A National Crisis: Extreme U.S. Pricing Abuse

Two Whistleblower Cases: Unprecedented Public and Taxpayer Financial Harm

• A shocking $175+ billion in abusive U.S. brand drug sales over the past decade-plus just for the 22 blockbuster drugs in the two whistleblower cases
• More than $11 billion in abusive "pharma fees" paid to the four dominant health insurer/PBMs over the past decade-plus just for these 22 U.S. brand drugs
  • United Health, CVS/Aetna, Cigna/Express Scripts and Humana
• Link to the summary of U.S. sales and "pharma fee" abuse from the Southern District of New York (SDNY) whistleblower case involving fourteen (14) major U.S. insulin, cancer, rheumatoid arthritis and other brands
• Link to the summary of U.S. sales and "pharma fee" abuse from the District of Rhode Island (D-RI) whistleblower case involving eight (8) major U.S. multiple sclerosis brands

The Most Extreme Abuse: "Old" U.S. Blockbuster Brand Drugs Facing Severe Competition

• Massive U.S. pharma sales/profits over the past decade-plus
  • Driven by 5-10 fold price increases, while use by doctors and patients plummeting -40-70%
  • THIS CANNOT HAPPEN IN A LEGITIMATE U.S. PHARMACEUTICAL MARKET
  • THIS SECRET PHARMA/HEALTH INSURER/PBM "FEE" SCHEME  IS THE ONLY EXPLANATION

• Huge "fees" secretly paid by pharma to the dominant health insurer/PBMs "partners", directly tied to massive "sticker" prices and price increases
  • Severe U.S. drug costs passed on to U.S. patients, families, businesses and taxpayers

A Systemic Scheme and An Escalating National Crisis

• The collusive pricing scheme that began in Medicare Part D has expanded across the entire U.S. health insurance market
• After a decade of abuse, "old" U.S. brand drugs now routinely cost 8-10 fold higher than in Europe
• Massive price increases for "old" brands has led to even higher prices for new U.S. brand drugs
• Many other U.S. brand drugs involved beyond the Whistleblower cases
  • Epipen, Acthar Gel, Valeant Pharmaceuticals, and many others
  • Purdue's Oxycontin and the opioid crisis

Severe Patient and Family Harm

• Diabetics dying without insulin
• Severely ill patients losing access to life-saving drugs
• Rising financial distress – bankruptcies
• Rising health insurance premiums, increased healthcare costs and deteriorating coverage for all Americans