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Healthy Skepticism Library item: 18937

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Electronic Source

Silverman E
Not Dead Yet: Drug Price Manipulation Scams Enter Their Sunset Years
BNet 2010 Nov 11
http://www.bnet.com/blog/drug-business/not-dead-yet-drug-price-manipulation-scams-enter-their-sunset-years/6400


Full text:

The state of Hawaii’s lawsuit against pharmacy benefit manager McKesson (MCK) and drug database manager First DataBank could signal the end of drug price manipulation, at least as we currently know it. The Hawaii suit makes the usual allegations: That McKesson and First DataBank cooperated with companies to report fictitious “average wholesale price” lists of drugs on which Medicaid and Medicare base their reimbursements. After rebates and discounts are factored in, the real prices are much lower, but the taxpayer pays the higher price.

AWP manipulations aren’t small: Drugs have ended up costing taxpayers five times as much as they should. In one spectacular case against Baxter International (BAX), the government was allegedly charged $928 on bags of saline solution costing just $1.71 – a 54,000 percent markup. They might be increasingly rare, however, following dozens of mostly successful suits in which states and whistleblower have demanded that overcharges be repaid. Like the plague victim in Monty Python and the Holy Grail, AWP scams aren’t dead yet, but they might as well be.

State attorneys general have spent years going after drug companies for this scam. Some, such as AstraZeneca (AZN), Merck (MRK) and Pfizer (PFE) have settled. Now governments are turning their attention to McKesson and First DataBank. In McKesson’s most recent quarterly report it listed eight drug pricing scam lawsuits filed against it since 2008, and four of those were filed this year (see page 16):

In re McKesson Governmental Entities Average Wholesale Price Litigation, filed against the Company in the United States District Court for Massachusetts.
Board of County Commissioners of Douglas County, Kansas et al. v. McKesson Corporation, Civil Action No. 1:08-CV-11349-PBS
San Francisco Health Plan v. McKesson Corporation, Civil Action No. 1:08-CV-10843-PBS
State of Connecticut v. McKesson Corporation, Civil Action No. 1:08-CV-10900-PBS, settled on October 15, for $26 million.
State of Kansas ex rel. Steve Six v. McKesson Corporation, et al., Case No. 10CV1491.
State of Mississippi v. McKesson Corporation, et al., Cause No. 251-10-862CIV.
State of Utah v. McKesson Corporation, et al., Case No. CV 10-4743-SC.
State of Wisconsin ex rel. Hagens Berman Sobol Shapiro LLP, et al. v. McKesson Corporation, Case No. 10CV3411.
The dam broke after McKesson settled a massive AWP case with the Prescription Access Litigation project, for $350 million. Virtually all drug companies and PBMs have been named in suits alleging AWP manipulation. As the settlements keep rolling in – Hawaii extracted another $82 million from a swathe of pharmaceutical firms in October – it dims the prospect that the remaining defendants can win any of the cases against them.

Don’t declare “marketing the spread” between AWP and the real price of drugs dead yet, but the prospect could be within sight.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909