Luca Maini, assistant professor of health care policy in the Blavatnik Institute at Harvard Medical School, studies competition and regulation in pharmaceutical markets.
- By JAKE MILLER
He has studied how national price negotiations in Europe affect access to new drugs and analyzed how mergers and acquisitions, different price negotiation methods, and government regulations influence spending and access to medicines in the United States.
Harvard Medicine News spoke with Maini to understand the stakes and the many factors at play with talk of tariffs on pharmaceuticals, direct-to-consumer sales of prescription medications, and the U.S. federal administration's negotiations with pharmaceutical manufacturers.
Harvard Medicine News: Why study pharmaceutical markets?
Maini: Worldwide pharmaceutical markets were valued at more than $1.5 trillion in 2024. Some predictions say that number could reach $3 trillion in the next 10 years. The U.S. pharmaceutical market is the largest in the world, valued at over $600 billion in 2024 and projected to exceed $1 trillion within the next decade.
The numbers are growing because populations are aging, the prevalence of chronic diseases is rising, and there's growing demand for innovative treatments, which can be quite expensive.
Health systems everywhere are struggling with unsustainable costs and with sometimes staggering unmet needs. Understanding how pharmaceutical markets work is crucial to fixing both of those problems and ultimately ensuring that people have access to affordable medicines.
HMNews: Why are prescription drugs so expensive?
Maini: Some pharmaceuticals are quite reasonably priced. Generic drugs are mass produced as a commodity, and most of the competition between manufacturers is to see who can sell the drug for the lowest price.
Branded pharmaceuticals, like the newest GLP-1 medicines for diabetes and obesity or next-generation cancer drugs, can be highly sought after, unique products that are controlled by a monopoly that has a certain amount of power to ask for a higher price.
