• Home
  • Latest
  • Fortune 500
  • Finance
  • Tech
  • Leadership
  • Lifestyle
  • Rankings
  • Multimedia

Trendingnow

1

The millennial generation is split in 2: an older crowd with boomer-style comfort, a younger set going 'back to the early 1900s'

2

'The demographic dividend of the last 40 years is ending': J.P. Morgan says the world is running out of the two things that kept interest rates down

3

Jensen Huang made his $172 billion fortune on AI chips. His family's $75 million gift to Vanderbilt argues art decides what technology is for

1

The millennial generation is split in 2: an older crowd with boomer-style comfort, a younger set going 'back to the early 1900s'

2

'The demographic dividend of the last 40 years is ending': J.P. Morgan says the world is running out of the two things that kept interest rates down

3

Jensen Huang made his $172 billion fortune on AI chips. His family's $75 million gift to Vanderbilt argues art decides what technology is for
HealthBrainstorm Health

Two Stories That Help Explain Runaway Drug Prices

By
Clifton Leaf
Clifton Leaf
Down Arrow Button Icon
By
Clifton Leaf
Clifton Leaf
Down Arrow Button Icon
June 30, 2017, 1:32 PM ET
Add Fortune on Google for similar content.

Having now decamped to their home sanctuaries for the Fourth of July weekend, Senate Republicans may get a momentary break from the pressure to have to vote on a Trumpcare bill their leadership wants, the President sort-of seems to want—and four-fifths of Americans appear to detest.

Good.

After the fireworks and festivals, the barbecues and backyard banquets, maybe they’ll get to curl up on their senatorial Barcaloungers in their well-appointed senatorial dens, and read.

They can start with a pair of articles that were published by Bloomberg this morning and yesterday.

This morning’s piece, by Robert Langreth, explores why the prices for many generic drugs—including essential cancer-fighting medicines—have risen, in some cases to an “extraordinary” degree, according to the Government Accountability Office. Prices for roughly 300 generic drugs at least doubled from 2010 to 2015.

In yesterday’s article, Langreth and Paul Barrett point to what some plaintiffs allege is a more scandalous behind-the-scenes arrangement that’s helping to drive drug costs ever higher: that drug makers raise their prices in part to allow middlemen known as pharmacy benefit managers, or PBMs, to demand fatter rebates on those drugs, which they then share with their clients (who are the companies ultimately paying the coverage bills and who hire the PBMs to lower their costs).

Got that?

“One of the main functions of PBMs,” explain Barrett and Langreth, “is to elicit rebates from drug manufacturers on behalf of health plans. The incentive—or threat—is that if drug companies fail to pay rebates, they might not win spots on a list of preferred medications that the PBMs maintain. Absence from the list, known as a formulary, means that health plans won’t cover the drugs in question, which would cut into the manufacturers’ sales.”

The drug at the heart of four lawsuits in New Jersey is insulin—“a century-old medicine that for most of its history cost $15 or less,” write Barrett and Langreth, but “whose list price has risen more than 270 percent over the past decade.”

Federal prosecutors, report the Bloomberg writers, “are also investigating relationships between PBMs and large drug companies” and the U.S. Attorney’s Office in Manhattan has ordered three makers of insulin to turn over documents regarding those relationships.

(“The three drug companies say they’re cooperating with the government’s document demands,” Bloomberg reports. “The same companies and the three PBMs say the private suits are meritless”—with one PBM CEO declaring: “It is a complete falsehood that we would prefer prices to go up.”)

The PBM clients, in any case, benefit from the rebates—though it’s hard to know how much because, as the Bloomberg writers point out, the after-rebate “net price” they ultimately pay is confidential. But others—notably the uninsured—are left to pay the higher list prices. And, as Barrett and Langreth write, drug makers often raise those list prices “to make up some of the lost revenue” from rebating.

FORTUNE contributor Katherine Eban dove into the murky PBM-client-drugmaker nexus back in 2013, in a classic feature entitled, “Painful Prescriptions.” And it would seem that little has changed since then.

Maybe the senators will, in their quiet time at home, absorb this thoughtful reporting—then come up with some good ideas to combat the outrageous surge in the price of medicines, and of healthcare in general. Maybe that’s a way for them to deliver on their promises to their constituents—who really just want some way to afford the medications their families need, not have their insurance taken away or their premiums surge.

Then, maybe next Independence Day, when they’re at their hometown fireworks display, some good soul might come over to hand them a cold beer—which is what big-hearted Americans do on the Fourth of July.

 

This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.

About the Author
By Clifton Leaf
See full bioRight Arrow Button Icon
Add Fortune on Google for similar content.

Latest in Health

Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025

Most Popular

Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Fortune Secondary Logo
Rankings
  • 100 Best Companies
  • Fortune 500
  • Global 500
  • Fortune 500 Europe
  • Most Powerful Women
  • World's Most Admired Companies
  • See All Rankings
  • Lists Calendar
Sections
  • Finance
  • Fortune Crypto
  • Features
  • Leadership
  • Health
  • Commentary
  • Success
  • Retail
  • Mpw
  • Tech
  • Lifestyle
  • CEO Initiative
  • Asia
  • Politics
  • Conferences
  • Europe
  • Newsletters
  • Personal Finance
  • Environment
  • Magazine
  • Education
Customer Support
  • Frequently Asked Questions
  • Customer Service Portal
  • Privacy Policy
  • Terms Of Use
  • Single Issues For Purchase
  • International Print
Commercial Services
  • Advertising
  • Fortune Brand Studio
  • Fortune Analytics
  • Fortune Conferences
  • Business Development
  • Group Subscriptions
About Us
  • About Us
  • Press Center
  • Work At Fortune
  • Terms And Conditions
  • Site Map
  • About Us
  • Press Center
  • Work At Fortune
  • Terms And Conditions
  • Site Map
  • Facebook icon
  • Twitter icon
  • LinkedIn icon
  • Instagram icon
  • TikTok icon
  • YouTube icon

Latest in Health

A Hims cofounder fired his entire marketing team for AI. Now his 24/7 online vet service is growing 20% a month
SuccessMarketing
A Hims cofounder fired his entire marketing team for AI. Now his 24/7 online vet service is growing 20% a month
By Sydney LakeJuly 25, 2026
7 hours ago
Roderick Wong, MD is Managing Partner and Chief Investment Officer of RTW Investments
Commentary250 Years of Innovation
When 10,000 doctors stood up and cheered for a cancer drug — America’s innovation machine made it possible
By Roderick WongJuly 25, 2026
9 hours ago
What it’s like to be a founder of the most high-stakes startup ever, OpenAI
AIOpenAI
What it’s like to be a founder of the most high-stakes startup ever, OpenAI
By Alyson ShontellJuly 25, 2026
11 hours ago
Photo of RFK Jr.
HealthFDA
RFK Jr.’s peptide push narrowly gains backing from FDA advisers despite objections from scientists
By The Associated Press and Matthew PerroneJuly 24, 2026
1 day ago
PartiQular as best resveratrol supplement
HealthDietary Supplements
The Best Resveratrol Supplements (2026): Expert Reviewed
By Christina SnyderJuly 24, 2026
1 day ago
Sunlight Sauna Review
HealthDietary Supplements
Sunlighten Sauna Review (2026): Features, Cost, and Our Take
By Emily PharesJuly 24, 2026
1 day ago

Most Popular

The millennial generation is split in 2: an older crowd with boomer-style comfort, a younger set going 'back to the early 1900s'
Real Estate
The millennial generation is split in 2: an older crowd with boomer-style comfort, a younger set going 'back to the early 1900s'
By Nick LichtenbergJuly 25, 2026
9 hours ago
'The demographic dividend of the last 40 years is ending': J.P. Morgan says the world is running out of the two things that kept interest rates down
Economy
'The demographic dividend of the last 40 years is ending': J.P. Morgan says the world is running out of the two things that kept interest rates down
By Eleanor PringleJuly 24, 2026
2 days ago
Jensen Huang made his $172 billion fortune on AI chips. His family's $75 million gift to Vanderbilt argues art decides what technology is for
Big Tech
Jensen Huang made his $172 billion fortune on AI chips. His family's $75 million gift to Vanderbilt argues art decides what technology is for
By Sydney LakeJuly 23, 2026
3 days ago
An 11-year-old is cleaning his neighbors' trash cans for $10 each—he now has 100K followers as teens face the worst summer job market since 1948
Success
An 11-year-old is cleaning his neighbors' trash cans for $10 each—he now has 100K followers as teens face the worst summer job market since 1948
By Orianna Rosa RoyleJuly 25, 2026
11 hours ago
The $39 trillion U.S. national debt isn’t as high as Japan’s and Singapore’s relative to economy size—and yet it's still worse somehow
Economy
The $39 trillion U.S. national debt isn’t as high as Japan’s and Singapore’s relative to economy size—and yet it's still worse somehow
By Sasha RogelbergJuly 23, 2026
2 days ago
Jensen Huang just used his first ever X post to warn the AI industry not to make the mistake that software narrowly avoided in the 1980s
AI
Jensen Huang just used his first ever X post to warn the AI industry not to make the mistake that software narrowly avoided in the 1980s
By Nick LichtenbergJuly 24, 2026
1 day ago

© 2026 Fortune Media IP Limited. All Rights Reserved. Use of this site constitutes acceptance of our Terms of Use and Privacy Policy | CA Notice at Collection and Privacy Notice | Do Not Sell/Share My Personal Information
FORTUNE is a trademark of Fortune Media IP Limited, registered in the U.S. and other countries. FORTUNE may receive compensation for some links to products and services on this website. Offers may be subject to change without notice.