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The simple corporate scheme behind massive US Brand Drug Prices

My 7-year whistleblower effort
"People Before Profits"

Month: February 2020

Forced Mail Order Pharmacy: Central to Pharma/Health Insurer/PBM price collusion, while harming patients and decimating independent pharmacies.

Across this nation, the dominant health insurer/PBMs are forcing patients and families to use their in-house mail order pharmacies for almost all chronic therapies. The dominant health insurer/PBMs (UnitedHealth, CVS/Aeta, Cigna/Express Scripts and Humana) are routinely blocking patients from getting their prescriptions filled at local independent pharmacies, many of which have been serving their communities for generations. In fact, in recent communications CVS has been informing patients that their chronic medications will not be covered at all if they don’t use CVS’ mail order pharmacy. The health insurer/PBMs claim they are only forcing mail order to lower costs and improve …

Forced Mail Order Pharmacy: Central to Pharma/Health Insurer/PBM price collusion, while harming patients and decimating independent pharmacies. Read More »

Pharma/Health Insurer/PBM Price Collusion: More than a decade of severe patient harm and a huge missed drug savings opportunity for all Americans.

As per my last blog post, the two main drivers of this remarkably simple “fee” price collusive partnership were: Medicare Part D: With taxpayers paying for massive price increases in the new program when our senior citizens were given much needed outpatient drug coverage for the first time in 2006. Medicare Part D has been the largest revenue and profit driver for both the pharma and health insurer/PBM market over the past decade-plus. Massive U.S brand drug patent losses: In the U.S., brand drug Rx volume fell from 50% of the market to less than 10% in only a few …

Pharma/Health Insurer/PBM Price Collusion: More than a decade of severe patient harm and a huge missed drug savings opportunity for all Americans. Read More »

Pharma/Health Insurer/PBM Price Collusion: Medicare Part D, widespread u.s. patent losses and the shocking choice made by a handful of industry executive leaders.

I cannot overstate the remarkable simplicity of the scheme behind systemic massive U.S. brand drug price increases across this nation over the past 15 years. The vast patient and public harm has been caused by a simple, but seismic change in the way that pharmaceutical companies pay the handful of dominant health insurer/PBMs (UnitedHealth, CVS/Aetna, Cigna/Express Scripts and Humana) that control 80-90% of drug benefits in this country. Before Part D: Virtually ALL health insurer/PBM brand drug profits came by secretly keeping most of the rebates (i.e., discounts) negotiated with pharma companies that they were supposed to pass on to …

Pharma/Health Insurer/PBM Price Collusion: Medicare Part D, widespread u.s. patent losses and the shocking choice made by a handful of industry executive leaders. Read More »

The Obvious Pharma/Health Insurer/PBM “Partnership” in Massively Raising U.S Brand Drug Prices – Six Facts in Plain sight

Six Facts in Plain Sight Virtually ALL brand drug profits for the four dominant health insurer/PBMs (United Health Care, CVS/Aetna, Humana) have secretly come from the pharmaceutical industry for the past 20+ years. Before Part D, the profits came from secretly keeping most pharma rebates/discounts that should have gone to patients and clients. Now their profits come from keeping virtually all “fees” from secret national contracts as a percentage of massive U.S. brand drug prices and price increases. All the public rebate talk now is just nonsense and a diversion tactic. The three largest PBMs were OWNED by pharmaceutical companies …

The Obvious Pharma/Health Insurer/PBM “Partnership” in Massively Raising U.S Brand Drug Prices – Six Facts in Plain sight Read More »

The largest healthcare whistleblower case in history – yet the silence is deafening.

The largest healthcare whistleblower cases in history by a wide margin – yet the silence remains deafening. $175 Billion and growing every day. The scale of harm sounds ridiculous, but it is not – it has been driven by massive 5-10-fold U.S. price increases over more than a decade for 22 blockbuster brand drugs. Just look at the picture links on the website or in the whistleblower complaints. Truly shocking. The two whistleblower cases target the simple systemic “fee” scheme behind one of the greatest healthcare crises to afflict this nation in the past several decades – the widespread increase …

The largest healthcare whistleblower case in history – yet the silence is deafening. Read More »

THE CAUSE OF MASSIVE U.S. INSULIN PRICES: “FEES” FROM PHARMA PAID TO THEIR LARGE HEALTH INSURER/PBM PARTNERS, DIRECTLY TIED TO MASSIVE “STICKER” PRICE INCREASES

Health insurer/PBM Lobbyist (PCMA) report, May 2018 : https://www.pcmanet.org/wp-content/uploads/2018/05/Insulins-Prices-Rebates-Costs.pdf Quotes directly from the PCMA Report: “Insulin prices have increased more than 10-fold since 1985. Prices have escalated more dramatically during the past 10 years.” “During the past 10 years, gross sales for insulins have increased significantly due entirely to price increases, while overall utilization/prescription volume has remained flat.” “During the past 20 years, new insulin competitors have entered the market, but always at higher prices than the existing market.” “Top insulin brands: no correlation between rebates and price increases” “Top insulins with lower average rebates have actually had higher annual …

THE CAUSE OF MASSIVE U.S. INSULIN PRICES: “FEES” FROM PHARMA PAID TO THEIR LARGE HEALTH INSURER/PBM PARTNERS, DIRECTLY TIED TO MASSIVE “STICKER” PRICE INCREASES Read More »

Simple Take home message from Drug Price truth: Pharma and the dominant Health Insurer/PBMs are “PARTNERS” in Massively Raising U.S. Brand Drug Prices on all of us

Dear DPT Readers: Lots of info on this website and in the Whistleblower legal documents, but all boils down to just a few key points: Pharma and the dominant Health Insurer/PBMs are PARTNERS, not Enemies: Pharma and the dominant Health Insurer/PBMs (United Health, Cigna/Express Scripts, CVS/Aetna) and Humana) have long been secret PARTNERS in massively raising U.S. brand drug prices, with both making huge profits while passing the costs on to all of us. They are just pretending to be “enemies” to create confusion and keep it going. These four health insurer/PBMs control drug plans for 85-90% of Americans, including …

Simple Take home message from Drug Price truth: Pharma and the dominant Health Insurer/PBMs are “PARTNERS” in Massively Raising U.S. Brand Drug Prices on all of us Read More »

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