In 2008, a box of 30 prescription suppositories sold for less than $200. In 2021, the same box cost $10,000 — an outrageous increase of 4,900%. Is there any better example of how employer health plan sponsors and patients are getting shafted by a dysfunctional health care industry?
Creative profiteering has become a criminal art form as evidenced by the 2021 Shkreli Awards, so named for the “Pharma Bro” whose egregious price hikes shocked the world. We wish we could say Shkreli and the latest award winners are the exception. They’re not, and patients continue to suffer without access to affordable prescription drugs and health care.
Plan sponsors can mitigate this dysfunction with employee health plans that challenge the current state of affairs with accurate, timely data, and clear medical evidence. Claims should include pre-payment integrity controls based on value instead of whatever trumped-up charges are billed. And everyone benefits from a high-performing formulary that uses clinical evidence to balance comparative drug effectiveness with costs.
It’s time to take action that eliminates the industry’s figurative suppositories foisted upon plan members and employer plan sponsors.