Pharmaceutical pricing is a perpetually contentious policy issue. Branded drug list prices grew annually by 9.1 percent over the last decade. The growth rate in net prices (reflecting discounts and rebates) was lower, at around 4.5 percent, but still much higher than gross domestic product (GDP) growth. Patients’ out-of-pocket costs for specialty drugs also have increased faster than GDP growth over the same period (2.8 percent versus 2.3 percent).