Access versus excess: value-based cost sharing for prescription drugs.

The preponderance of published medical literature and clinical guidelines compels the expansion of pharmaceutical use among Americans, at the same time that private and public health plans seek to restrict such use. The emerging collision course between the march of medical science and the countermarch of medical policy arises from diverging views about the optimal use of drugs and growing philosophical conflict over the abundance and inequities that characterize the U.S. health care system. The consequent turmoil in the market's approach to managing drug benefits can be remedied through adoption of a value-based (rather than price-based) approach to pharmaceutical spending.