
Warrant: The cost of developing a vaccine is very high
Martinez, Josh. How Much Does It Cost to Develop a Vaccine? | Passport Health. 2 Feb.
2018, https://www.passporthealthusa.com/2018/02/how-much-does-it-cost-to-
develop-a-new-vaccine/.
Unfortunately, with newly discovered diseases, there’s also a need to develop more
vaccines. Researchers and companies can undergo years of research and studies to find
a working vaccine. This does not factor in the many failed vaccines. As the diseases get
more complicated, there’s greater difficulty to make some kind of prevention.
According to a report in 2006, vaccines could cost around $800 million dollars to
develop. But, many variables proved that this price could change wildly. In looking at
costs, The Washington Post reported a range of $521 million and $2.1 billion
depending on the manufacturer and vaccine. The country of development can also
greatly change costs. Facilities, permits and qualification from worldwide organizations
can increase costs in countries that don’t usually develop vaccines. Even today, experts
are unsure about the final costs in creating a new and successful vaccine. Some
estimates put the total at $1 billion, while others can peak around $5 billion.
Warrant: Vaccine costs make them unavailable for many

Rosenthal, Elisabeth. “The Price of Prevention: Vaccine Costs Are Soaring.” The New
York Times, 2 July 2014. NYTimes.com,
https://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-
Till-It-Hurts.html.
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To deal with the rising prices, some doctors, who say they lose money on every
vaccination, reserve their shots for longstanding patients. A survey of family-practice
doctors, who along with pediatricians are among the lowest-earning physicians, found
that about one-third were considering giving up immunizations because of the
expense. Another survey found that 40 percent do not offer at least some required
childhood immunizations. That is why Breanna Farris, a San Antonio mother, had to call
10 pediatricians in April before she found Dr. Irvin to vaccinate her son, Traven, who is
entering kindergarten this fall. The family’s usual doctors do not offer vaccinations, and
referred Ms. Farris to local pharmacies (which do not vaccinate children) or the city
health clinic (which would not take Traven’s insurance).
Analysis: This is a good response because it entirely takes out the impact of having a vaccine if
too few people ever receive it. This means that the con has no reason for the judge to vote for
them because it becomes very easy to say that the cost of medicine matters more than the
quality of medicine available.
Response: Vaccines are already researched and available
Warrant: Much research is done by universities
Caceres, Marco. “Big Pharma Pays Universities for Most Medical Research in U.S.
Today.” The Vaccine Reaction, 15 Apr. 2018,
https://thevaccinereaction.org/2018/04/big-pharma-pays-universities-for-most-
medical-research-in-u-s-today/.
In the past, collaboration between scientists in academia and pharmaceutical

companies was relatively uncommon. However, lately there has been a growing
interest in developing financial partnerships between these two sectors. The drug
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industry’s funding patterns for academic research has shifted from handpicked projects
on investigation of the biology of disease to large integrated programs, with an
emphasis on the development of therapeutic drugs and vaccines. In the last few years,
pharmaceutical companies have also formed “science hubs” in bigger academic
institutions to promote biomedical innovation.1 Some of these partnerships include
GlaxoSmithKline at Harvard University, Pfizer at University of California, and
AstraZeneca at University of Washington, etc.1 In fact, with the increasing financial
ties between academia and the pharmaceutical industry, many drug companies have
formed specialized divisions that are solely responsible for seeking research and
development relationships with academic institutions.
Warrant: The government finances vaccine distribution
Hinman, Alan R., et al. “Financing Immunizations in the United States.” Clinical
Infectious Diseases, vol. 38, no. 10, May 2004, pp. 1440–46. academic.oup.com,
doi:10.1086/420748.
Children in the United States receive immunizations through both private and public
sectors. The federal government has supported childhood immunization since 1963
through the Vaccination Assistance Act (Section 317 of the Public Health Service Act).
Since 1994, the Vaccines for Children (VFC) program has provided additional support
for childhood vaccines. In 2002, 41% of childhood vaccines were purchased through
VFC, 11% through Section 317, 5% through state and/or local governments, and 43%
through the private sector. The recent introduction of more-expensive vaccines, such as
pneumococcal conjugate vaccine, has highlighted weaknesses in the current system.
Adult immunization is primarily performed in the private sector. Until 1981, there was
no federal support for adult immunization. Since 1981, Medicare has reimbursed the
cost of pneumococcal vaccine for its beneficiaries; influenza vaccine was added in 1993.
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This paper summarizes the history of financing immunizations in the United States and
discusses some current problems and proposed solutions.
Analysis: This is a good response because it means that there is little reason to have high prices
of vaccines if we do not need companies to conduct the research. This makes the impact of this
con argument non-unique because you can argue that we are likely to develop these vaccines
either way.
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CON – Price controls will limit research to treat new diseases
Argument: There are many diseases that remain untreatable, but may see a treatment arise
from future research. Lowering prices will hurt pharmaceutical companies’ ability to conduct
such research.
Warrant: It costs a lot to invest in new treatments
Winegarden, Wayne. “Pharmaceutical Price Controls Risk Future Cures.” Forbes, 2 Dec.
2015, https://www.forbes.com/sites/econostats/2015/12/02/pharmaceutical-
price-controls-risk-future-cures/.
These health and economic contributions will only continue if the innovating
manufacturers are provided opportunities to recoup their costs of capital. Price controls
limit the ability for innovators to recoup their costs and therefore reduce the amount of
pharmaceutical innovation. Developing a new pharmaceutical drug is an expensive
process that is fraught with failure. These costs include the billions of dollars in outlays,
the years it takes to develop a new drug (estimated to be between 10 to 15 years), as
well as the large risks of failure. Estimates of the actual dollar outlays (the direct
expenditure costs) vary. On the lower end, and including the expenditures on the
drugs that were unsuccessful, the development of a new patented pharmaceutical can
cost $1.3 billion.[iv] On the upper end, and including the expenditures on drugs that
were unsuccessful, the total R&D cost per drug were estimated between $5.5 billion
and $5.9 billion.[v] These expenditures are not what the industry must repay, however.
Warrant: Price controls decrease investment into pharmaceutical companies
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Winegarden, Wayne. “Pharmaceutical Price Controls Risk Future Cures.” Forbes, 2 Dec.
2015, https://www.forbes.com/sites/econostats/2015/12/02/pharmaceutical-
price-controls-risk-future-cures/.
People will not invest in (or lend to) the innovative pharmaceutical industry if, after
bearing all of the risks of developing a new therapy, they are only returned their
original investment. Instead, the pharmaceutical industry must pay investors a
competitive return on the money invested – adjusted for the risks of failure and the
long time it takes to develop a new drug. It is only possible for pharmaceutical
manufacturers to bear these costs, and invest in pharmaceutical innovation, if the
revenues generated from drug sales equals the company’s total capital costs. Price
controls, by definition, limit the revenues that can be earned from developing
innovative therapies and therefore limits the total amount of capital costs that
innovative manufacturers are able to recover. By capping drug prices, policymakers are,
consequently, effectively capping innovation and jeopardizing the tremendous health
and economic benefits that the pharmaceutical industry has been creating for
decades.
Warrant: Price controls will decrease investment by 30 percent
Chressanthis, George. “The Potential Pitfalls of Price Controls.” The Medicine Maker,
Nov. 2016, https://themedicinemaker.com/issues/1016/the-potential-pitfalls-of-
price-controls/.
But what of the second link in the chain – the relationship between the adverse effects
of R&D development and drug innovation, and patient health outcomes? Here too, the
literature can guide us. The most direct study is one that estimated the effect of real
(inflation-adjusted) price declines from price controls on reductions in R&D investment,
and then in turn, on life-years lost (in millions) (26). Model estimates determined that a
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10 percent, 30 percent, and 50 percent decrease in real drug prices from price
controls, decreased R&D investment by 5.8 percent, 17.5 percent, and 29.2 percent,
and led to life years lost (in millions) of 40.1, 113.5, and 178.8, respectively. This
connection to reductions in life-years lost depends on the relationship between the
diffusion and utilization of new drug innovation, and patient health. Pharmaceutical
innovation was estimated to increase life expectancy by 1.27 years during the period
2000–2009 for 30 developing and high-income countries (27).
Impact: New drugs have saved thousands of lives
Easton, Robert. “Price Controls Would Stifle Innovation in the Pharmaceutical Industry.”
STAT, 22 Jan. 2018, https://www.statnews.com/2018/01/22/price-controls-
pharmaceutical-industry/.
The pharma industry’s efforts have been quite productive in attacking some of the
most vexing problems in medicine. Cardiovascular mortality in the U.S. has declined
more than 50 percent since the introduction of propranolol, the first beta blocker, in
1964. Many cancers, such as childhood leukemia, have almost been cured. AIDS is now
a chronic disease, as the death rate has declined from near 100 percent to near 0
percent. Hepatitis C is now curable. Even metastatic melanoma, formerly a death
sentence for 95 percent of its victims, is now curable for many. Lung cancer may be
next. All these miracles have been brought through the clinic and into the market by
commercial pharmaceutical companies. Yet there remain huge unmet needs for new
and better treatments for most cancers; all neurological problems, especially
Alzheimer’s disease; most autoimmune diseases; most major gastrointestinal disorders;
macular degeneration; and diabetes — not to mention the global scourge of drug-
resistant bacterial and viral infections. Advances in these areas will come if money
continues flowing to pharmaceutical companies and their primary sources of
innovation, biotechnology startups.
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Analysis: This is a good argument because it can outweigh any pro argument in the long run.
Even if the prices of medicines become slightly less affordable, this will only marginally affect
the amount of people who can cure themselves of diseases because at least the treatments
exist. This argument affects far more people because it helps people with diseases for which
there are absolutely no treatments.
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A/2 - Price controls will limit research to treat new diseases
Response: Treatments to new diseases are unaffordable
Warrant: The cost of developing a new medicine is very high
Herper, Matthew. “The Cost Of Developing Drugs Is Insane. That Paper That Says
Otherwise Is Insanely Bad.” Forbes, 16 Oct. 2017,
https://www.forbes.com/sites/matthewherper/2017/10/16/the-cost-of-
developing-drugs-is-insane-a-paper-that-argued-otherwise-was-insanely-bad/.
You probably know this poem, or at least the story it tells. One man likens the elephant
to a wall, another to a spear, a third to a snake, a fourth to a tree. The point is that each
sees only part of the animal, and is thereby deceived. Well, here’s how the same thing
happened when it came to a new estimate of the cost of developing a new medicine.
For years, the pharmaceutical industry has relied on estimates from the Tufts Center
for the Study of Drug Development, the most recent of which that puts the cost of
bringing a medicine from invention to pharmacy shelves at $2.7 billion. Last month,
two cancer researchers grabbed headlines by asserting that estimate is way off. Their
number, published in JAMA Internal Medicine: $648 million. In an editorial that ran
alongside the new study, journalist Merrill Goozner wrote: “Policymakers can safely take
steps to rein in drug prices without fear of jeopardizing innovation.” There are reasons
to think that (more on that later), but this paper does not add to them.
Warrant: New medicines are unaffordable for many
Boseley, Sarah. “Why Do New Medicines Cost so Much, and What Can We Do about It?”
The Guardian, 9 Apr. 2018. www.theguardian.com,
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https://www.theguardian.com/news/2018/apr/09/why-do-new-medicines-cost-
so-much-and-what-can-we-do-about-it.
No. The new drugs that cure the liver disease hepatitis C were launched at a price that
elicited squeals of pain from the UK, western Europe and the United States, as well as
India and Romania, which both have high numbers of infections. In the US, the drug
sofosbuvir (brand name Sovaldi), launched at a cost of $1,000 a pill. In the UK, the
manufacturer Gilead was asking £35,000 for a 12-week course, with some patients
needing 24 weeks. It was soon clear that no country was going to be able to treat
everybody who needed them, even though hepatitis C is a killer in the long term and
the drugs are – unusually – a cure. In the UK, the National Institute for Health and Care
Excellence (Nice), which decides whether drugs are value for money, said yes to
hepatitis C drugs, provided Gilead gave a discount. The drugs would save years of
expensive NHS treatment, including liver transplants. But the government balked at the
cost of treating everybody – an estimated 160,000 people are infected. Normally the
deal is that the NHS must introduce any drug Nice approves, but in this case it chose to
phase it in, treating the sickest first and making others wait, which was unprecedented.
In the US, the cost was out of the question for many people without good health
insurance cover. The prices of new cancer drugs have also been prohibitive.
Analysis: This is a good response because it essentially takes out the impact of the con
argument. If no one can afford to buy a new medicine when it is put on the market, then it
offers no benefit to the people. A medicine is only as good as the amount of people it is able to
treat, but that number will be zero if the price is too high.
Response: High prices increase insurance costs
Warrant: High drug prices increase premiums
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Komendant, Erik. Skyrocketing Drug Prices: What’s Driving Up Costs? | Association for
Accessible Medicines. 2017,
https://accessiblemeds.org/resources/blog/skyrocketing-drug-prices-whats-
driving-costs.
Prescription drugs treat conditions and improve patient health. But when drug prices
are too high, access to medicines becomes out of reach for far too many patients. When
the price of prescription drugs fits within a family’s budget, everyone is able to live
and work at their healthiest. On the other hand, when people are unable to afford
their medication, this negatively affects their health and their lives and exacts a heavy
toll on society. This crisis is fueled by the high launch prices of new brand biologics and
year-over-year price increases of brand drugs that face no competition in the market for
many years due to abuses of the patent system. A recent report shows the average
annual price of specialty drugs has tripled over the last ten years from nearly $18,000 to
more than $52,000 today.1 With brand-name drugs now accounting for 77 percent of
all spending on prescription drugs, patients are experiencing higher pharmacy costs,
higher premiums and higher deductibles as a result of high brand drug prices.2
Moreover, taxpayers are footing the bill as increased prescription drug spending drives
up Medicare and Medicaid spending. The increasing cost of brand drugs is
unsustainable.
Warrant: Rising drug prices increase the cost of medicare
Drash, Wayne. “Medicare Drug Prices Soar at 10 Times Rate of Inflation, Report Says.”
CNN, 26 Mar. 2018, https://www.cnn.com/2018/03/26/health/report-medicare-
drug-prices-soaring/index.html.
The new report, called "Manufactured Crisis: How devastating drug price increases are
harming America's seniors," said the extreme price hikes show the need for further
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investigation to determine the "impact on healthcare system costs and financial

burdens for the growing U.S. senior population.” "Soaring pharmaceutical drug prices
remain a critical concern for patients and policymakers alike," the report concluded.
"Over the last decade, these significant price increases have emerged as a dominant
driver of U.S. health care costs -- a trend experts anticipate will continue at a rapid
pace.” The report examined the costs of the 20 most-prescribed drugs under the
Medicare Part D program from 2012 to 2017. It found that the drug Nitrostat, used to
relieve chest pain, had increased the most: a percentage change of 477%.
Analysis: This is a good response because it can easily prove that offering new treatments do
not matter. This is because if the cost of insurance is too high, then people will be unable to
afford new medicines either way. This takes out the impact of the con argument entirely.
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CON – Cost of medicine is absorbed by insurance companies

Argument: Since the cost of medicine is mostly paid by insurance companies, there is no reason
capping prices should help consumers because they will never see the impact of lower prices
themselves.
Warrant: Insurance companies pay for most medicines
Zaken, Ministerie van Algemene. What Medicines Are Covered by Insurance? -

Government.Nl. 29 Sept. 2015, topics/medicines/question-and-answer/what-
medicines-are-covered-by-insurance.
What medicines are covered by insurance? The standard package covers most
medicines prescribed by your general practitioner or consultant. In some cases you
may have to pay part of the cost yourself. Or your insurer may only provide full cover
for the cheapest version of a drug. The cost of medicines that are covered by your
insurance policy is first deducted from your excess. Most health insurers only provide
cover for the cheapest version of a medicine. It contains the same active ingredient or is
essentially the same as the branded drug. Your insurer may agree to reimburse the
more expensive medicine if your doctor has prescribed it for a medical reason. For
instance, you may be allergic to certain ingredients in the cheaper drug. In that case, the
doctor must write ‘medically necessary’ on the prescription.
Warrant: Price increases are absorbed by insurance companies

Baker, Danial E. “High Drug Prices: So Who Is to Blame?” Hospital Pharmacy, vol. 52, no.
1, Jan. 2017, pp. 5–6. PubMed Central, doi:10.1310/hpj5201-5.
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The company needs to use more of its income to offset the increased cost. It may shift
some or all the increased burden to their employees by decreasing the amount of
coverage their program provides, increasing the employees' contribution to offset the
expense of the program, or increasing deductibles and/or copays. Also affected are
patients who need these medications for the prevention or treatment of various
medical conditions. Some of us are insulated from the true cost of our health care and
the cost of medications. The majority of the costs for these health care programs has
been covered by our employer or federal programs. For decades, the copay for most
medications was relatively low compared to their acquisition cost, therefore the
majority of the public did not know the true cost of medications. This trend has been
changing through the use of tiered copay systems and formulary placements that are
based on cost of the pharmaceutical and its perceived value to the care of the patient.
Another group affected by these higher prices is the health insurance companies, self-
insured companies, and managed care organizations. Each of these companies and
organizations has to cover the increase in cost somehow.
Warrant: Insurance companies do not change premiums based on medicine prices
Even if the recently announced drug price freezes or cuts translate into some savings
for insurers, it’s not at all a given that insurers will pass along those savings directly to
patients taking that particular drug, Purvis cautions. For starters, many health plans
don’t make changes to their formulary — that’s their list of covered drugs and pricing
schemes — mid-year. And even if your drug is getting a price cut, insurers could choose
to pass savings along more broadly next year, by limiting price hikes for all covered
consumers, Purvis says. That’s because insurers usually pass high drug costs on to
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customers in the form of higher copayments, coinsurance, premiums and deductibles.

So while more modest price increases for your medications could benefit everyone on
your plan, they won’t necessarily mean a huge change for you, Purvis notes. Experts
argue that — rather than relying on one-off actions by manufacturers — the health
care system actually needs structural changes to meaningfully lower drug prices.
Impact: Price decreases have not affect patients in the past
Take Gleevec, a cancer drug by Novartis that ranked 25th among the top 200
prescription drugs in 2016 by global sales, according to Connecture. Gleevec’s price will
be frozen, but it had already hit $140,000 a year by 2017, according to David Mitchell,
founder and president of Patients for Affordable Drugs, a nonprofit advocacy
organization. “It’s hard to give drug companies credit for keeping prices high,” says
Mitchell, a cancer patient himself who has experienced high drug costs first-hand. And
some of the drug price changes may simply have limited impact. Merck announced it
would lower prices on Zepatier, its treatment for Hepatitis C, by 60%, for instance, as
well as cutting costs on several other medications by 10%. But Zepatier itself was a late
entrant into the market with very lackluster sales, says Jim Yocum, senior vice president
of federal programs at Connecture — so the Zepatier cut won’t really affect either
patients or the company’s bottom line.
Analysis: This is a good argument because it strategically allows the con team to change the
focus of the round, and shift it away from the arguments about affordability that the pro is
bound to make. This leaves the ground open for the con to come in and argue anything they
want without fear of the pro being able to outweigh because this short-circuits any pro path to
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the ballot. Though this argument is largely defensive, it is still strategic to place in case so it can
be a core part of your narrative from the beginning.
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A/2 - Cost of medicine is absorbed by insurance companies
Response: Higher prices of drugs lead to higher insurance prices
Warrant: Insurance companies will simply pay for less of the drug
Chan, Kelvin. “Why We’re All Talking about Drug Prices Inaccurately: The EpiPen
Controversey.” Medium, 26 Sept. 2016, https://medium.com/unraveling-
healthcare/why-were-all-talking-about-drug-prices-inaccurately-the-epipen-
controversey-2d061689b904.
Drugs feel more expensive when health insurers cover less of a drug. And as
healthcare costs rise, health insurers look to shift the burden of expenses onto its
patients through higher deductibles or premiums. Deductibles refer to the amount you
have to pay before coverage kicks in. And since 2010, average deductibles have
increased over 67%. As more Americans enroll in High-Deductible Health Plans (HDHP),
so does the feeling of cost. Under an HDHP, EpiPen, which may have been previously
covered by a health insurer for a $50 co-pay, now costs $600 until the deductible is met.
Premiums or the monthly payments one makes to be covered are rising too, and have
increased by about 27%. What’s ultimately driving this feeling of “cost” boils down to
rising healthcare costs and insurers counteracting those costs by covering less of it.
Warrant: High drug prices force insurers to raise premiums
Healthline Board. “Drug Price Increases and Your Health.” Healthline, 18 July 2018,
https://www.healthline.com/health-news/rising-drug-prices-risk-to-your-health.
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Drug price increases also greatly outpace healthcare inflation costs, which have been
comparatively low in the past few years. These price increases affect insurance
premiums and out of pocket expenses, but it’s hard to say exactly how much. However,
Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology
and president of the American Society of Health Economists, says the overall direction is
clear. “Higher drug prices translate to higher health insurance costs for all of us,” he
says. He notes the convoluted system of rebates and discounts between pharmaceutical
companies, pharmacy benefit managers, and insurance companies makes things even
more murky. “Obviously, if they raise the price, that’s going to pass through to some
extent to consumers. Whether PBMs are helping or hurting is still unclear, it all depends
on how these rebates play through,” says Gruber. “We just don’t know yet. When they
raise the price, how much of that is actually making its way to consumers?”
Analysis: This is a good response because it entirely takes out the impact of the con’s
argument. The con argument relies on a reframing of the debate that takes the cost of drugs
out of the picture— however, you can easily circumvent that strategy by simply saying that the
cost of medicines are not the out of pocket expenses but the increasing cost of insurance.
Response: The poor lack the benefits of insurance
Warrant: Many people lack insurance altogether
Kaiser, Henry. Nov 29, Updated:, et al. “Key Facts about the Uninsured Population.” The
Henry J. Kaiser Family Foundation, 19 Sept. 2017,
https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-
population/.
Even under the ACA, many uninsured people cite the high cost of insurance as the
main reason they lack coverage. In 2016, 45% of uninsured adults said that they
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remained uninsured because the cost of coverage was too high. Many people do not
have access to coverage through a job, and some people, particularly poor adults in
states that did not expand Medicaid, remain ineligible for financial assistance for
coverage. Some people who are eligible for financial assistance under the ACA may not
know they can get help, and undocumented immigrants are ineligible for Medicaid or
Marketplace coverage. Most uninsured people are in low-income families and have at
least one worker in the family. Reflecting the more limited availability of public
coverage in some states, adults are more likely to be uninsured than children. People of
color are at higher risk of being uninsured than non-Hispanic Whites.
Warrant: High quality insurance is too expensive
Stepanikova, Irena, and Karen S. Cook. “Effects of Poverty and Lack of Insurance on
Perceptions of Racial and Ethnic Bias in Health Care.” Health Services Research,
vol. 43, no. 3, June 2008, pp. 915–30. PubMed Central, doi:10.1111/j.1475-
6773.2007.00816.x.
Two factors that are especially important in the context of health care delivery are
poverty and the lack of health insurance. We know that they represent formidable
barriers to obtaining high-quality health care (IOM 2002; AHRQ 2003). These structural
obstacles affect minorities more commonly than whites (Hargraves 2004). As the
numbers of the poor and the uninsured, who are disproportionately nonwhite, continue
to rise in America (Strunk and Reschovsky 2004; The Kaiser Commission of Medicaid and
the Uninsured 2005; DeNavas-Walt, Proctor, and Lee 2006), it is important to better
understand the implications of poverty and lack of insurance for patients' experiences,
especially among nonwhites and people with limited English skills, who also face
language barriers to high-quality care (David and Rhee 1998; Carrasquillo et al. 1999;
Weech-Maldonado et al. 2001). The purpose of this paper is to investigate whether
poverty and lack of insurance are related to perceived racial and ethnic bias in health
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care. While this problem is not well understood in the context of health care, the
sociological literature suggests that socioeconomic disadvantage is linked to perceived
racial and ethnic discrimination in other areas of daily living
Analysis: This is a good argument because even if the con is entirely right in proving that
insurance companies cover the cost of increasing medication costs, this only matters for people
who have good quality insurance. Since most poor people have inadequate insurance or,
worse, no insurance at all, they will still be hurt by price increases.
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CON - Price controls will cause political backlash
Argument: Because pharmaceutical companies stand to lose a lot from price controls, it is likely
that imposing such a regulation would lead them to mobilize lobbying groups to advocate for
less pharmaceutical regulation.
Warrant: Price controls impose a cost on pharmaceutical companies
Herper, Matthew. “Trump’s Comments Are Big Pharma’s Nightmare.” Forbes, 11 Jan.
2017, https://www.forbes.com/sites/matthewherper/2017/01/11/trumps-
comments-are-big-pharmas-nightmare/.
Donald Trump is going to be a populist president. Pharmaceutical companies are a

popular villain. That's it. And there are ways Trump could use executive power to hurt
drug companies that charge high prices. When Dendreon, a Seattle biotech since
bought and sold by Valeant Pharmaceuticals, introduced a cancer drug that cost almost
$93,000 in 2010, Medicare put it through a gauntlet called a National Coverage
Determination, slowing adoption of the drug. (It flopped.) There are plenty of steps a
Medicare administrator motivated by working for an angry Donald Trump could take
to hurt a drug company whose price had been deemed too high. Drug company
executives have not been blithely unaware that this might happen. Some have been
addressing it publicly. In December, at the Forbes Healthcare Summit, Allergan Chief
Executive Brent Saunders announced an expanded patient assistance program to make
sure that patients could get access to Allergan medicines for mental illness and
infectious disease. He'd also pledged not to take large price increases, limiting Allergan
to 10% increases no more than once a year.
Warrant: Lobbyists are already mobilized at the threat of price controls
Champion Briefs 178

Morgan, John. “A Bitter Pill: How Big Pharma Lobbies to Keep Prescription Drug Prices
High.” CREW, 2017, https://www.citizensforethics.org/a-bitter-pill-how-big-
pharma-lobbies-to-keep-prescription-drug-prices-high/.
With the political heat on pharmaceutical manufacturers increasing in Washington,

D.C., the industry is preparing for a fight over perhaps the most controversial issue
confronting it: drug pricing. As many of the industry’s largest companies increase the
prices of their products, they have also increased their lobbying spending on Capitol
Hill, and some have reported lobbying on drug pricing in particular, as well as on
specific bills that attempt to rein in the problem. There are also more companies
lobbying on this issue than ever before. The industry’s biggest trade group has also
increased dues for its member companies by 50% in order to raise $100 million for an
influence campaign to stave off possible pricing regulations by U.S. lawmakers. In this
report, Citizens for Responsibility and Ethics in Washington (CREW) examines how the
pharmaceutical industry’s lobbying activity has responded to the growing possibility that
legislators may take action to rein in the cost of prescription drugs. First, we explore the
size of the drug pricing lobby by examining lobbying records for mentions of drug pricing
and other similar search terms. We found that lobbying on this issue has dramatically
increased over the past decade. CREW found 153 different companies and
organizations that reported some variation of the term “drug pricing” on their federal
lobbying disclosures during the first three quarters of 2017. This number has more
than quadrupled over the past five years.
Warrant: Pharmaceutical lobbyists are especially powerful
Pear, Robert. “As Trump Prepares Plan to Lower Drug Prices, Big Pharma Girds for a
Fight.” The New York Times, 7 May 2018. NYTimes.com,
Champion Briefs 179

https://www.nytimes.com/2018/05/06/us/politics/trump-drug-prices-
lobbying.html.
Every major industry lobbies for its interests, but congressional aides said that
lobbyists for pharmaceutical companies were special: They outnumber the lobbyists
for many other industries. Congressional aides said it was not unusual for the industry
to dispatch 10 or 15 lobbyists to meet with two congressional aides. In addition, they
said, drugmakers are fierce opponents of proposals they dislike, and are often reluctant
to suggest alternatives of their own when Congress is seeking ways to save money. The
pharmaceutical industry’s intransigence has begun to irk even staunch Republican allies.
It contrasts with the industry’s support for adoption of the Affordable Care Act in 2009
and 2010 and its role in shaping the prescription drug benefit added to Medicare under
a 2003 law. Drug companies say their lobbying reflects the fact that they are concerned
about myriad issues, including Medicare and Medicaid, trade and taxes, patent rights,
drug regulation, opioids and the budget for biomedical research.
Impact: Pharmaceutical lobbying hurts consumers by promoting ineffective techniques
Wright, Oliver. Big Pharma Lobbyists Exploit Patients and Doctors | The Independent. 10
Feb. 2014, https://www.independent.co.uk/voices/comment/big-pharma-
lobbyists-exploit-patients-and-doctors-9120189.html.
And I heard the stories of the other places they had visited. The conferences held
around world-famous golf courses, the meetings held in beach resorts. Those involved,
of course, said that the exchange of expertise that such conferences facilitated was
invaluable. But the reason why the drug companies picked up the bill was not that
altruistic: they just wanted to sell more of their product, boost their profits and were
using all the tools in the lobbying box to do so. What the drug – and increasingly the
medical devises - industry want is for the NHS to constantly ‘refresh’ the treatments
Champion Briefs 180

that they offer patients with the newest, brightest techniques and drugs available. But
such new treatments often come at inflated prices and sometimes offer limited – or
unproven - benefits over existing therapies. For a long time the National Institute of
Clinical Excellence has done a good job at objectively assessing claims made by drugs
companies and making recommendations for what should and what should not be
available on the NHS. But they have been fighting an uphill struggle. Every time they
turn down a drug its manufacturers fight a proxy battle using patients groups (which
they often fund) and doctors (who may have been on similar trips to mine) to campaign
for the ruling to be reversed.
Analysis: This is a good argument because even if the pro can prove that this individual policy is
good for consumers of medicine, a reduction in the overall amount of good policy or the
passage of more bad policy is sure to outweigh. This is because other types of policies can
regulate the effectiveness and quality of drugs, meaning that even if they are affordable, they
will not help patients.
Champion Briefs 181

A/2 - Price controls will cause political backlash
Response: Lobbying is generally ineffective
Warrant: Progressive congressmen will not listen
Novak, Jack. A Warning for Big Pharma: Lobbying Won’t Work Anymore–Commentary.
28 Oct. 2016, https://www.cnbc.com/2016/10/28/a-warning-for-big-pharma-
lobbying-wont-work-anymore-commentary.html.
Let's be blunt. Corporate America is in delusional denial about how much the ground
in Washington has shifted against it. The rise of Senators Bernie Sanders and Elizabeth
Warren, both inside the halls of Congress and throughout the country, is more than
just a passing fad. Just ask Wells Fargo CEO John Stumpf... oops, I mean former CEO
John Stumpf, who stepped down in part thanks to Senator Warren's grilling during
recent Senate hearings. Here's a warning and a wake up call to big business: If you try to
use the same old lobbying and crony networks to get your way, it won't work. Not
anymore. And here's a special warning call just for Big Pharma: You need to change
your public relations and marketing strategies now, or die. The good news is, unlike so
many other industries, the drug companies have a very effective way out of this mess.
Warrant: Legislation is proposed to increase transparency
Bowmer, Rick. “Fighting Special Interest Lobbyist Power Over Public Policy.” Center for
American Progress, 27 Sept. 2017,
https://www.americanprogress.org/issues/democracy/reports/2017/09/27/439
675/fighting-special-interest-lobbyist-power-public-policy/.
Champion Briefs 182

Some proposals would even ban members from lobbying permanently. Extending the
ban on lobbying would give lawmakers one less reason to elevate special interest
concerns over the concerns of their constituents. Implementing effective policies to
fight the corrupting influence of special interest lobbyists depends on an accurate and
effective system of lobbyist registration. Unfortunately, the current definition is all
too easily evaded and has resulted in many people engaged in lobbying activities
deregistering or failing to register in the first place. Fortunately, bills have been
introduced in both the House and Senate that would institute a commonsense
definition of lobbying that applies to anyone who makes more than one lobbying
contact on behalf of a client over a two-year period. In addition to enabling
enforcement of the proposals above, expanding lobbying disclosure would also allow
the public to better understand who is spending money to try to influence
government—as well as how much money is being spent—so that representatives are
held accountable.
Analysis: This is a good response because it means you can essentially agree to every part of
the con argument but still win by saying that even if pharmaceutical lobbies are mobilized, it
does not matter because lobbyists generally get nothing done anyway. This means there is no
reason to worry about backlash and the argument has no impact.
Response: Price controls help pharmaceutical companies
Warrant: Pharmaceutical companies will not be hurt
Bailey, Ronald, and 2017. “President Trump: Pharmaceutical Price Controls Are a Bad
Idea.” Reason.Com, 10 Mar. 2017,
https://reason.com/archives/2017/03/10/president-trump-dont-resort-to-
pharmaceu.
Champion Briefs 183

Trump was characteristically vague about just how he would lower pharmaceutical
prices, but let's assume that Medicare was legally mandated to negotiate prices with
drug companies. In this case, "negotiate" amounts to creating price controls since
pharmaceutical manufacturers would largely have to take whatever price the
government wanted to offer, much like what already occurs in the case of the Veterans
Affairs Department. Most companies would likely agree to the government price
controls because they would still make money from their existing drugs because
marginal costs of each additional pill are so low. What would happen? A new study in
Forum for Health Economics & Policy by a team of researchers led by Jeffrey Sullivan at
the consultancy Precision Health Economics finds that price controls would indeed
reduce the cost of drugs to Medicare Part D participants.* But the unintended
consequences to Americans' lives and health in the future would be substantial and bad.
Warrant: Lower prices can increase sales
Ashe-Edmunds, Sam. Is Cutting Prices a Good Marketing Strategy? | Chron.Com. 2017,

https://smallbusiness.chron.com/cutting-prices-good-marketing-strategy-
61446.html.
The price you set for your product sends a message to consumers about your worth,
creating a perceived value for your products or services. Selling your product at prices
lower than the competition tells consumers who buy based on value and affordability
that you are a bargain. Low prices can scare away high-end shoppers. High prices might
send a message that you offer superior quality because of your product’s features, the
customer service you offer or both. Selling at a lower price often increases your sales
volume, hopefully making up for your decreased profit per unit by returning bigger
gross profits. Raising your price might increase your profit margins, but often results in a
decrease in sales volumes. In a best-case scenario, a price increase creates enough
perceived value among consumers that you realize both increased profit margins and
Champion Briefs 184

sales volumes. Test different prices in several geographic areas to learn the elasticity of
the demand for your product and help you find the optimal selling price.
Analysis: This is a good response because it responds to the internal warrant of the argument.
Even if it is true that angering pharmaceutical companies would cause them to mobilize
lobbyists, that doesn’t matter if the companies never get mad. In fact, if anything this response
can turn the argument, leading to less lobbying because it means companies have gotten
something they want and thus have less to lobby for.
Champion Briefs 185

CON – Price controls will result in lower quality assurance
Argument: Because it costs a lot of money to make medicines that work effectively, limiting the
profitability of selling medication will limit the ability of pharmaceutical companies to make
good quality medicines.
Warrant: Price controls will limit the profit of medicines
Morton, Fiona M. Scott. “The Problems of Price Controls.” Cato Institute, 20 June 2001,
www.cato.org/publications/commentary/problems-price-controls.
In both cases of government price controls, serious welfare loss results because not
enough of the good is sold. The wasted chance to create both producer and consumer
surplus from those sales is known as ‘deadweight loss’ because it is income that is lost
forever. In addition to creating deadweight loss, an artificially high price transfers profits
from consumers to producers; these rents are often wasted because producers spend
them on lobbying and other influence activities to maintain the regulated price. In the
case of a low price, producers transfer profits to consumers. Consumers, in competing
for a limited amount of the controlled product, may waste as much as they gain from
getting it at a low price. For instance, the people who waited in the 1970s gas lines
probably shouldered as much cost from the lost time queuing as they saved from the
price controls on gasoline. (Researchers Robert Deacon and Job Sonstelie have even
argued that the gas lines cost consumers more than they saved from the controlled gas
prices.) Thus, the artificially low prices not only hurt producers, but also consumers.
Warrant: It costs a lot to make a good quality drug
Champion Briefs 186

Francis, David. “The Effect of Price Controls on Pharmaceutical Research.” NBER, NBER,
5 May 2017, www.nber.org/digest/may05/w11114.html.
Their basic finding is that cutting prices by 40 to 50 percent in the United States will lead
to between 30 and 60 percent fewer R and D projects being undertaken in the early
stage of developing a new drug. Relatively modest price changes, such as 5 or 10
percent, are estimated to have relatively little impact on the incentives for product
development - perhaps a negative 5 percent. For the pharmaceutical industry, one
economic problem is that only 3 out of every 10 of their products generate after-tax
returns (measured in present value terms) in excess of average, after-tax R and D
costs. The scientific process is heavily regulated, and involves significant technical risk.
Only one in several thousand compounds investigated ever makes it through the full
development process to gain approval of the Food and Drug Administration. The vast
majority of R and D projects fail for reasons related to safety, efficacy, or commercial
viability, the authors note. For compounds that do gain FDA approval and are taken to
market, the entire process from discovery to launch takes on average about 15 years.
Warrant: Price controls have been bad for the quality of goods in other industries
Morton, Fiona M. Scott. “The Problems of Price Controls.” Cato Institute, 20 June 2001,
www.cato.org/publications/commentary/problems-price-controls.
The French Convention, which governed the nation at that time, tried to address the
problem by establishing maximum prices for grain and instructing farmers to supply it
to local markets. As one might expect, farmers did not cooperate with the new law.
Markets were empty of grain; further shortages developed; official tallies of grain
supplies failed to find and keep track of stocks; urban riots continued. The Convention
passed another law later in 1793 extending maximum prices to other essential supplies.
Those price controls, in combination with government requisitioning and corruption,
Champion Briefs 187

created chaos in the French economy. Merchants responded by reducing the quality of
their goods and the black market blossomed, Bourne noted. “It was the honest
merchant who became the victim of the law. His less scrupulous compeer refused to
succumb. The butcher in weighing meats added more scraps than before…other
shopkeepers sold second-rate goods at the maximum [price]…. The common people
complained that they were buying pear juice for wine, the oil of poppies for olive oil,
ashes for pepper, and starch for sugar.”
Impact: Lower quality drugs hurt patients
Bate, Roger. Oct 4, 2014. “Bad Medicine.” Foreign Policy,

https://foreignpolicy.com/2013/10/04/bad-medicine/. Accessed 7 Oct. 2018.
Champion Briefs 188

Analysis: This is a good argument because even if the pro is able to effectively argue that
research and development will be unharmed by price controls, the current drugs that are
already being made will see a reduction in quality. This is important because it means that
everyone on the market will be adversely affected by less effective medication.
Champion Briefs 189

A/2 - Price controls will result in lower quality assurance
Response: Generic versions will solve this problem
Warrant: The FDA helps generics
Reframing the Conversation on Drug Pricing - NEJM Catalyst.

https://catalyst.nejm.org/reframing-conversation-drug-pricing/. Accessed 7 Oct.
2018.
Efforts by the U.S. government to foster the generic pharmaceutical industry have
been extraordinarily successful in bringing high-quality medicines to the American
public at low cost. Branded drugs transition to generics very efficiently, often the day
after patent expiration. These efforts continue: Scott Gottlieb, MD, the new FDA
Commissioner, recently announced that the FDA will undertake efforts to reduce the
backlog of generic drug applications to speed these less expensive drugs to market and
enhance competition. The FDA regulates the generics industry, and the quality of
generic drugs entering the U.S., with few exceptions, has been high. Generics stimulate
innovation: because research-driven drug companies know years in advance when their
patents will expire, they strive to replace those losses with new patent-protected drugs.
Generally, they leave the generic market to manufacturers who specialize in that area.
Warrant: Generics offer a cheaper alternative of the same quality
Mrioa. “Generic Versus Proprietary Medications.” Medical Review Institute of America

LLC, 2 Apr. 2015, http://www.mrioa.com/generic-versus-proprietary-
medications/.
Champion Briefs 190

A generic drug (generic drugs, short: generics) is a drug defined as “a drug product that
is comparable to a brand/reference listed drug product in dosage form, strength,
quality and performance characteristics, and intended use.” It has also been defined as
a term referring to any drug marketed under its chemical name without advertising.
Although they may not be associated with a particular company, generic drugs are
subject to the regulations of the governments of countries where they are dispensed.
Generic drugs are labeled with the name of the manufacturer and the adopted name
(nonproprietary name) of the drug. A generic drug must contain the same active
ingredients as the original formulation. According to the U.S. Food and Drug
Administration (FDA), generic drugs are identical or within an acceptable bioequivalent
range to the brand-name counterpart with respect to pharmacokinetic and
pharmacodynamic properties. By extension, therefore, generics are considered (by the
FDA) identical in dose, strength, route of administration, safety, efficacy, and intended
use. The FDA’s use of the word “identical” is very much a legal interpretation, and is not
literal. In most cases, generic products are available once the patent protections
afforded to the original developer have expired. When generic products become
available, the market competition often leads to substantially lower prices for both
the original brand name product and the generic forms. The time it takes a generic
drug to appear on the market varies. In most countries of the world, patents give 20
years of protection. However, many countries/regions, e.g. the European Union and the
USA may grant up to 5 years of additional protection for drugs (“patent term
restoration”).
Analysis: This is a good response because even if the drugs created by big pharmaceutical
companies are of lower quality, generics will certainly be able to continue producing drugs at
the quality they are already at for an even lower price. This will solve back for the problem of
lower quality and thus eliminate the impact.
Response: the FDA regulates drug quality
Champion Briefs 191

Warrant: The FDA can demand a recall

Pharmaceutical Technology Editors, Costs of Failure in Product Quality | Pharmaceutical
Technology. http://www.pharmtech.com/costs-failure-product-quality. Accessed
7 Oct. 2018.
Poor quality in pharmaceuticals is often not visible or otherwise obvious to the

consumer, so the quality control and quality assurance (QA) activities performed by
the manufacturer are crucial. All products must be manufactured under strict cGMP
guidelines and require extensive controls and testing prior to release of the product.
Extensive testing is necessary to determine if a product is defective. When a quality
issue is suspected at any time, there must be proper investigations, root-cause
analyses, and action plans to address issues (1). In addition, if the products do not
meet specifications, all affected lots of the drug products must be recalled from
distribution after informing FDA and other regulatory agencies. Lots that have not
been distributed should be quarantined to prevent distribution.
Warrant: The FDA audits companies for drug quality
FDA, Research, Center for Drug Evaluation and. Manufacturing - Quality Systems
(Drugs).
https://www.fda.gov/drugs/developmentapprovalprocess/manufacturing/ucm2
78584.htm. Accessed 7 Oct. 2018.
The requirements of good manufacturing practice are underpinned by a central

objective: to create a system of programs, policies, processes, and facilities that
prevent errors and defects. Senior managers in the drug industry are responsible for
the effectiveness of this system, which is known as the Pharmaceutical Quality System
(PQS). A PQS is successful when it assures an ongoing state of control. In a healthy
Champion Briefs 192

PQS, managers establish a vigilant quality culture in which timely action is taken to
prevent risks to quality. Lifecycle adaptations are made to address manufacturing
weaknesses and continually improve systems. An effective process performance and
product quality monitoring program provides early warning of emerging quality issues.
Systemic solutions are implemented rather than ineffective shortcuts. A firm will also
habitually attend to the seemingly small problems that quality experts remind us later
would accumulate into costly, complex problems. An effective PQS will ultimately
support stable processes, and predictable quality and supply. FDA's routine
surveillance inspections determine whether a site’s Quality System is operating in a
state of control. Inspections cover multiple systems (see below compliance program).
All inspections audit the overall quality assurance system to determine if it is
functioning well. This aspect includes evaluating if responsible managers are notified of,
and respond to, emerging quality problems, process control issues, or any new stresses
on the system that may lead to defective medicines.
Analysis: This is a good argument because even if the quality of medicine goes down, the
quality will never reach a point that is harmful to consumers. This is because the FDA ensures
that there is at least a certain level of quality assurance for drugs.
Champion Briefs 193

CON – Price controls limit capital for research
Argument: Limiting the prices of drugs will decrease the amount of money companies make,
which will limit their research into more effective drugs. This will cost lives.
Warrant: Price controls hurt revenue for pharmaceutical companies
Sood, Neeraj, et al. “The Effect of Regulation on Pharmaceutical Revenues: Experience in

Nineteen Countries.” Current Neurology and Neuroscience Reports., U.S.
National Library of Medicine, 2009,
The lack of consensus is driven in part by the lack of systematic information about
current trends in pharmaceutical regulation and its effect on revenues. One strand of
existing studies compares pharmaceutical prices or spending across regulated and
unregulated markets. For example, a recent study by the U.S. Department of
Commerce reviewed pricing in eleven OECD countries and found that for patented
drugs that were best sellers in the United States, the prices in other OECD countries
were 18–67 percent less than U.S. prices, depending on the country. The study
concluded that price deregulation in these countries would increase pharmaceutical
revenues by 25–38 percent. 6 In general, these studies are limited by their reliance on
cross-sectional variation in revenues or prices and by their resulting vulnerability to
heterogeneity across countries in type of regulation and other determinants of prices.
There are some studies that address the heterogeneity problem by analyzing
longitudinal data and comparing pharmaceutical spending before and after policies take
effect.
Warrant: Price controls stifle research and development
Champion Briefs 194

Lakdawalla , Darius. “Should the Government Impose Drug Price Controls?” The New
York Times, The New York Times, 23 Sept. 2015,
www.nytimes.com/roomfordebate/2015/09/23/should-the-government-
impose-drug-price-controls/drug-price-controls-end-up-costing-patients-their-
health.
Price control advocates argue that curtailing profits in the pharmaceutical industry
would save the country money without reducing innovation. There is, however, no such
thing as a free lunch. Bureaucratic price manipulation would only hurt the sickest
patients. Research shows that price controls in the United Sates would powerfully
dampen innovation. "Cutting prices by 40 to 50 percent in the U.S. will lead to
between 30 to 60 percent fewer R&D projects being undertaken," one study found. A
2008 RAND study exploring the effect of U.S. price controls on those aged 55 to 59 in
the United States and Europe similarly found that, on net, pharmaceutical price controls
would hurt patients. The idea that we “overspend” on drugs is also misleading. In
2014, drug spending accounted for just 10 percent of U.S. health care spending, and
according to government actuaries, spending will increase by only 0.4 percentage points
over the next decade. Hospitals, for comparison, account for more than 30 percent of
total health care spending. Countries that use price controls advocated by industry
critics actually spend a larger share on drugs and use fewer cost-saving generics than
the United States does. Absent price controls, however, private negotiation works.
Warrant: Research is necessary to develop more effective drugs
Carroll, Aaron E. “This Drug Is Safe and Effective. Wait. Compared With What?” The New
York Times, The New York Times, 20 Aug. 2018,
www.nytimes.com/2018/08/20/upshot/medical-treatments-compared-
important-everyday-questions.html.
Champion Briefs 195

He said the research institute was the only organization dedicated primarily to
supporting and expanding this kind of research in the United States “with a rigor and
scale that match the importance of this relatively new approach to building knowledge
and information.” The research institute’s budget constitutes a small percentage of
overall public research funding. Basic science research is necessary to make
breakthroughs in how treatments might be created. Randomized controlled trials are
necessary to determine if they have efficacy. Pragmatic trials can tell us if and how
they’re effective in real world settings. Health services research can improve the ways
in which we deliver them. But without comparative effectiveness research, too many
important questions that concern patients will remain unanswered.
Impact: More effective drugs will save more lives
Lichtenberg, Frank. “Genuine Innovation: New Drugs Save Lives.” Seven Things I Learned
about the Transition from Communism | VOX, CEPR Policy Portal, 29 June 2008,
voxeu.org/article/genuine-innovation-new-drugs-save-lives.
Our estimates indicate that mean age at death increased more for diseases with larger
increases in mean drug vintage, and that increasing the mean vintage of drugs by 5
years would increase mean age at death by almost 11 months. The estimates also
indicated that using newer drugs has reduced premature mortality—especially
mortality before age 65—in the Australian population. The estimates of three potential
years of life lost equations tended to confirm the estimates of the mean age at death
equation. Our estimates allowed us to compare the actual increase in mean age at
death during the period 1995-2003 to the increase that would have occurred in the
absence of any increase in drug vintage. As shown in Figure 2, during this period, mean
age at death increased by about 2.0 years, from 74.4 to 76.4. The estimates imply that,
in the absence of any increase in drug vintage, mean age at death would have
Champion Briefs 196

increased by only 0.7 years. The increase in drug vintage accounts for about 65% of
the total increase in mean age at death.
Analysis: This argument is easy to weigh against any pro argument about the affordability of
medicine because even if it is true that the cost of medicine goes up without price controls, the
effectiveness of medicine will more than compensate for it. Any small dosage of leading
medicines will be able to cure people such that the high cost is no longer a barrier.
Furthermore, we will see cures to diseases that currently have no cures, which matters more
than prices because there currently exists no treatment for some diseases at any price at all, let
alone a low one.
Champion Briefs 197

A/2 - Price controls limit capital for research
Response: Investment is not always effective
Warrant: There is a point of diminishing returns
Frank, Richard, and Paul Ginsburg. “Pharmaceutical Industry Profits and Research and
Development.” Brookings, Brookings, 5 Mar. 2018,
www.brookings.edu/blog/usc-brookings-schaeffer-on-health-
policy/2017/11/17/pharmaceutical-industry-profits-and-research-and-
development/.
When the challenge of affording prescription drugs is raised, pharmaceutical

manufacturers often argue that steps to reduce prices will lead to less innovation in the
future. This response presumably applies to policies that use the market, such as
shortening periods of exclusivity and making approvals of generics more rapid, as well as
regulatory tools such as price controlsThe manufacturers’ argument has validity in that
expectations of lower revenues will lead to less investment in research and
development (R&D). But we question the premise that more innovation is always a
good thing. A central tenet of economics is the law of diminishing returns. In this case,
additional resources going into innovation inevitably yield fewer important
breakthroughs. At some point, perhaps already reached, the yield from additional
resources going into R&D no longer justifies what society is paying in the form of
higher prices to support this.
Warrant: There is a lack of collaboration between academia and pharmaceuticals
Champion Briefs 198

Ginsburg, Paul. “Pharmaceutical Industry Profits And Research And Development.” The
Physician Payments Sunshine Act, 13 Nov. 2017,
www.healthaffairs.org/do/10.1377/hblog20171113.880918/full/.
It seems obvious that many of the obstacles to effective academic-pharmaceutical

partnerships result from a fundamental lack of understanding by each party of the
other’s motivations and career pressures. Though, at least in principle, hypothesis
generation and testing drive the research in both environments, the culture, goals, and
guiding principles of the two sectors are fundamentally different. Investigators who
have spent their careers in one ecosystem are generally unaware of the values and
beliefs of their collaborators across the public-private divide. Unfortunately, academic
scientists are also often blind to the constraints dictated by the need to fund and
publish their own work, having lived with them so long that they are no longer
noticeable. Perhaps the root of most of the differences in culture can be traced to the
fundamental disparity in the commodity serving as the main internal and external
measure of achievement. In the academic world, the immediate unit of success is the
publication, whereas in preclinical research in the pharmaceutical sector it is a new
chemical or biological entity that can be advanced safely into human trials to treat
disease.
Analysis: This is a good response because it takes out the internal warrant of the argument—
the premise that the whole point relies on. Even if there is an increase in funding for research
and even if an increase in innovation would be great in theory, in practice it does not succeed
because of structural economic and practical barriers to success.
Response: Drug innovation will occur either way
Warrant: Innovation is driven by profit
Champion Briefs 199

There has been a variety of evidence assembled regarding the relationship between
profitability and innovation in the pharmaceutical industry. One major strand of
evidence involves natural experiments regarding industry responses to growth in the
size of markets.[ii] The logic behind this quasi-experimental approach is simple: Larger
markets generate greater revenues that in turn create expectations of more profits to
manufacturers, which expand investment in new drugs to pursue those profits. These
studies use factors that cause markets for prescription drugs to differ in size, such as
demographic changes like aging of the population (Acemeglu and Lin), expansion in
insurance coverage (Blume-Kohout and Sood; Dranove, Garthwaite, Hermosilla), and
country-disease prevalence differences in market sizes for specific drugs (Dubois, de
Mouzon, Scott-Morton, Seabright; Kyle and McGahan) to measure differences and
changes in market size. They then examine the innovation response from the industry.
Warrant: Public policy already drives innovation
McCaughan, Mike. “Pricing Orphan Drugs.” The Physician Payments Sunshine Act, 21
July 2017, www.healthaffairs.org/do/10.1377/hpb20170721.588081/full/.
A 1983 law created incentives to develop drugs to treat rare diseases that might
otherwise not justify commercial investment. Many of the drugs developed by
companies relying on incentives created by the Orphan Drug Act have high prices. This
has made the law controversial, though the relationship between those high prices and
the incentives in the law is not always clear. One prominent incentive in the Act is a
special period of market exclusivity that prohibits the Food and Drug Administration
(FDA) from approving a competing version of the drug for seven years--in essence, a
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statutory protection that increases pricing power for a drug marketer. In some
prominent cases, however, the orphan drug exclusivity has been used to provide
protection for drugs that have been available in unapproved forms for many years.
The resulting increase in the price of those products has garnered significant attention
from policy makers and the public.
Analysis: This is a good response because even if the entirety of the con argument is true, that
does not mean it is necessary to impose price controls to see innovation. There are plenty of
other opportunities to increase innovation that will exist either way, which means it will happen
with or without price controls.
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CON – Price controls increase long term costs of medicine
Argument: Because companies will make less money if the costs of drugs are lowered by price
controls, they will have less money coming in to fund much needed research into cheaper
drugs.
Warrant: Price controls will decrease revenue for pharmaceutical companies
Sood, Neeraj, et al. “The Effect of Regulation on Pharmaceutical Revenues: Experience in

Nineteen Countries.” Current Neurology and Neuroscience Reports., U.S.
National Library of Medicine, 2009,
Model 1 is the most general one and presents the impact of six broad categories of
policies: profit controls, budgets (either global budgets or at the physician level), direct
price controls (of any kind), reference pricing (of any kind), economic evaluations, and
number of policies for promoting generic use. We also included a control variable for
whether a country allows pharmacy chains. The results from this specification show that
three out of the six aggregate regulation groups reduce revenues significantly. Direct
price controls have the largest impact on revenues, followed by economic evaluations
and budgets. In particular, direct price controls reduce revenues by 18.3%, economic
evaluations and budgets have a much smaller impact of around 6%. Note that the
small impact of economic evaluations might in part be due to our definition of
economic evaluations that includes both mandatory economic evaluations (which
would probably have a larger impact) and regulations that strongly encourage
pharmaceutical firms to conduct economic evaluations (which would probably have a
smaller impact). It is important to note that since all the policy variables are
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dichotomous the size of the coefficient should be interpreted as an average of the short
and long term impacts of the policy.
Warrant: Price controls will decrease money allocated to innovation

Lakdawalla , Darius. “Should the Government Impose Drug Price Controls?” The New
York Times, The New York Times, 23 Sept. 2015,
impose-drug-price-controls/drug-price-controls-end-up-costing-patients-their-
health.
Turing Pharmaceuticals pursued a windfall gain from a drug they did not bring to
market, but the episode is more the exception than the rule. Effective new drugs bring
greater rewards to patients than to the firms that sell them. For instance,
breakthroughs in the treatment of H.I.V. generated financial rewards for their inventors,
but also decades of healthy life to patients who once saw their H.I.V. as a death
sentence. Indeed, academic research finds more than four-fifths of the value created by
new drugs flows to patients in the form of health benefits, and less than one-fifth flows
to manufacturers. Rather than price controls, we need value-based payment policies
that reward companies that bring real value to patients and penalize firms who do
not. Drug price controls would stifle the introduction of valuable new drugs, because
innovators will spend less pursuing new drugs if they expect to earn fewer rewards
from discovering them. Our research finds that, if the U.S. government were to begin
negotiating drug prices the way other governments do, drug prices would fall by about
20 percent, but innovation would fall by even more. Patients would see their lives cut
short by delayed or absent drug launches. On balance, America would lose more in the
form of premature mortality from price controls than it would gain in lower spending.
Warrant: Innovation brings more drugs on the market, reducing prices through competition
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Howard, Paul. “Should the Government Impose Drug Price Controls?” The New York
Times, The New York Times, 28 Sept. 2015,
impose-drug-price-controls/to-lower-drug-prices-innovate-dont-regulate.
Better prices can be enjoyed today without compromising tomorrow’s cures. But
instead of exercising greater control over the industry, reformers should opt for less —
focusing instead on efficiency, innovation and competition. First, modernize the drug
development process to ensure that companies can develop safe and effective
medicines for Food and Drug Administration approval faster and at less cost than is
currently possible. Getting more drugs to market means more competition between
producers. As we’ve seen from new medicines combating hepatitis C, the emergence
of multiple drugs has helped insurers negotiate up to 50 percent price cuts. And
because the health benefits of new medicines are so large, advancing one generation
of F.D.A. drug approvals (or 25 new drugs) by a just a single year would generate $4
trillion in benefits to U.S. patients.Second, Congress should retool entitlement
programs to encourage greater competition among providers and insurers based on real
health outcomes. Ground level efficiency in patient care, not top-down price controls,
will ensure consumers and taxpayers get the maximum value for their health care
dollars without dampening innovation.
Impact: High drug prices make drugs unaffordable
Fielding, Jonathan. “The High Cost of Rising Drug Prices.” U.S. News & World Report,
U.S. News & World Report, 21 Dec. 2017, www.usnews.com/opinion/policy-
dose/articles/2017-12-21/the-high-cost-of-rising-drug-prices.
Lowering drug prices is long overdue, but this report shows what patients are up
against. Right now, spending on prescription drugs rises at a rate faster than any other
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health care cost. Growing numbers of Americans can't afford their medications,
forcing too many to skip them altogether. Alex Azar, President Donald Trump's pick for
health and human services secretary, told a Senate Committee last month that bringing
drug prices down would be his top priority, confirming this is the president's priority as
well. Encouraging words, but choosing Azar as a change agent is ironic. Consider insulin,
critical to more than 6 million Americans with Type 1 diabetes. Between 2002 and 2013,
drug makers Sanofi, Novo Nordisk and Eli Lilly (under Azar's leadership) raised prices in
lockstep. Their insulin more than tripled in price to as much as $300 per patient, per
month. Closed-door negotiations between drug makers, insurance companies and
middlemen pharmacy benefit managers, which came to light earlier this year,
contributed to these outsize price increases. When list prices rise, many with health
insurance still see their out-of-pocket costs go up. Increasingly high patient co-
payments, which require them to pay a portion of their drug costs, are based on
whether the drugs are generic, preferred branded, other branded or specialty. The
result: costs of some commonly prescribed drugs have become unaffordable for many
patients.
Analysis: This is a really good argument because you can agree to the weighing mechanism of
the pro, which will likely have to do with making medicine affordable and simply say that you
outweigh in the long run. This is because, for a long term reduction in drugs, companies need to
develop more cost efficient ways to manufacture them, which you can only get with research in
development.
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A/2 - Price controls increase long term costs of medicine
Response: Research and development increases the costs of drugs
Warrant: Companies must raise the cost of drugs to compensate for research spending
In addition, for many drugs the costs of imitation are low. It is simple and low cost for a
firm that did not develop the drug to produce a copy of a new drug. This means that if
free competition were permitted, firms spending hundreds of millions of dollars to bring
a new drug to market would be unlikely to recoup those investments, as competition
would drive prices down to production costs ("pennies a pill”). It is these features of the
economics of new drug development that make the establishment of intellectual
property rights through the patent system and regulation of marketing exclusivity so
important to promoting innovation in prescription drugs. Establishing temporary
monopoly power for makers of new prescription drug products enables innovator
companies to raise prices above the level of production costs and realize economic
profits to compensate for the investment in pharmaceutical R&D.
Warrant: Research and development involves costs that are included in medicine prices
Angell, Marica. “Why Do Drug Companies Charge so Much? Because They Can.” The
Washington Post, WP Company, 25 Sept. 2015,
www.washingtonpost.com/opinions/why-do-drug-companies-charge-so-much-
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because-they-can/2015/09/25/967d3df4-6266-11e5-b38e-
06883aacba64_story.html?utm_term=.af0856bca6a3.
Drug companies say high prices are necessary to cover their research and
development costs, enabling them to discover innovative new medicines. Turing says
it planned to use the profits from Daraprim’s higher price to fund research into better
treatments for toxoplasmosis. But in fact, Daraprim illustrates the way most drugs are
priced: They are invented not by the companies that sell them now but by someone
else. Then, like big fish swallowing little fish, larger companies either buy small firms
outright or license promising drugs from them. Very often, the original discovery occurs
in a university lab with public funding from the National Institutes of Health (NIH), then
licensed to a start-up company partly owned by the university and then to a large
company. There is very little innovation at the big drug firms. Instead, their major
creative output is trivial variations of top-selling medications that are already on the
market (called “me-too drugs”), to cash in with treatments just different enough to
justify new patents.
Analysis: This is a good response because even if there is more research and development,
there is no guarantee that will actually reduce prices. In fact, this turns the argument into a
voting issue for the pro because the whole reason we have high prices to begin with is due to
high spending on research and development.
Response: Drug innovations will occur either way
Warrant: Policies already exist to incentivize innovation
Yin, Wesley. “Market Incentives and Pharmaceutical Innovation.” Science Direct, 2008.
https://luskin.ucla.edu/sites/default/files/download-pdfs/ODA_innovation.pdf
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I study the impact of the Orphan Drug Act (ODA), which established tax incentives for
rare disease drug development. I examine the flow of new clinical drug trials for a large
set of rare diseases. Among more prevalent rare diseases, the ODA led to a significant
and sustained increase in new trials. The impact for less prevalent rare diseases was
limited to an increase in the stock of drugs. Tax credits can stimulate R&D; yet because
they leave revenue margins unaffected, tax credits appear to have a more limited
impact on private innovation in markets with smaller revenue potential. This paper
studies the impact of public policy on private innovation. Policy intervention is
normatively justified when market failures lead to inefficient allocation of R&D
investments. Whether public policies can improve welfare in these cases depends in
large part on whether they are able to stimulate innovation.
Warrant: Innovation is driven by profit
Krieger, Joshua, et al. “Everyone Wants Pharmaceutical Breakthroughs. What Drives

Drug Companies to Pursue Them?” Kellogg Insight, 6 Sept. 2018,
insight.kellogg.northwestern.edu/article/everyone-wants-pharmaceutical-
breakthroughs-what-drives-drug-companies-to-pursue-them.
Yet the researchers found that firms were eager to work on novel drugs—under the
right financial circumstances. When pharmaceutical companies got a windfall, such as
a sudden increase in profits, they were more likely to spend it on developing novel
drugs than on incremental improvements. The reverse, of course, is also likely true,
Papanikolaou says. Firms may be held back from pursuing innovative therapies because
they lack the cash to turn their financially riskier ideas into reality. “These financial
frictions may be limiting innovation,” says Papanikolaou, who collaborated with Joshua
Krieger of Harvard Business School and Danielle Li of MIT Sloan School of Management
on the research. If society wants to encourage more novel drugs, he says, one solution
would be to increase the supply of capital to these firms.
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Analysis: This is a good response because even if the entirety of the con argument is true, that
does not mean it is necessary to impose price controls to see innovation. There are plenty of
other opportunities to increase innovation that will exist either way, which means it will happen
with or without price controls.
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CON – Price Controls would raise drug prices elsewhere
Argument: When the United States institutes price controls this will cut pharmaceutical profits,
leading to shortages and price spikes abroad.
Warrant: The US is one of the only countries without price controls
Anupam B. Jena, The Hill, "US drug prices higher than in the rest of the world, here's
why", 1/19/18, https://thehill.com/opinion/healthcare/369727-us-drug-prices-
higher-than-in-the-rest-of-the-world-heres-why
One answer is that nearly all countries except the U.S. have policies to lower drug
prices, including price controls, regulations that limit the profitability of drugs,
reference pricing, and cost-effectiveness thresholds (e.g., in the U.K., the National
Health Service is the main purchaser of drugs and frequently does not cover therapies
whose cost per "quality-adjusted" life year gained exceeds $50,000 per year).
Warrant: The United States, by paying higher prices, subsidizes research costs for foreign
governments
William Safire, The New York Times, "The Doughnut's

Hole", 10/27/2003, https://www.nytimes.com/2003/10/27/opinion/the-
doughnut-s-hole.html
The price of most new prescription drugs is high in the U.S. mainly because it includes
the producers' huge investment in scientific research. In Canada, the government strips
out the cost of such research and imposes a low price ceiling. Shortsightedly, our
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pharmaceutical companies have meekly or greedily gone along with this foreign rip-
off, picking up extra sales on a research investment already made. But this foolish
acceptance of foreign price controls means that the U.S. consumer is subsidizing the
foreign consumer. Not being dopes, pursuing their economic interest, American
bargain-hunters are now buying these drugs where they are sold cheaply -- outside the
U.S.
Warrant: Companies will have less funding for research if we institute price controls
Robert J. Easton, Stat News, "Price controls would stifle innovation in the
pharmaceutical
industry", 12/22/18, https://www.statnews.com/2018/01/22/price-controls-
pharmaceutical-industry/
But if U.S. drug prices come under bureaucratic control, as they have in most of
Europe and Japan, it will be a different story. Little pharmaceutical innovation occurs in
price-control jurisdictions. The United States has always, by a large margin, led the
world as a source of new drugs, and that lead has widened as Japan and Germany have
imposed price controls over the past few decades. All major international
pharmaceutical companies, without exception, have instituted R&D and commercial
operations in the U.S. to take advantage of its pricing environment.
Impact: Higher prices would be particularly harmful for developing countries
Chris Lo, Pharmaceutical Technology, "Cost control: drug pricing policies around the
world", 2/12/18, https://www.pharmaceutical-technology.com/features/cost-
control-drug-pricing-policies-around-world/
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And for developing countries, where medicines can represent up to 60% of healthcare
spending and the vast majority of people pay out-of-pocket for prescription drugs, the
stakes are even higher. A lack of widespread access to innovative treatments has a
major impact on public health. A vital method of boosting access is forming coherent
national pricing policies that best serve the health of a country’s population while
maintaining a viable, as acknowledged by the World Health Organization.
Analysis: This argument is strategic because you can concede the affirmative’s arguments that
drugs in the United States would be cheaper, but then argue that this is less important than
drugs being cheaper for the less fortunate in developing countries.
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A/2 - Price Controls would raise drug prices elsewhere
Response: Slightly cutting profits won’t change much for pharmaceutical companies- they have
exorbitant profits as it is
Warrant: The industry has huge profit margins
Richard Anderson, BBC News, "Pharmaceutical industry gets high on fat

profits", 11/6/14, https://www.bbc.com/news/business-28212223
Last year, US giant Pfizer, the world's largest drug company by pharmaceutical
revenue, made an eye-watering 42% profit margin. As one industry veteran
understandably says: "I wouldn't be able to justify [those kinds of margins]." Stripping
out the one-off $10bn (£6.2bn) the company made from spinning off its animal health
business leaves a margin of 24%, still pretty spectacular by any standard. In the UK, for
example, there was widespread anger when the industry regulator predicted energy
companies' profit margins would grow from 4% to 8% this year.
Warrant: Pharmaceuticals ranked as the most profitable industry
Public Citizen, "Pharmaceuticals Rank as Most Profitable Industry,

Again", https://www.citizen.org/article/pharmaceuticals-rank-most-profitable-
industry-again
While the overall profits of Fortune 500 companies declined by 53 percent the second
deepest dive in profits the Fortune 500 has taken in its 47 years the top 10 U.S. drug
makers increased profits by 33 percent. Collectively, the 10 drug companies in the
Fortune 500 topped all three of the magazine s measures of profitability in 2001,
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according to Fortune magazine s annual analysis of America s largest companies. These

companies had the greatest return on revenues, reporting a profit of 18.5 cents for
every $1 of sales, which was eight times higher than the median for all Fortune 500
industries and easily more than the next most profitable industry, commercial banking
(13.5 percent return on revenue). The drug industry also dominated others by realizing a
return on assets of 16.5 percent almost six times the median (2.5 percent) posted by all
industries. Pharmaceutical companies completed the sweep with a return on
shareholders' equity (33.2 percent) that was more than three times the median of all
Fortune 500 industries (9.8 percent). (See Graph 1 and Table 1)
Analysis: This is a good response because even if you concede the link that profits would go
down, you reduce the probability of the impact by showing that even a large reduction in profit
would not be enough to force the companies to change their prices for the rest of the world.
Response: The concept of foreign free riding is a myth
Warrant: In foreign countries, companies more than profit
Donald W Light, US National Library of Medicine, "Foreign free riders and the high price
of US
medicines", 10/22/05, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1261198
/
We can find no convincing evidence to support the view that the lower prices in affluent
countries outside the United States do not pay for research and development costs. The
latest report from the UK Pharmaceutical Price Regulation Scheme documents that drug
companies in the United Kingdom invest proportionately more of their revenues from
domestic sales in research and development than do companies in the US. Prices in
the UK are much lower than those in the US yet profits remain robust.9,10 Companies
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in other countries also fully recover their research and development costs, maintain
high profits, and sell drugs at substantially lower prices than in the US. For example, in
Canada the 35 companies that are members of the brand name industry association
report that income from domestic sales is, on average, about 10 times greater than
research and development costs.11 They have profits higher than makers of computer
equipment and telecommunications carriers12 despite prices being about 40% lower
than in the US.11
Analysis: This is a good response because it shows, at least in the case of the UK, a world with
price controls could be better for R&D investment. Additionally, this would prove that no
matter what other countries would be unaffected by changes in drug prices in the United
States.
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CON – Drugs Account for Very Little of Healthcare Spending
Argument: Prescription medications and their prices are a non-issue.
Warrant: Spending on prescription drugs has remained the same
Patrick Gleason, Forbes, "States Consider Imposing Drug Price

Controls", 2/21/17, https://www.forbes.com/sites/patrickgleason/2017/02/21/s
tates-consider-imposing-drug-price-controls/#1d791645639b
For starters, the justification for price controls on prescription drugs is based in myth.
The claim that U.S. drug spending is growing out of control is simply not true. Spending
on prescription drugs as a share of all health care spending in the U.S. is the same as it
was 60 years ago.
Warrant: Spending growth is slowing in the status quo
Centers for Medicare & Medicaid Services, "National Health Expenditures 2016
Highlights ", https://www.cms.gov/Research-Statistics-Data-and-
Systems/Statistics-Trends-and-
Reports/NationalHealthExpendData/downloads/highlights.pdf
Growth in retail prescription drug spending slowed in 2016, increasing 1.3 percent to
$328.6 billion. The slower growth in 2016 follows two years of strong growth in 2014
and 2015, 12.4 percent and 8.9 percent, respectively. This strong growth reflected
increased spending on new medicines and price growth for existing brand-name drugs,
particularly for drugs used to treat hepatitis C. Growth slowed in 2016 primarily due to
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fewer new drug approvals, slower growth in brand-name drug spending as spending
for hepatitis C drugs declined, and a decline in spending for generic drugs as price
growth slowed.
Warrant: Drug costs make up a marginal amount of American healthcare spending
Paul Howard, Manhattan Institute, "Issues 2016: Drug Price Controls Hurt Patients
Most", 10/2/15, https://www.manhattan-institute.org/html/issues-2016-drug-
price-controls-hurt-patients-most-7949.html
U.S. drug spending is not out of control; reducing it will not substantially affect overall
health care costs. U.S. spending on drugs accounts for a smaller share of total health
care spending—about 10 percent—than in Europe, where drug price controls are in
place. U.S. drug spending as a share of health care spending is expected to remain flat;
the out-of-pocket share of drug spending is expected to decline. Drug spending is
cyclical. After a decade of low increases in drug spending, driven by generic competition
(drug spending by private insurers actually declined by 0.5 percent in 2013), more new,
powerful drugs are coming to market. Eventually, these drugs will lose patent protection
and become cheap generics.
Impact: Even a large reduction in drug spending would have a negligible affect on the average
American’s healthcare costs.
Darius Lakdawalla, The New York Times, "Drug Price Controls End Up Costing Patients
Their
Health", 9/23/15, https://www.nytimes.com/roomfordebate/2015/09/23/shoul
d-the-government-impose-drug-price-controls/drug-price-controls-end-up-
costing-patients-their-health
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On the other side of the ledger, drug price controls would not save that much money.
According to federal government data, prescription drug spending makes up roughly
one-tenth of America’s total bill for health care. Lopping 20 percent off drug prices by
negotiating prices would thus shave all of 2 percent off our total health care bill.
What’s more, we will enjoy only a one-time cost reduction, because drug spending has
been growing no faster than overall health care spending over the past 10 years.
Bluntly pushing down all drug prices will save us little and cost us dearly. America needs
a more refined solution that preserves rewards for the hard work of innovators but
snatches them away from speculators.
Analysis: This argument is strategic as even if your opponents win that price controls do as
they’re intended, they have a menial impact on healthcare spending, meaning that there’s no
reason to affirm.
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A/2 - Drugs Account for Very Little of Healthcare Spending
Response: US drug spending is massive
Warrant: US spends 50% more than other countries on healthcare
Dan Mangan, CNBC, "US health-care spending is high. Results are...not so

good", 10/8/15, https://www.cnbc.com/2015/10/08/us-health-care-spending-is-
high-results-arenot-so-good.html
The U.S. spent an average of $9,086 per person on health care in 2013, which translated
to more than 17 percent of gross domestic product, the fund noted. That level of health
spending relative to GDP is about 50 percent more than any of the countries studied
for the report, which are Australia, Canada, Denmark, France, Germany, Japan, the
Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.
Warrant: Prescription drug spending is increasing
Carolyn Y. Johnson, The Washington Post, "U.S. spending on drugs will grow faster than
on other health-care services over the next
decade", https://www.washingtonpost.com/news/wonk/wp/2018/02/14/u-s-
spending-on-drugs-will-grow-faster-than-other-health-care-services-over-the-
next-decade/?utm_term=.53f70b897bc7
Prescription drug spending will grow faster than any other major medical good or
service over the next decade, according to a projection from the Centers for Medicare
and Medicaid Services. The analysis, published in the journal Health Affairs, estimates
that by 2026, national health spending will climb to $5.7 trillion, or nearly a fifth of the
Champion Briefs 219

economy. Prescription drug spending is forecast to grow at 6.3 percent per year, on
average, between 2017 to 2026.
Analysis: This is a good response because even if the negative wins that drug spending is a
small percentage of overall spending, this shows that overall spending is ridiculously high and
should be reduced at all costs. Additionally, the second study disproves the assertion that
spending is not likely to increase.
Response: Even 10% of healthcare spending is too expensive
Warrant: Americans are foregoing medications because of cost
Renal and Urology News, "Almost 1 in 10 Americans Can't Afford Medications Says
CDC", 2/4/15, https://www.renalandurologynews.com/news/cdc-americans-can-
not-afford-medications-eight-percent/article/395374/
Nearly 1 in 10 American adults don't take their medications as prescribed because

they can't afford to, according to a January data brief published by the U.S. Centers for
Disease Control and Prevention's National Center for Health Statistics. The researchers
used data from the 2013 National Health Interview for the report. Overall, they found,
7.8% of adults admitted not taking medication as recommended because of high costs.
Insurance was a key factor in whether patients took their medications as prescribed.
Among adults younger than 64, 6.1% with private insurance skipped medications to save
money, compared with 10.4% of those with Medicaid and 14.0% of uninsured patients.
Analysis: This is a good response because even when assuming that drug prices are a small
percentage of overall expenses, this proves that even that small percentage is too much and
has adverse health effects.
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CON – Price Controls Limit Research into Orphan Diseases
Argument: Price controls would remove the incentive for companies to research rare diseases
Warrant: Many Americans are affected by rare diseases
Jones, Nicola. “Sea Holds Treasure Trove of Rare-Earth Elements.” Nature News, Nature
Publishing Group, 3 July 2011,
www.nature.com/news/2011/110703/full/news.2011.393.html.
The last day of February has been designated as World “Rare Disease Day” to call
attention to the public health issues associated with rare diseases. The Project Charity
— The Children’s Rare Disease Network has compiled some facts and figures about rare
disease that we thought would be of interest. If you have other facts and figures not on
our list, please send them to us. We are particularly interested in international facts on
rare disease that do not seem to be available. Approximately 7,000 rare disorders are
known to exist and new ones are discovered each year. Rare disease affects between
25-30 million people in the United States and approximately 30 million people in the
European Union .One in 10 Americans is living with a rare disease. Children represent
the vast majority of those afflicted with rare disease
Warrant: If pharmaceuticals become less profitable after price controls, investors will put their
money into other industries
Sarah Kliff, Vox, "The true story of America’s sky-high prescription drug prices", 5/10/18,
https://www.vox.com/science-and-health/2016/11/30/12945756/prescription-
drug-prices-explained
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What’s harder to see is that if we did lower drug prices, we would be making a trade-off.
Lowering drug profits would make pharmaceuticals a less desirable industry for
investors. And less investment in drugs would mean less research toward new and
innovative cures. There’s this analogy that Craig Garthwaite, a professor at Kellogg
School of Management who studies drug prices, gave me that helped make this clear.
Think about a venture capitalist who is deciding whether to invest $10 million in a social
media app or a cure for pancreatic cancer. “As you decrease the potential profits I’m
going to make from pancreatic cures, I’m going to shift more of my investment over to
apps or just keep the money in the bank and earn the money I make there,”
Garthwaite says.
Warrant: Less profit and less investment means long term fewer treatments
Anupam B. Jena, The Hill, "US drug prices higher than in the rest of the world, here's
why", 1/19/18, https://thehill.com/opinion/healthcare/369727-us-drug-prices-
higher-than-in-the-rest-of-the-world-heres-why
Multiple economic studies suggest that lower profits will lead future patients to have
fewer new therapies. These studies typically examine how the number of new FDA-
approved drugs change when policies make drugs more or less profitable (e.g.,
Medicare Part D, which expanded drug insurance coverage for the elderly and raised
expected profits to drug manufacturers, was associated with increases in R&D for drug
classes with high Medicare market-share).
Impact: Less investment overall would deprive those with orphan diseases of treatment
Robert J. Easton, Stat News, "Price controls would stifle innovation in the
pharmaceutical
industry", 12/22/18, https://www.statnews.com/2018/01/22/price-controls-
Champion Briefs 222

pharmaceutical-industry/
Squeezing pharmaceutical R&D spending down to one-fifth of what it is today would

also have an enormous impact on the problems that drug developers often choose to
address. Orphan diseases would be deprioritized, as the returns under price controls
would not warrant the investment. Complex diseases would also be deselected. While
Alzheimer’s disease and diabetes have huge patient populations, the extremely high
cost of conducting the difficult research and the need for huge and complex clinical
trials would dissuade all but the largest companies from pursuing those illnesses if the
potential pricing upside was to be significantly constrained. Moreover, for difficult
diseases like schizophrenia, where today’s treatments are mostly inadequate, the flow
of more effective new treatments would slow from a trickle to a rivulet, depriving
those with these conditions from the possibility of relief.
Analysis: This argument is strategic as you could argue that more expensive medicines for
everyone is preferable to no treatments existing for one-tenth of the US population.
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A/2 - Price Controls Limit Research into Orphan Diseases
Response: Existing laws encouraging research into orphan diseases would continue to do so
even with price controls
Warrant: Companies receive many benefits from the government for researching orphan
diseases
Shawn Radcliffe, The Huffington Post, "Why Are Drug Prices for Rare Diseases on the
Rise?", 3/16/17, https://www.huffingtonpost.com/entry/why-are-drug-prices-
for-rare-diseases-on-the-rise_us_58caf2fae4b0537abd956eff
According to the National Institutes of Health (NIH), there are around 7,000 rare
diseases, which affect a total of 25 to 30 million Americans. In exchange for investing in
research and development of orphan drugs, companies receive a tax credit on
research and development, access to federal grants, and exclusive rights to sell the
drug for that disease in the United States, even if the patent expires before then.
Warrant: The ODTC has increased orphan drug investment by one-third.
National Organization for Rare Disorders , "Trends in Orphan Drug Costs and
Expenditures Do Not Support Revisions in the Orphan Drug Act: Background and
History", https://rarediseases.org/wp-content/uploads/2017/10/NORD-IMS-
Report_FNL.pdf
From the patient perspective, the Orphan Drug Act has been extremely successful,
encouraging research and development of products for diseases that would otherwise
have no treatment. While the vast majority of the 7,000 diseases do not yet have an
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FDA-approved treatment, many patients and caregivers feel that the ODA offers hope
that even those with the rarest of diseases may someday have a treatment, thereby
eliminating or reducing the need for a lifetime of medical care. The three primary
incentives of the ODA, along with waived user fees, have each contributed substantially
to the success of the law. Credit is most often given to exclusivity, which has indeed
proven a powerful incentive. However, a 2015 study underscored the substantial
importance of the orphan drug tax credit (ODTC). According to that study, investment
in orphan drugs would be reduced by one-third without the ODTC.12
Analysis: This is a good response because even if companies would profit less off of orphan
drugs, there are other incentives in place to protect those profit margins. This legislation
ensures that orphan disease cures will still be researched.
Response: Orphan disease research is cheaper
Warrant: It is far simpler to pass clinical trials
Diana Kwon, The Scientist, "How Orphan Drugs Became a Highly Profitable
Industry", 5/1/18, https://www.the-scientist.com/features/how-orphan-drugs-
became-a-highly-profitable-industry-64278
“There’s an opportunity to generate convincing clinical safety and efficacy data with
very limited patient populations,” says James Wilson, director of the Orphan Disease
Center at the University of Pennsylvania. “There could be a quick path to [regulatory
approval], which means the cost of development would be a fraction of what it could be
for more-common diseases.” According to Wilson, a company could achieve approval
for an orphan drug with as few as 20 individuals, whereas a treatment for a common
cardiovascular condition or a vaccine to prevent infection might need to be tested on
thousands of people. For example, the Phase 3 trial for Luxturna included only 31
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participants. And the FDA greenlighted vestronidase alfa-vjbk (MEPSEVII), an enzyme

replacement therapy for another rare lysosomal storage disorder, in November 2017
after testing in just 23 patients.
Warrant: FDA fast tracks can even be used on different products made by the same company
U.S. Food and Drug Administration, "Rare Pediatric Disease Priority Review Voucher
Program", 11/02/17, https://www.fda.gov/forindustry/developingproductsforrar
ediseasesconditions/rarepediatricdiseasepriorityvoucherprogram/default.htm
Under Section 529 to the Federal Food, Drug, and Cosmetic Act (FD&C Act), FDA will
award priority review vouchers to sponsors of rare pediatric disease product
applications that meet certain criteria. Under this program, a sponsor who receives an
approval for a drug or biologic for a "rare pediatric disease" may qualify for a voucher
that can be redeemed to receive a priority review of a subsequent marketing
application for a different product.
Analysis: This is a good response because it shows yet another reason why companies are
motivated to invest in orphan disease treatments other than purely profit. The FDA vouchers
can even be used on other treatments made by the same company for more common diseases.
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CON – Most Americans use generic medicines that are already

inexpensive
Argument: Due to the accessibility of generic medicines, price controls wouldn’t affect most
Americans.
Warrant: Most prescribed medicines are generic
Hensley, Scott. “3 In 4 U.S. Prescriptions Are Now For Generic Drugs.” NPR, NPR, 20 Apr.
2011, www.npr.org/sections/health-shots/2011/05/16/135538006/3-in-4-
prescriptions-are-now-for-generic-drugs.
In 2010, generic medicines accounted for more than three-quarters of the

prescriptions dispensed by retail drugstores and long-term care facilities. The exact
figure is 78 percent, a historic high, that was up four percentage points from 2009.
Generic use has climbed steadily from 63 percent of dispensed prescriptions in 2006.
Warrant: The FDA is approving new generic medications at record high rates
Foley, Katherine Ellen. “The US Is Approving More Generic Drugs than Ever.” Quartz,
Quartz, 13 Oct. 2017, qz.com/1101897/more-generic-drugs-were-approved-by-
the-us-fda-in-fy-2017-than-ever-before/.
By the end of the 2017 fiscal year in September, the US Food and Drug Administration
had approved 763 new generic versions of drugs—112 more than it had in 2016,
almost twice as many as in 2014. This record push is part of an effort to lower
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prescription drug costs. Generic drugs, which work the same way as previously
patented pharmaceuticals, are less expensive than name-brand drugs.
Warrant: Prescribing generic drugs lowers the cost of name brand medications as well
“Expanding the Use of Generic Drugs.” ASPE, ASPE, 23 Mar. 2017, aspe.hhs.gov/basic-
report/expanding-use-generic-drugs.
Another possible pathway for savings is a reduction in average branded prices paid by
consumers resulting from generic substitution. A study by Rizzo and Zeckhauser found
that a higher share of generic prescriptions result in lower average brand drug prices.
The theory is that consumers are more likely to substitute generics for higher cost
branded drugs and conversely less likely to substitute generics for lower cost branded
drugs. This selective substitution would then effectively lower the average cost of
branded drugs by leading brand name manufacturers to choose lower initial prices.
This study found that a 10 percent increase in the generic substitution rate is
associated with a 15.6 percent decline in the average price paid for branded drugs(10).
Impact: Total pharmaceutical spending is lower in the US compared to other OECD nations
www.forbes.com/sites/econostats/2017/10/12/price-controls-will-reduce-
innovation-and-health-outcomes/#481badd863a6.
spending as a percentage of total health care spending is lower in the U.S. (12.2
percent) than the average for the 30 nations that comprise the Organization for
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Economic Cooperation and Development, or OECD, (16.9 percent). This is due to, in
part, the prevalence of generic medicines that are more affordable here than in other
OECD nations.
Analysis: This argument is beneficial as it shows not only an alternative to expensive brand
name drugs, but reveals a trend of drug prices decreasing over time as more generics are
prescribed pushing down the price of brand name drugs.
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A/2 - Most Americans use generic medicines that are already

inexpensive
Response: Even if generic medications exist, doctors may not prescribe them
Warrant: Americans spent an unnecessary $73 billion due to doctors unnecessarily prescribing
the name brand
Silverman, Ed. “What Generics? Americans Spent an Extra $73b for Brand-Name
Meds.” STAT, STAT, 24 May 2016,
www.statnews.com/pharmalot/2016/05/09/generics-drug-prices-cholesterol/.
Doctors may be encouraged to prescribe lower-cost generics, but a new study found
that Americans spent an extra $73 billion between 2010 and 2012 on pricier brand-
name drugs because physicians failed to sufficiently recommend these copycat
treatments to their patients. And consumers paid nearly one-third of those additional
costs through out-of-pocket payments. Notably, the study found that the excess
spending occurred when a generic version was not available for a specific brand-name
drug, but a doctor could have prescribed a lower-cost, copycat for a similar brand-name
medicine. For example, instead of prescribing a lower-cost generic for a brand-name
cholesterol pill, a doctor might have prescribed a similar brand-name cholesterol
medicine.
Warrant: Doctors can be incentivized to prescribe name brand medications due to handouts
from companies
Hensley, Scott. “Why Didn't Your Doctor Prescribe A Generic? Look In The Mirror.” NPR,
NPR, 7 Jan. 2013, www.npr.org/sections/health-
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shots/2013/01/07/168810473/why-didnt-your-doctor-prescribe-a-generic-look-
in-the-mirror.
So when there's a generic available, why do doctors still write prescriptions for the
brand? One reason: You asked for it. Some 37 percent of doctors surveyed say they
sometimes go ahead and prescribe a brand-name drug upon request, even when
there's a generic available. The researchers found that doctors' willingness to
prescribe a brand was associated with their acceptance of free food from drugmakers.
They were also more likely to accept samples of brand-name drugs to hand out to
their patients, too. The findings were just published online by JAMA Internal Medicine.
The researchers figure their estimates of doctors' willingness to prescribe a brand are
at the low end of what happens in reality. Doctors surveyed (about 1,900 in this study)
may not be inclined to fess up about going along with patients' requests.
Analysis: This response takes out the internal link in the neg’s argument as a prerequisite to
generic drugs solving is that they actually get prescribed to patients. This weighs well as your
opponents have the burden of proof to show that these drugs, no matter how effective,
actually get to patients.
Response: Generic manufacturers have shortages that cost American lives
Warrant: Because generics are less profitable, few companies produce them
Ramsey, Lydia. “We're Running out of Commonly Used Drugs - and Hospitals Say It's
'Quickly Becoming a Crisis'.” Business Insider, Business Insider, 10 Nov. 2017,
www.businessinsider.com/drug-shortages-are-getting-worse-american-hospital-
association-2017-11.
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There simply are not enough companies making the drug to keep up with demand. It's
all part of a consolidation of the manufacturers who produce generic drugs. US generic
companies have had a harder time turning a profit on generic drugs while competing
with companies outside the US that are able to make the same drugs at a cheaper cost.
That's caused manufacturers to home in on certain generic drugs and discontinue
others that don't make as much money. And if a generic manufacturer has a shortage,
there's no easy fix — you can't just pass off the job to another company while the first
fixes its problems, since getting approval to take on a new drug can take years.
Warrant: Generic manufacturers don’t have the incentive to produce a surplus of drugs when
they are less profitable
Chagpar, Anees. “America's Ongoing Lack of Generic Drugs Is a Matter of Life and
Death.” Quartz, Quartz, 3 Apr. 2016, qz.com/653136/americas-ongoing-lack-of-
generic-drugs-is-a-matter-of-life-and-death/.
Some, like Owen’s dad (cancer surgeon Kelly McMasters), believe that generic
manufacturers simply do not have a financial incentive to produce drugs like
methotrexate. They cite as evidence the fact that we never seem to run out of the
drugs that cost thousands of dollars, and that shortages increased after the 2003
Medicare Modernization Act restricted Medicare reimbursement on these drugs to the
average selling price, plus a 6% administrative fee. Others argue that increasing
regulations imposed by the FDA have created more red tape and propagated
shortages, a claim the FDA vigorously denies.
Analysis: This is a good response because it turns the negative’s argument. A reliance on
generics can cost American lives in the long term when there are shortages. Additionally,
because generics are less profitable, people can be forced to pay for the name brand anyway
when there is a shortage.
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CON – Companies charge high prices to make up for failed

products
Argument: Pharmaceutical research is a risky and costly endeavor. Clearly not all products
make it to market, thus in order for companies to profit and continue to innovate the products
that do are marked up.
Warrant: Research and development is costly and takes on average 15 years, few products
make it to market
Francis, David R. “The Effect of Price Controls on Pharmaceutical Research.” NBER,

NBER, www.nber.org/digest/may05/w11114.html.
For the pharmaceutical industry, one economic problem is that only 3 out of every 10 of
their products generate after-tax returns (measured in present value terms) in excess
of average, after-tax R and D costs. The scientific process is heavily regulated, and
involves significant technical risk. Only one in several thousand compounds
investigated ever makes it through the full development process to gain approval of
the Food and Drug Administration. The vast majority of R and D projects fail for reasons
related to safety, efficacy, or commercial viability, the authors note. For compounds
that do gain FDA approval and are taken to market, the entire process from discovery
to launch takes on average about 15 years. Further, it's estimated that the pre-tax cost
of a new drug runs around $802 million. The after-tax cost of an average drug is about
$480 million, assuming the company has sufficient revenues to take advantage of the
tax benefits or can somehow sell the tax benefits to another firm. The average net
revenues for a new drug amount to about $525 million in present value. Thus at the
time of a product launch, the drug company can foresee a potential average profit or
economic value for their pharmaceutical R and D of about $45 million.
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Warrant: 80% of drugs that make it to market don’t recover the cost of development
completely
Texas A&M University. "Price controls on drugs: Striking the balance between
affordability and innovation." ScienceDaily. ScienceDaily, 30 May 2017.
<www.sciencedaily.com/releases/2017/05/170530122236.htm>.
Adding to the risk is the possibility that drugs might be pulled from the market before
they can make any money at all, and as many as 80 percent of the drugs that are sold
don't recover the amount of money spent on their development completely, according
to Khan. At the same time, some blockbuster drugs manage to make billions of dollars,
and that helps encourage drug companies to continue to create new medications. "It's
an extremely high-risk, but highly profitable business," he said.
Warrant: Companies would research fewer medicines if there were price controls as it makes
pharmaceutical research more risky.
Pitts, Peter J. “The False Promise of Drug-Price Controls.” National Review, National
Review, 19 May 2017, www.nationalreview.com/2017/05/drug-price-controls-
bad-idea/.
Pharmaceutical prices reflect massive development expenses. Creating just one new
drug is an extremely expensive, time-consuming process, usually costing several billion
dollars and taking at least a decade. And the failure rate is sky-high: Drug scientists test
thousands of promising compounds for every one that’s turned into a marketable
product. Companies are willing to make such a risky investment because a
breakthrough product can generate a huge payoff. But price controls squeeze that
payoff. They prevent drug firms from charging prices commensurate with those
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massive development costs. For some companies, the payoff is no longer worth the
risk, and they’re forced to scale back on new research. The U.S. Department of
Commerce calculates that price controls among countries in the OECD, a major
economic organization comprising much of Europe, drives away $5 billion to $8 billion
in potential pharmaceutical development investment every year. That prevents the
creation of three to four new drugs annually.
Impact: Price controls would lead to 50-60% reduction in research and development
Abbott, Thomas A., and John A. Vernon. “The Cost of US Pharmaceutical Price
Reductions: A Financial Simulation Model of R&D Decisions.” NBER, NBER, 7 Feb.
2005, www.nber.org/papers/w11114.
Our simulations find that if successful, cutting pharmaceutical prices significantly (40 to
45%) would have a significant impact on the incentives for private firms to invest in
research and development. Specifically, our results suggest that the number of
compounds moving from the laboratory into human trials would decrease by 50 to 60
percent. Because of the uncertainties involved, fewer compounds moving into clinical
trials directly translates into fewer new products – the effects of which wouldn’t be
fully felt for several decades because of the long development cycle. Moreover, because
of the spillover effects of R&D, less activity today reduces the possibilities for new
opportunities in the future. Thus, these effects would likely compound themselves
over time.
Analysis: This argument is particularly persuasive because less research and development into
new medicines in the long term would produce worse health outcomes. Additionally, it would
be strategic to argue that the production of medicines is a prerequisite in the debate, as it is
irrelevant how costly medicines are if there aren’t medicines to be prescribed in the first place.
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A/2 - Companies charge high prices to make up for failed

products
Response: Research and Development isn’t actually that expensive
Warrant: Most funding comes from public sources
Light, Donald W, and Joel R Lexchin. “Pharmaceutical Research and Development: What
Do We Get for All That Money?” The BMJ, British Medical Journal Publishing
Group, 7 Aug. 2012, www.bmj.com/content/345/bmj.e4348.
Although the pharmaceutical industry emphasises how much money it devotes to

discovering new drugs, little of that money actually goes into basic research. Data from
companies, the United States National Science Foundation, and government reports
indicate that companies have been spending only 1.3% of revenues on basic research
to discover new molecules, net of taxpayer subsidies.23 More than four fifths of all
funds for basic research to discover new drugs and vaccines come from public
sources.24 Moreover, despite the industry’s frequent claims that the cost of new drug
discovery is now $1.3bn (£834m; €1bn),25 this figure, which comes from the industry
supported Tufts Center,26 has been heavily criticised. Half that total comes from
estimating how much profit would have been made if the money had been invested in
an index fund of pharmaceutical companies that increased in value 11% a year,
compounded over 15 years.26 While used by finance committees to estimate whether a
new venture is worth investing in, these presumed profits (far greater than the rise in
the value of pharmaceutical stocks) should not be counted as research and
development costs on which profits are to be made. Half of the remaining $0.65bn is
paid by taxpayers through company deductions and credits, bringing the estimate
down to one quarter of $1.3bn or $0.33bn.27 The Tufts study authors report that their
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estimate was done on the most costly fifth of new drugs (those developed in-house),
which the authors reported were 3.44 times more costly than the average, reducing the
estimate to $90m. The median costs were a third less than the average, or $60m.
Deconstructing other inflators would lower the estimate of costs even further.
Warrant: Companies spend more on marketing than actual research
Swanson, Ana. “Big Pharmaceutical Companies Are Spending Far More on Marketing
than Research.” The Washington Post, WP Company, 11 Feb. 2015,
www.washingtonpost.com/news/wonk/wp/2015/02/11/big-pharmaceutical-
companies-are-spending-far-more-on-marketing-than-
research/?utm_term=.680cde0cb363.
Prescription drugs are a massive market: Americans spent $329.2 billion on prescription
drugs in 2013. That works out to about $1,000 per person in the U.S., as John
Oliver pointed out in his show on Sunday night.
Oliver also mentioned that nine out of 10 big pharmaceutical companies spend more
on marketing than on research. León Markovitz of Dadaviz found and graphed those
figures from healthcare research firm GlobalData in the graphic below. The amounts
spent on sales and marketing are shown in orange, while the amounts spent on research
and development are in blue. The biggest spender, Johnson & Johnson, shelled out
$17.5 billion on sales and marketing in 2013, compared with $8.2 billion for R&D. In
the top 10, only Roche spent more on R&D than on sales and marketing.
Analysis: This is a good response because even though many numbers reveal that costs of
research and development are higher than profits, this doesn’t take into account how much
companies spend on the actual development and how much of that money is from the
company itself rather than outside sources. Thus, the argument made by your opponents is
widely distorted, and has little impact on future profitability with price cuts.
Champion Briefs 237

Response: Costs of producing drugs are overstated
Warrant: Numbers currently used to justify high sale costs are inaccurate
Harris, Richard. “R&D Costs For Cancer Drugs Are Likely Much Less Than Industry Claims,
Study Finds.” NPR, NPR, 11 Sept. 2017, www.npr.org/sections/health-
shots/2017/09/11/550135932/r-d-costs-for-cancer-drugs-are-likely-much-less-
than-industry-claims-study-finds.
The analysis, published in the current issue of JAMA Internal Medicine, concludes that it
costs, on average, $650 million to develop a new cancer drug. The authors add in
another $100 million or so to account for income those companies could have had if
that money had been invested in the stock market instead of in new products. That
total is far lower than the $2.7 billion figure that the drug industry frequently points to
when it justifies the soaring cost of medicine. (It's far higher than $320 million — an
inflation-adjusted figure from a 2001 study by the consumer group Public Citizen).
In an invited commentary that accompanies the JAMA Internal Medicine analysis,

Merrill Goozner, editor emeritus of the magazine Modern Healthcare, notes that "the
industry consistently generates the highest profit margins among all U.S. industries."
He argues that the enormous value of patent protection for drugs far outweighs the
inherent riskiness of pharmaceutical research and development. And he agrees with the
study authors when he writes: "Policymakers can safely take steps to rein in drug
prices without fear of jeopardizing innovation."
Analysis: This is a good response because it indicts the statistic most authors use to justify
increased drug costs. Additionally, comparing that with how profitable the pharmaceutical
industry is a as a whole shows the overinflated burden on large pharmaceutical companies.
Champion Briefs 238

CON – Price Controls Disrupt Supply and Demand
Argument: When the government sets price controls, specifically price ceilings, it defines the
market price of a product, which often is less than the price determined by the interaction
between supply and demand. This in turn creates a situation where consumers will purchase
more of the product as price declines, causing demand to outpace supply.
Warrant: Price controls are often lower than the equilibrium price set by the market
Morton, Fiona M. Scott. “The Problems of Price Controls.” The Cato Review of Business
and Government, Cato Institute, 20 June 2001.
<www.cato.org/publications/commentary/problems-price-controls>
“The determining of market prices through the dynamic interaction of supply and
demand is the basic building block of economics. Consumer preferences for a product
determine how much of it they will buy at any given price. Consumers will purchase
more of a product as its price declines, all else being equal. Firms, in turn, decide how
much they are willing to supply at different prices. In general, if consumers appear
willing to pay higher prices for a product, then more manufacturers will try to produce
the product, will increase their production capacity, and will conduct research to
improve the product. Thus, higher expected prices lead to an increased supply of
goods. This dynamic interaction produces an equilibrium market price; when buyers and
sellers transact freely, the price that results causes the quantity demanded by
consumers to exactly equal the supply produced by sellers. But when government
adopts a price control, it defines the market price of a product and forces all, or a large
percentage, of transactions to take place at that price instead of the equilibrium price
set through the interaction between supply and demand. Since supply and demand
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shift constantly in response to tastes and costs, but the government price will change
only after a lengthy political process, the government price will effectively never be an
equilibrium price. This means that the government price will be either too high or too
low.”
Warrant: Price controls artificially inflates supply and demand
Kramer, Leslie. “How Does the Law of Supply and Demand Affect Prices?” Investopedia,
Investopedia, 19 June 2018, <www.investopedia.com/ask/answers/033115/how-
does-law-supply-and-demandaffect-prices.asp.>
Price controls can also distort the effect of supply and demand on a market.
Governments sometimes set a maximum or a minimum price for a product or service,
and this results in either the supply or the demand being artificially inflated or
deflated. This was evident in 1979 when the U.S. temporarily capped the price of
gasoline at about $1 per gallon. Demand increased because the price was artificially
low, making it more difficult for the supply to keep pace. This resulted in much longer
wait times and people making side deals with stations to get gas.”
Impact: Disrupting supply and demand creates economic consequences
Reed, Lawrence W. “What Price Control Really Means | Lawrence W. Reed.” FEE,
Foundation for Economic Education, 1 Apr. 1978, <fee.org/articles/what-price-
control-really-means/>.
"The economic consequence of government price control is economic disruption. A

controlled price will still allocate resources, but not in accordance with supply and
demand. Likewise, a controlled price will still direct production, but not in the same
directions as consumers, by their voluntary purchases, would have dictated. The signals
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are falsified and distorted by fixed prices. The history of price control in America and
everywhere else has been the history of shortages, queues, and popular disaffection.”
Impact: Creates a tradeoff with low-return long term investments
Easton, Robert J. “Price Controls Would Stifle Innovation in the Pharmaceutical

Industry.” STAT, STAT, 19 Jan. 2018, <www.statnews.com/2018/01/22/price-
controls-pharmaceutical-industry/>.
"An important corollary is that, if profitability and value creation opportunities for
new drugs declined, the appetite of the venture community for risky, long-term
biopharmaceutical investments would shrink exponentially. Price controls on drugs
would have the surprising effect of accelerating the flow of investment into high
technology, where timelines to market are shorter, less regulated, and less risky. The
venture capital community is flush with cash and anxious to invest where high returns
can be achieved — ideally within a much shorter time than is typically possible in the
realm of drug R&D. As a society, if we force pharma into a chemical industry model,
where there is no biotech equivalent and no venture investing, we will be trading
better and sooner effective drugs for better and sooner virtual reality devices and self-
driving cars.”
Impact: Creates a tradeoff with smaller, lesser-known diseases
Easton, Robert J. “Price Controls Would Stifle Innovation in the Pharmaceutical

Industry.” STAT, STAT, 19 Jan. 2018, <www.statnews.com/2018/01/22/price-
controls-pharmaceutical-industry/>.
"Squeezing pharmaceutical R&D spending down to one-fifth of what it is today would

also have an enormous impact on the problems that drug developers often choose to
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address. Orphan diseases would be deprioritized, as the returns under price controls
would not warrant the investment. Complex diseases would also be deselected. While
Alzheimer’s disease and diabetes have huge patient populations, the extremely high
cost of conducting the difficult research and the need for huge and complex clinical
trials would dissuade all but the largest companies from pursuing those illnesses if the
potential pricing upside was to be significantly constrained. Moreover, for difficult
diseases like schizophrenia, where today’s treatments are mostly inadequate, the flow
of more effective new treatments would slow from a trickle to a rivulet, depriving those
with these conditions from the possibility of relief.”
Analysis: While the literature surrounding this argument isn’t the flashiest, the notion of
disrupting supply and demand in a market like the pharmaceutical industry can have disastrous
consequences on a macroeconomic scale. This argument probably isn’t strong enough on its
own to serve as an independent argument, but could work really well as a link into a bigger
argument about market disruption. Moreover, this could serve as a link for why production and
input companies would flee the market.
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A/2 - Price Controls Disrupt Supply and Demand
Answer: The pharmaceutical market cannot be trusted to regulate prices on their own
Warrant: We can’t count on the private sector to make necessary medicines affordable
Bernstein, Jared. “Should the Government Impose Drug Price Controls?” The New York
Times, The New York Times, 29 June 2016,
<www.nytimes.com/roomfordebate/2015/09/23/should-the-
government-impose-d rug-price-controls/drug-price-controls-are-vital-in-
a-market-thats-not-free..>
“Price controls for drugs, which are common in other advanced economies, increase
affordability. But even when the mechanism is “cost-plus” pricing — the government
allows drug companies some degree of markup — their profits will still decline from
current levels. The producers argue that this will stifle their incentive to innovate. But
the evidence is increasingly clear that we cannot count on the private sector to make
necessary medicines affordable. In fact, given the incentive structure, neither can we
count on private drug companies to develop the drugs we most need versus the ones
that will be most profitable. In health economics, maximizing social benefits is often
at odds with private benefits. The simplest solution is to take excessive profit out of
the equation and ramp up what is already a robust public medical research
infrastructure. This could take the form of an expanded National Institutes of Health,
where researchers are employed by the government, or private research could be
subsidized. Either way, the key outcome is that the patents themselves would be public
goods in the public domain, meaning no more price gouging”
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Warrant: Unregulated markets don’t factor in social costs, and therefore don’t adequately
display the true price
Lipsky, Michael. “Why Regulation Is Necessary and Proper for a Well-Functioning

Democracy and Market Economy.” Scholars Strategy Network, 12 Apr. 2016,
<scholars.org/brief/why-regulation-necessary-and-proper-well-functioning-
democ racy-and-market-economy.>
“However, this abstract academic lesson tells us little about the real world, because
pure market conditions almost never exist in actual commerce. Real-world markets
differ from theoretical models in markets in several ways – and good regulations can
help those imperfect markets work better. Real-world customers often lack complete
information about products they might buy, or have difficulty understanding technical
terms describing goods like cars, pharmaceutical drugs, and mortgages. Consumer
protection regulations help by requiring companies to spell out the features and risks of
their products. In the real world, markets are often dominated by one or a small
number of sellers, who can limit production and force customers to pay artificially
high prices. Anti-monopoly regulations can insure greater competition and fairer
prices. Unregulated markets do not take social costs into account. Unimpeded by
public rules, anything-goes markets give us air and water pollution, employment
discrimination, exposure to pornography by children, and other harmful results that
most people in society abhor. Democratic governments can put in place rules that force
sellers to avoid or limit such unacceptable consequences of market activities (called
“negative externalities”).”
Warrant: The Pharmaceutical industry is so monopolized that prices cannot be dictated by the
market
“High Drug Prices & Monopoly.” Open Markets Institute, 2016,
Champion Briefs 244

<openmarketsinstitute.org/explainer/high-drug-prices-and-monopoly/.>
“These policy changes have resulted in many negative effects, starting with monopoly
pricing. In the drug industry, as with any industry, consolidation facilitates collusion.
When a few companies control a market, it becomes easier to maintain an effective
cartel because no member can step out of the agreement without being quickly
detected by the others. The market for insulin may be a case in point. Since 2010, the
three American manufacturers of the drug have all raised their prices by 168 percent,
169 percent, and 325 percent, respectively. Even without forming cartels, monopolistic
companies have a greater ability to raise prices because they don’t face the full
pressure of a competitive market. Mylan Pharmaceuticals could raise the price of its
Epipen by 450 percent precisely because it held about 90 percent of the market. And
this applies to all kinds of drugs, branded and generic alike. Between 2010 and 2015,
for instance, nearly a quarter of all generic drugs saw at least one price increase of 100
percent or more, and some saw increases of 1,000 percent or more.”
Analysis: The best way to go about responding to this warrant is by going after the
pharmaceutical industry as a whole. It is important to recognize that there is a difference in
“price setting” in a market with normal competition and a monopolized market. Given that the
pharmaceutical industry is so monopolized, a select handful of companies get to determine the
prices of medicine, which often disregards those who need it most, the poor. Therefore, rather
than arguing the specifics of disrupting supply and demand, it’s much better to respond to this
argument by highlighting that the pharmaceutical industry does not behave the same given
that it is a monopolized market
Champion Briefs 245

CON – Price Controls Encourage a Shift to the Black Market
Argument: When prices are artificially adjusted, buyers and sellers will turn to extralegal
markets to engage in the exchange of goods. Moreover, price controls often result in shortages
which motivates consumers to turn to the black market in search of similar, if not the same,
goods.
shortages/.>
Champion Briefs 246

IEA, Institute of Economic Affairs, 2015,
<iea.org.uk/wp-content/uploads/2016/07/Coyne-Interactive.pdf.>
Warrant: Price ceilings trigger a shift to secondary markets
Champion Briefs 247

Fontinelle, Amy. “The Mechanics Of The Black Market.” Investopedia, Investopedia, 9

Sept. 2012, <www.investopedia.com/articles/economics/12/mechanics-black-
market.asp>.
"Black markets can also appear when government-imposed price ceilings create
shortages. For example, if the government caps the price at which a grocery store may
sell bottled water after a natural disaster, the store will quickly run out of water.
Vendors will then appear selling that water at the higher prices people are actually
willing to pay. This secondary market is a black market. Governments can also cause
black markets through overregulation. An extreme example can be found in Cuba,
where the rationing and ineffective central planning of communism make it difficult to
purchase desired quantities of even basic products such as cooking oil. Black markets
are rampant because citizens want to buy things that are difficult to come by through
legal channels. They're also common because it's so hard to find a job.”
patients

Champion Briefs 248

Analysis: This argument can have a lot of cool impact scenarios. Moreover, there is empirical
examples of when price controls, specifically price ceilings, have lead to things like the
emergence of black markets, and more specifically, shortages. World War 2 England as well as
Venezuela in 2015 have all experienced the devastating effects of shortages and the ensuing
crime that followed.
Champion Briefs 249

A/2 - Price Controls Encourage a Shift to the Black Market
Answer: Most of the drugs and medicines that consumers use are generic medicines.
Therefore, these price ceilings won’t apply to these cheap medicines and therefore won’t cause
a shift to the black market.
Warrant: Most consumer medicine is cheap and affordable already
nations.”
Champion Briefs 250


LLC, 2 Apr. 2015, <http://www.mrioa.com/generic-versus-proprietary-
medications/.>
“A generic drug (generic drugs, short: generics) is a drug defined as “a drug product
that is comparable to a brand/reference listed drug product in dosage form, strength,
restoration”).”
Analysis: By showing that 90% of the market is generic, low cost drugs, you mitigate your
opponents offense to the 10% of drugs that aren’t. Moreover, by showing that generic drugs
Champion Briefs 251

offer the same quality, you can frame the argument as a reason why people don’t need to turn
to the black market if they can receive a similar drug at a quarter of the cost.
Champion Briefs 252

CON – Price Controls Encourage a Shift to the Black Market
Argument: When prices are artificially adjusted, buyers and sellers will turn to extralegal
markets to engage in the exchange of goods. Moreover, price controls often result in shortages
which motivates consumers to turn to the black market in search of similar, if not the same,
goods.
shortages/.>
Champion Briefs 253

IEA, Institute of Economic Affairs, 2015,
<iea.org.uk/wp-content/uploads/2016/07/Coyne-Interactive.pdf.>
Warrant: Price ceilings trigger a shift to secondary markets
Champion Briefs 254

Fontinelle, Amy. “The Mechanics Of The Black Market.” Investopedia, Investopedia, 9

Sept. 2012, <www.investopedia.com/articles/economics/12/mechanics-black-
market.asp>.
"Black markets can also appear when government-imposed price ceilings create
shortages. For example, if the government caps the price at which a grocery store may
sell bottled water after a natural disaster, the store will quickly run out of water.
Vendors will then appear selling that water at the higher prices people are actually
willing to pay. This secondary market is a black market. Governments can also cause
black markets through overregulation. An extreme example can be found in Cuba,
where the rationing and ineffective central planning of communism make it difficult to
purchase desired quantities of even basic products such as cooking oil. Black markets
are rampant because citizens want to buy things that are difficult to come by through
legal channels. They're also common because it's so hard to find a job.”
patients

Champion Briefs 255

Analysis: This argument can have a lot of cool impact scenarios. Moreover, there is empirical
examples of when price controls, specifically price ceilings, have lead to things like the
emergence of black markets, and more specifically, shortages. World War 2 England as well as
Venezuela in 2015 have all experienced the devastating effects of shortages and the ensuing
crime that followed.
Champion Briefs 256

A/2 - Price Controls Encourage a Shift to the Black Market
Answer: Most of the drugs and medicines that consumers use are generic medicines.
Therefore, these price ceilings won’t apply to these cheap medicines and therefore won’t cause
a shift to the black market.
Warrant: Most consumer medicine is cheap and affordable already
nations.”
Champion Briefs 257


LLC, 2 Apr. 2015, <http://www.mrioa.com/generic-versus-proprietary-
medications/.>
“A generic drug (generic drugs, short: generics) is a drug defined as “a drug product
that is comparable to a brand/reference listed drug product in dosage form, strength,
restoration”).”
Analysis: By showing that 90% of the market is generic, low cost drugs, you mitigate your
opponents offense to the 10% of drugs that aren’t. Moreover, by showing that generic drugs
offer the same quality, you can frame the argument as a reason why people don’t need to turn
to the black market if they can receive a similar drug at a quarter of the cost.
Champion Briefs 258

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The Evidence Standard

1. We will never falsify facts, opinions, dissents, or any other information.

the source of the information is legitimate.

with clarity if we learn that a third-party has attempted to commit deception.

inaccurate methodologies to reach a conclusion or prove a point.

distributed by ourselves or by any third-party.

multitude of perspectives and schools of thought.

and vision of this activity.

Welcome to our first combined November/December edition of Champion Briefs! The

The Evidence Standard .......................................................................................4

Letter from the Editor .........................................................................................5

Table of Contents ...............................................................................................6

Topic Analyses ....................................................................................................8

General Information ......................................................................................... 34

Pro Arguments with Con Responses ................................................................. 42

Con Arguments with Pro Responses ............................................................... 153

Topic Analysis by Jakob Urda

The landscape of tournaments during the November-December topic is considerable.

they can adopt for later tournaments.

argue about what is and is not likely to happen.

first few tournaments in November, before the elections happen).

competition in order to establish a tactical understanding of what is the most likely

to advantage themselves dramatically before the round has even begun.

One argument that everyone should consider is a standard ‘increasing accessibility’

essential pharmaceuticals has disastrous consequences—prolonged illness and death. These

people who’s situation is so dire.

preparing responses to responses. This is because as a stock argument, ‘increasing access’ is

unprepared for predictable responses.

to protect individuals from bad medical outcomes.

the willingness of producers to be a part of the market.

This topic promises to be exciting—both politically charged and well developed.

this bring out the best in the circuit. Good Luck!

About Jakob Urda

winners of the NCFL national tournament, Harvard, and Blake.

Topic Analysis by Belén Mella

pharmaceutical industry," entering a decades-long national conversation. Proponents of price

experts have suggested that price controls be supplemented by measures to “restrict or

losing the incentive to stay in the risky business of making medicine.

countries are willing to accept.”

controls, finding that they

Patient Welfare”: “Small-probability, high-payoff pharmaceutical research is motivated

research budgets decreased to 4% before returning to normal levels of around 11%” as

the U.S. produced 8 of the 10 top-selling drugs.16”

narratives to strengthen their story.

Topic Analysis by Zachary Ginsberg

personally important experiences with. This is important to consider when crafting an

judges or bring up arguments that many people might disregard on face.

the best in us.

than your opponent’s.

prepared weighing will prove crucial to do well at the Glenbrooks.

Strategy and Weighing

other side does not have access to.

they simply affect a smaller number of people.

medicine that costs less for people to purchase.

certainly have to pay less when they need it.

determining the cost of medical care that the patient pays.

shell out extra money anyway.

Nevertheless, it still significantly increases the access to healthcare available to people,

especially the poor and the most vulnerable in society.

new medicine, from hiring researchers in house or at universities, to buying materials, to

renting out space.