QUICK READ: There is so much money in healthcare that every company wants their share even if patients get hurt. The amount of money Pfizer is going to make from their vaccine borders on obscene while PBMs quietly take a cut of every Rx transaction without really adding any value. It’s going to continue until we put politics aside and say “enough.”
J&J has had problems in the past, but they’re trying to be an ethical and responsible pharma company. Johnson & Johnson privately contacted other drugmakers producing COVID-19 vaccines to join a study into the potential risk of blood clots, but Pfizer and Moderna refused. Refused?! And we thought developing these vaccines was all about helping people during the pandemic.
Pharma is a big business. Pfizer is expected to earn $24 billion in revenue from the vaccine, and they are already positioning a booster shot as a necessity which will bring in even more profits. Pfizer CEO Albert Bourla cashed out 60% of his stock the day the company disclosed that its vaccine was more than 90% effective in preventing severe cases of COVID-19 and Pfizer held back a shipment to Israel because of payment issues. Pfizer is a company focused on one thing only: profits.
It’s not just big pharma that’s raking in money. A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to a new federal audit, which seeks to claw back the money. That’s a lot of money and of course Humana is fighting the audit results.
Gilead became infamous a few years ago for charging $84,000 per course of treatment for Sovaldi, a “groundbreaking” hepatitis-C drug. The company’s policies for pricing have more than once prompted congressional hearings, as in the case of Truvada, a drug to combat HIV transmission that was developed in part with the aid of government grants and that earned Gilead more than $30 billion in revenue.
When it comes to remdesivir, Gilead, a company with a market capitalization of more than $90 billion, making it bigger than Goldman Sachs, develops an antiviral drug with the help of $99 million in American government grant money. Though the drug may cost as little as $10 per dose to make, and is being produced generically in Bangladesh at about a fifth of the list price, and costs about a third less in Europe than it does in the U.S., Gilead ended up selling hundreds of thousands of doses at the maximum conceivable level, i.e., the American private-insurance price — which, incidentally, might be about 10 times what it’s worth, given its actual medical impact.
PBMs too are making a fortune. Ed Silverman in STAT News wrote “as states struggle to control the cost of prescription medicines, a new report found pharmacy benefit managers pocketed more than $89 million collected on behalf of the Florida Medicaid program — and the consultants who ran the analysis recommended state officials rework the arrangements. The report found that PBMs appear to have profited from what is known as spread pricing, which refers to the dispensing fees that these companies pay pharmacies but then bill at a different rate to state Medicaid programs. In this instance, the PBMs working with managed care plans made $8.64 for each Medicaid prescription, which accounted for 9.5% of total plan spending”.
Why is all this happening? Very simple: greed and Wall Street. We spend so much for healthcare that everyone wants a piece of the pie. Eventually it’s going to come to a head and the results won’t be pretty for pharma, PBMs and insurers. The clock is ticking/