[benmaraschino]

Exhibit A: Vimovo. One pill, consisting of two drugs that have been around for decades, and are available over the counter at any pharmacy. If bought separately, a month’s supply of these drugs would run you maybe $40, at most.

Vimovo, on the other hand, is routinely charged to insurers by pharmacies at prices ranging to over $3,000 for a month’s supply. And somehow insurers are willing to pay for it, to the tune of nearly $500 million a year. More details here from ProPublica: https://www.propublica.org/article/horizon-pharma-vimovo-com...

[zaroth]

I suspect that something very fishy is going on between when the money is “paid” by the insurance company to the money that actually makes it to the pharmaceutical company. I suspect most of this money gets rebated back to the insurer in some form or another.

Reading your link it’s actually an interesting story of an absolute fraud designed to thread a perfect path through all the existing regulations and checks & balances.

[refurb]

There have been a lot of fishy dealings with the drugs that came from Valeant.

They would charge outrageous prices for drugs that were just a combination of generics.

They funneled the scripts to a pharmacy they partnered with. Most insurers would not cover the drug, but the pharmacy knew all the tricks. 80% of claims might get rejected, but they made a ton of money off the 20%.

[refurb]

That’s a great example of how stupid insurers are. That drug have had zero sales, but they sneaked in the back when no one was looking.

[coryrc]

Wrong; insurers' profit is limited to a percentage of expenditure in the ACA. Increasing expenditure is the only way to increase profit.

[PopeDotNinja]

Insurers just pass the costs through to consumers. Health insurance premiums have been going up a stupid amount, too.

[zaroth]

Actually the insurers wisened up and largely stopped approving claims for this one.

[ChrisLomont]

Doesn't the same argument apply to the elements making any drug? Carbon, oxygen, etc.. are all pretty cheap. But there is significant value in mixing things properly and getting that mixture tested and through the FDA.

If it's trivial to take these cheap drugs and mix them, then why don't people simply do that?

[sooheon]

Check out the propublica piece. Their analogy is more akin to putting pb&j in one jar. As to why it happens? People are likely to do what their doctors say and what their insurance will cover. Pharma has ways to influence both.

[pxeboot]

Because people just accept what is prescribed, and neither the customer or doctor is aware of the actual cost?