Roger Passman-Fischel 
The High Cost of Prescription Medicine and More
Introduction: America’s Broken Healthcare System
America’s broken healthcare system continues to fail those it is meant to serve. Millions of Americans face overwhelming prescription costs, often leaving them to choose between their medications and other basic needs. At the heart of this issue are corporate greed, profit motives, and the powerful
Patient: “What are my options?”
Doc: “Self pay out of pocket to the tune of $250,000. and I’ll wave my fees.”
influence of the pharmaceutical industry. Meanwhile, political forces allow these corporations free rein by blocking price regulations and restricting government intervention. The result is a healthcare model driven by profit, not patient care, where corporate interests hold more power over patients’ health decisions than ever before.
Greed and Shareholder Considerations: The Inflation of Prescription Drug Prices in America’s broken healthcare system
Recent data underscores how corporate greed drives the costs of essential medications ever higher. In 2023, Humira, one of the top-selling drugs for treating autoimmune diseases, reached an annual treatment cost of over $84,000 per patient in the U.S., while its European cost remains only one-third of that amount (Yang, 2023). AbbVie, Humira’s manufacturer, actively prevented competition by filing over 250 patents, creating a legal “patent thicket” that blocks generic versions from entering the market. Meanwhile, AbbVie reaps enormous profits, increasing shareholder value at patients’ expense. Since the company’s 2013 split from Abbott Laboratories, AbbVie profits from Humira alone have exceeded $100 billion, benefiting shareholders and executives while patients pay the price (Yang, 2023).
Similarly, EpiPen price inflation illustrates corporate prioritization of profits over affordability. EpiPen, a life-saving device for severe allergic reactions, rose from $100 in 2007 to over $600 by 2016—a sixfold increase despite minimal production cost changes (Ingraham, 2019). Mylan, EpiPen’s manufacturer, attributed this hike to “market factors,” but public outcry highlighted its price-gouging tactics. Mylan’s CEO’s salary climbed in parallel, receiving a $19 million compensation package as EpiPen prices soared (Ingraham, 2019). These examples underscore how shareholder value often takes precedence, fueling price hikes that burden consumers, even for life-saving medications.
Neo-Liberal Policies Fuel Unchecked Pharmaceutical Profits in America’s broken healthcare system
Neo-liberal policies heavily shape the U.S. healthcare market by blocking efforts to rein in drug prices. Congress frequently prioritizes industry interests over consumer protection due to lobbying. In 2022 alone, pharmaceutical lobbying expenditures reached over $350 million, demonstrating the industry’s financial commitment to maintaining influence over policy decisions (Public Citizen, 2022). This spending often targets lawmakers from both major political parties, aiming to prevent policies that could cap drug prices or allow Medicare to negotiate costs directly.
This trend extends to Medicare, where the government remains barred from negotiating prices due to the 2003 Medicare Modernization Act. Recently, a proposal aimed at repealing this ban and granting Medicare negotiation power gained widespread public support. However, the pharmaceutical industry’s intense lobbying and political contributions impeded its passage (New York Times, 2023). These Neo-liberal influences help maintain a healthcare system designed to serve corporate interests rather than patients, showing how deeply ingrained industry interests are in America’s broken healthcare system.
Insurance Companies Drive Medical Decisions to Maximize Profits
Insurance companies increasingly dictate healthcare decisions, adding to the dysfunction within America’s broken healthcare system. As insurers expand their control over which medications they will cover, doctors face more restrictions in prescribing medications based on patient needs. A 2023 study found that 25% of physicians reported regularly having to alter treatments to align with insurers’ approved drug lists, known as formularies (American Medical Association, 2023). Insurers use these formularies to promote cheaper options, often forcing patients to switch from effective medications to less suitable alternatives to save costs.
The case of Optum, a subsidiary of UnitedHealth Group, illustrates this profit-driven interference. Optum recently acquired several smaller healthcare entities to exert greater influence over care plans and prescriptions. In 2022, Optum revenues topped $155 billion, and the company redirected nearly 15% of earnings toward shareholders, largely derived from cost-saving measures in healthcare coverage (UnitedHealth Group, 2022). This setup places insurers in control of critical health decisions, challenging the doctor-patient relationship and leaving patients at the mercy of profit-driven entities. America’s broken healthcare system endangers patients’ health and well-being by granting insurers the power to prioritize costs over care quality.
Government Inaction and a Broken Accountability System fuels America’s broken healthcare system
Lack of accountability enables pharmaceutical companies to exploit patients without consequence. Pharmaceutical corporations in the U.S. capitalize on patent laws to maintain monopolies on life-saving drugs, manipulating minor drug adjustments to renew patents and keep competitors at bay. For instance, Pfizer’s seizure medication Lyrica has remained patent-protected for over two decades due to such maneuvers, with Pfizer earning over $4.5 billion annually from its exclusive hold (Kesselheim & Avorn, 2022). Despite public pressure, Congress has failed to implement patent reform to end these monopolistic practices, allowing companies to keep prices artificially high and limit market competition.
Accountability efforts are similarly stymied at the FDA, where the pharmaceutical industry exerts significant influence. Pharmaceutical firms fund over half of the FDA drug evaluation budget through user fees, creating a potential conflict of interest. With this dependence on industry fees, FDA oversight becomes challenging, further entrenching profit-driven policies within regulatory agencies meant to protect consumers (Health Affairs, 2023). Such regulatory failures reveal a lack of checks and balances in America’s broken healthcare system, allowing drug manufacturers to place shareholder profits over patient access to affordable treatments.
Conclusion: Addressing America’s Broken Healthcare System
America’s broken healthcare system creates an inequitable landscape where corporate profits take precedence over patient needs. From skyrocketing drug prices to political roadblocks that block regulatory reforms, the forces at play create a system that financially benefits a small elite while burdening the majority. To reverse this trend, policymakers must dismantle monopolistic practices, limit the influence of corporate lobbying, and reclaim the power to negotiate drug prices. A fair and functional healthcare system can become a reality, but only if we demand accountability and reject the corporate interests that currently dominate U.S. healthcare.
Sources Cited
– American Medical Association. (2023). Insurance-driven medical decision barriers and patient outcomes. Retrieved from [https://www.ama-assn.org]
– Health Affairs. (2023). Industry-funded FDA oversight and implications for patient safety. Health Affairs, 42(2), 107–112.
– Ingraham, C. (2019). EpiPen’s price surge: The role of corporate greed in essential medication. Washington Post. Retrieved from [https://www.washingtonpost.com]
– Kesselheim, A. S., & Avorn, J. (2022). Patent manipulation and the cost of epilepsy medications. New England Journal of Medicine, 387, 144-147.
– New York Times. (2023). Lobbying in action: The fight over Medicare drug negotiation. NYT, August 1, 2023.
– Public Citizen. (2022). Lobbying by pharmaceutical companies in 2022. Public Citizen. Retrieved from [https://www.citizen.org]
– UnitedHealth Group. (2022). Annual Report 2022. Retrieved from [https://www.unitedhealthgroup.com]
– Yang, D. (2023). The patent thicket surrounding Humira and the impact on drug costs. Journal of Law and Public Policy, 45(1), 90–101.
Suggestions for Further Reading
- “Prescription for Greed” by John Abramson – Investigates how pharmaceutical companies prioritize profits over patient care in the U.S.
- “The Big Pharma Monopolies” by Robin Feldman – Analyzes the monopolistic practices of drug companies and their impact on the healthcare system.
- “Medicare Meltdown” by Phillip Longman – Critiques how political agendas have failed Medicare, impacting affordability and access for patients.
- “The Price of Profit” by Elizabeth Rosenthal – Details how healthcare costs in the U.S. exceed those in other countries due to corporate influence.
- “Sick and Tired” by Madeline Drexler – Examines the challenges facing patients with chronic illnesses under America’s healthcare system.
- “Out of Control” by Wendell Potter – Discusses the insurance industry’s role in reshaping healthcare policies to benefit corporate interests.
- “Broken Healthcare” by Martin Makary – Provides an inside look at how profit motives distort medical decisions in the U.S.
- “The Healthcare Conundrum” by Paul Starr – Explores the failures of America’s healthcare policies and the potential for systemic change.
- “The Other Side of Greed” by Frederick Lown – Analyzes the financial priorities within pharmaceutical companies and their consequences for patients.
Disclaimer: The images and videos in this post are AI-generated creations, intended purely for illustrative and conceptual purposes. They are not real-life representations and should not be interpreted as such. Their sole purpose is to offer a visual means of exploring the topics discussed in this post.
