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The simple corporate scheme behind massive US Brand Drug Prices

My 7-year whistleblower effort
"People Before Profits"

Caronavirus Pandemic: Bringing the Health Insurer CEO Schemers to the White House for a Worthless Photo Op

Last week, all the Health Insurer/PBM CEO Schemers appeared at the White House for a worthless photo opportunity.

You can see the video at this link: https://m.youtube.com/watch?v=CYdEUZZkDNI

As they always do, these Health insurer/PBM CEOs talked in rosy platitudes about how patients and the American public  are always their main concern. I have been hearing that spin for decades now. Please.

You don’t have to be familiar with the disturbing stuff on this website to know that these CEO claims are almost pure BS.

Their true “mission” is always profits and massive executive compensation packages, while spouting glossy nonsense and guarding their increasingly obvious financial secrets.

However, anyone dealing with massive medical and drug bills NOT covered by these health insurance companies when you get sick knows this all too well from personal experience.  

I don’t need to tell you anything.

You don’t need to be a physician and or a professional investment analyst like me to know that. You are living it every day.  

By the way, as per the video, the only commitment from these CEOs at the White House photo-op was to not charge us co-pays if we need a coronavirus test. Wow, thanks!

And the CEOs said they would not do any “surprise billing”, like they usually do, during the pandemic. How comforting.

Don’t you all feel so much better now that these astounding health insurer leaders have come to our rescue? Please.

Oh, of course these health insurance CEOs are not going to give us relief on all our shocking healthcare premiums, even though almost everyone is now avoiding all but emergency medical care. Not a chance.

And of course, these health insurance CEOs are not going to give us a break on the massive drug prices and price increases they are egregiously profiting from in collusion with drug manufacturers. Not a chance.

Are you all getting as tired of their BS, as I did long ago now?

More importantly, aren’t you getting tired of them harming you and your family while illicitly profiting off an entire nation?

Isn’t it time to do something about? You can help by simply sharing this website with everyone you know.

That is all I ask. No asking for money/donations. We just need regular good citizens of all shapes and sizes to be informed and help each other.

It is time to stop being afraid. Been asked many times if I am afraid of the drug companies, the insurance companies, their big corporate law firms, the DOJ, etc.

I respond always the same way. Of course, I am. Been following these companies closely as a professional stock analyst for 30 years. In fact, they are more powerful than even I could have imagined.

They have lots of people, including many you would not expect, in their back pockets. Is that really a surprise to anyone at this point?

However, I am never going to let fear stop me. Especially since they and I know it is all true. The broad public will eventually know that too when we all talk about it in a Court room or wherever. Hasn’t happened yet in 7+ years to date, but looking forward to it.

Giving into that fear means giving up on what is right  and good in this country. That would be accepting an awful future for all of us, but especially our younger people that deserve far better.

Not going to do that. That has never been an option.

And it is time for others to stop letting fear stop them as well, because the drug price collusion scheme is simple, the evidence is irrefutable and there are a lot more of us than them.

Because this centralized national scheme has been orchestrated by just a handful of pharma/health insurer senior executives. I have long known that these culpable pharma/health insurer CEOs are the ones who should really be scared.

How dare they do this to all of us and think they can get away with it. That they are above the law.

You see, I have nothing to hide from anyone and have caught these CEOs red-handed staring at the Indiana Jones Ark and they know it.

These CEOs are desperately trying to hide the truth and keep silent.

Truth that is already in the public domain for all to see in two vast federal whistleblower cases. With all the information and evidence right on this website, including all the key Federal Court documents.

Please take a closer look and tell your friends and families to do the same. Our lives and futures are literally at stake.

And please join the mailing list. I mean it when I say I will never ask you for money like many other sites that continue to hound me. I just want you to be informed, share the information and help me stop this. That is all.

So far the pharma/health insurer silence strategy has worked. But we will see what the future brings. I am betting on the American people coming together over time.

Remember, 99% of the hardworking people in the pharmaceutical or health insurance industry have nothing to do with this simple “fee” collusion scheme. Most of these hardworking people are being badly harmed just like the rest of us.

And once the simple, but secret scheme is broadly publicized and these pharma/health insurance executives are asked a few basic questions, it can all come quickly crashing down around them. I have known that all along. It is very long overdue now.

How are you paying them? And how are you really making money? That’s it.

Very easy to open Pandora’s Box and get these pharma/health insurer executives caught in more obvious secrets and lies. As they say, the jig will be up.

I knew this straightforward investigative path when I gave this simple scheme to the Department of Justice on a silver platter in January 2014, in the public interest, with a wide array of firsthand witnesses.

Do you think I would have really bothered with all of this if it were not so obviously true? Taking on the powerful drug and health insurance industries? Risking my career? Really?

I filed the whistleblower case because the Department of Justice encouraged me,  and I thought they were on the side of the American people. They told me they were.

Boy did that turn out to be naïve and wrong.

I never imagined that the Department of Justice would not do a real investigation and then block me from doing so, but that is exactly what happened.

Never would have believed it was possible in this country, until it happened.  

Sad and shocking to accept, but just the truth.

But that does not really change anything. To me, this has never been about whistleblower cases, making false claims settlement money, bogus government investigations or inappropriate Court dismissals.

However, we are pursuing the unprecedented whistleblower cases until the end in both Federal Appeals Courts, even if we can’t get any other healthcare or legal experts to pay attention.

We always follow the law, stick to the facts and evidence, never give up hope and create a public record. We know no other way.

For me, this has always been about clear priorities. People’s Lives. Our Families. Our Children. Our Future. Our Country.

I am a physician that took the Hippocratic Oath. I did not go through all that training and patient care to violate my conscience and sell my soul for a buck in the stock market.  

In sharp contrast to my background, check the biographies of the senior managements of these dominant health insurers.

Only couple of these executives even have any medical or clinical training. Virtually none of them have every treated or cared for a patient. Yet they are among the most powerful healthcare executives in this country, wielding tremendous influence in Washington, DC.

Considering their backgrounds, the horror these executives continue to inflict across this nation, while accumulating vast personal wealth and deceiving us all, really is not so shocking.

My favorite is the senior executive team at UnitedHealth, the largest health insurance company in this country. Only one member of its senior executive team (other than the former CEO of Glaxo, which is an obvious indication of the pharma price collusion scheme) had any apparent health care training or experience prior to arriving at the company.

The UnitedHealth executive team came from Fidelity, Northwest Airlines, Fannie Mae, two from Lockheed Martin, two from Wall Street firms, a consumer tech company,  a law firm and Deloitte Touche accounting.

Link to UnitedHealth’s senior executive biographies: https://www.unitedhealthgroup.com/about/executives.html

However, my greatest personal favorite is the CEO of UnitedHealth, David Wichmann, who made glowing statements about public commitment at the recent White House photo op.

Of course, Mr. Wichmann also has no apparent prior healthcare experience or training.  However, prior to taking a senior position at UnitedHealth in 1998, Mr. Wichmann was a partner at the accounting/consulting firm, Arthur Andersen.

Arthur Andersen is most famous for going out of business about fifteen years ago after the firm was convicted of destroying documents in the Enron scandal.

In the Enron scandal, investors lost a total of about $74 billion when the company went bankrupt.

In my two whistleblower cases, the estimated public financial harm is now more than $200 billion and rising every day. Of course, the personal harm to patients and families is immeasurable.

In closing this blog post, back to the coronavirus pandemic. I think most of us are trying to see some light in all this darkness.

I am hopeful that the pandemic may shine some “sunlight” on this obvious “fee” price collusion scheme and other abusive healthcare practices in this country.

While most other American businesses and people are suffering severely, I have little doubt that the pharma and health insurance CEOs will get through the pandemic just great.

Regarding the drug price collusion “fee” scheme, the big profits should keep rolling in for both the pharmaceutical and health insurance partners.

Because about 85% of the massively priced “specialty” drugs driving the scheme come to patients’ homes from the dominant health insurer’s distant mail order pharmacies.

While forced mail order delivery may be oddly convenient for patients during a pandemic (I am sure the insurer CEOs will harp on that now), the real goal it always profits for these guys and lots of them.

On average, UnitedHealth, CVS/Aetna, Cigna/Express Scripts and Humana are getting pharma “fees” of about 8% of the “sticker” price for these skyrocketing specialty drugs.

That is now about $8,000 in “fees” per year for each patient treated with a $100,000 “list” price multiple sclerosis (MS) drug, such as Avonex, Rebif, or Copaxone, that used to cost about $10,000/year when this scheme began with Medicare Part D long ago.

Simple math – that is $667 for each monthly MS script arriving to your door – largely only for shipping and handling costs, with only the modestly-paid Fed Ex guy at any coronavirus risk!

That is about  $500 a month in “fees” to these dominant health insurers for each Humira or Enbrel rheumatoid arthritis prescription reaching a home. Two drugs that have skyrocketed in unison from about $12,000/year per U.S. patient when Part D began to about a $78,000 “sticker” price now.

Many other high cost drugs with the same kind of secret “fee” deals tied to massive drug prices and price increases. Epipen, Valeant, Pharma Bro, along with many other far bigger U.S. brand drugs.

Lots of profits for these health insurers and pay for their senior executives, without even seeing the patient or having any risk from coronavirus.

You get the picture. Printing money at our expense.

Have we all had enough of this abuse yet?

Abuse only in the U.S. – the only country where we have these four health insurer/PBMs that control almost all of us.

 But I feel so much better knowing that I may not have a coronavirus test co-pay after the White House photo op.

Don’t you?

I can be easily reached via email at info@drugpricetruth.org.

I would be glad to speak with any interested parties.

Thank you,

John R. Borzilleri, M.D.

8 thoughts on “Caronavirus Pandemic: Bringing the Health Insurer CEO Schemers to the White House for a Worthless Photo Op”

  1. Van G. Coble Dph

    Dr. Borzilleri
    Many states have price gouging laws. Hydroxychloroquine is out of stock at the wholesalers. My bet is the drug comes back at a highly increased price. Pharmacies will fill prescriptions only to be reimbursed by PBMs at the old price resulting in large under reimbursements and the PBMs will bill the prescriptions at the higher price causing a huge profit for the PBM. Pharmacies situated in states with price gouging laws need to report wholesalers. I would go as far as to report the under reimbursements by PBMs. While not covered it would place reports at the AGs office and then the next legislative session the AG could be called as a witness to testify before legislative committees hearing the bill. Trying to refute the AG would be harder than refuting the money grubbing pharmacists as the PBMS call us.

    1. John Borzilleri

      Thanks for your comment. Yes, no surprise to expect price gouging with caronavirus and hydroxychloroquine. Always remember, these dominant PBMs track every nickel and rarely miss an opportunity for profit. They will certainly take their profits with any hydrocholoroquine abuse. But do remember, that the big money game for the Pharma and the PBMs is the brand drug market and fees tied to massive drug sticker prices. Brands are only 10% of U.S. Rx volume now, but still 80-85% if sales, driven by this simple fee scheme that began with Part D more than 15 years ago now. As a pharmacist and as per your comment, you know that the PBM profit cut for GENERIC hydrochloroquine abuse is likely to come by the abuse of “spreads”. They will get it far cheaper, either from the generic manufacturer or the wholesaler, and charge independent pharmacists and clients the far higher price. As you know better than I, destroying lots of independent pharmacies this way because they are largely dependent on the generic markets these days. Been largely cut out of the U.S. brand drug market, especially high-cost specialty drugs where the real money is, via forced mail order and narrow network.

      Thanks again for your great comment. Please share website with any and all. Time for this abuse to stop. John

  2. Hi there to all, the contents existing at this website are truly remarkable for people experience, well, keep up the good work fellows. Lyndsay Chaim Derick

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