…Trying to Pry Drug Pricing Secrets Out of Big Pharma

…His insulin case paints a picture of each drug company sitting at the head of a table like a crime boss, with the three major PBMs — Express Scripts, CVS Caremark, and OptumRx — gathered to carry out its bidding. None of the PBMs is charged in the suit, but under RICO, they don’t need to be. Berman portrays them as actors in the drug companies’ protection racket.


The PBM’s, and our federal government, are key players, maybe even prime movers, in this scam of high drug prices. But I guess out of those three entities, big pharma has the deepest pockets. Now that’s scary.

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The mechanism by which the prices go up will hopefully become more transparent, fingers crossed. I am not a huge fan of class action lawyers but this seems like a good use of their time.

In most of the industry they have now figured out that raising prices attracts scrutiny, so you should go into the market with absurdly high prices and then lower them (which doesn’t attract scrutiny). Look at the latest Hep C treatments as an example. They willingly dropped their prices 50% as soon as competition entered the market, and I am reasonably sure they are still making a profit.

Until transparency reigns, and someone (purchasers) is allowed to group themselves and negotiate, we will always be in a place where we don’t have the control we should over the price of medicines and healthcare in general. Opaque markets don’t function well.


Would anyone be interested in trying to interview the guy for one of our early blog posts?

@Chris, it would be interesting for you to be somehow involved in putting together some of the questions, since you know the industry so well, and can bring a balanced view into the picture.

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I am open to help with the question creation.


I think people who are uninsured should be allowed to group together to create their own drug price negotiation teams. Maybe that’s something that already exists but I guarantee if it does most people don’t know about it.


@TiaG I just might drop my insurance if I’m allowed to negotiate my drug prices. My insurance company does a completely unsatisfactory job of it now.

A group of consumers could do a far better job of controlling drug prices. BTW, that’s called “free market controls”. :wink:

except it’s not, because a group of individuals is not the same as a random subset of individuals who are individually trying to negotiate drug prices. I would guess a group of thousands of individuals have a lot more bargaining power than one-offs here or there.

Tia - you would need many thousands to get the buying power desired. However, I think you both are onto something good, which is gain transparency and try and effect an outcome. Which isn’t going to happen with the current system. In fact the bigger that health insurance and delivery institutions get the less help I think we are going to get on this, since so few (relatively speaking) patients take insulin it likely won’t be the first place to get attention.