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The drug companies are ripping us off, pill by pill, shot by shot. Instead of working to earn reasonable returns by relieving our suffering and saving lives, they now focus on profits above all. Their main targets are insurance companies. But when insurance companies take a hit, they bump up premiums to employers or the government. So we all pay — in taxes, reduced take-home pay, copayments and deductibles. (Daniel J. Stone, 7/6)

Last month, House Speaker Paul Ryan unveiled the GOP’s comprehensive plan for health reform. It included 30-odd pages of constructive proposals for replacing Obamacare, reforming entitlements, and promoting innovation. But the plan was also notable for what it didn’t contain: a clear plan to tackle the high and rising price of branded prescription drugs. Like objects in the rear-view mirror, drug prices are a bigger problem than they seem. (Avik Roy, 7/12)

Americans spend more on prescription drugs — average costs are about $1,000 per person per year — than anyone else in the world. It’s true that they take a lot of pills. But what really sets the U.S. apart from most other countries is high prices. Cancer drugs in the U.S. routinely cost $10,000 a month. Even prices for old drugs are spiking, as companies buy up medicines that face no competition and boost charges. While private insurers and government programs pick up the biggest share of the bill, high drug costs are ultimately passed down to the public through premiums and taxes. (Robert Langreth, 7/11)

Fighting yourself is a losing battle. A long-cherished hope of some companies that make expensive biologic medications -- complex drugs made with living cells -- is that they were relatively safe from competition because biologics are tougher to copy and replace than traditional drugs. That's looking a bit less true every day. In a delightfully incestuous turn, big companies aren't just fighting so-called biosimilar versions of these drugs anymore -- they're making them. (Max Nisen, 7/12)

In an unusual development, Pfizer signed a pact with the city of Chicago and agreed not to engage in the sort of marketing that helped fuel the epidemic in the first place. Chicago Mayor Rahm Emanuel boasted of a “landmark agreement” and a “big step” toward blunting the risks of these prescription painkillers, which were blamed for more than 14,000 deaths two years ago, according to federal health officials. To be sure, any time a drug maker agrees to restrict or enhance its marketing in ways that benefit public safety is noteworthy, especially given the eye-popping fines that so many of these companies have paid over the past decade to settle charges of illegal marketing. But this particular deal is unlikely to make much, if any, difference. In fact, for the moment, the only certain winner in this arrangement is Pfizer. And it’s a big win. (Ed Silverman, 7/12)

It is safe to say there is broad agreement -- among policymakers, healthcare providers, and patients alike -- that steps must be taken to make prescription drugs and treatments more affordable. Opinion varies, however, on exactly what direction to take to accomplish this goal. The Centers for Medicare & Medicaid Services (CMS) has recommended a path that we fear many physicians and their patients simply can't navigate because it is paved by false assumptions that endanger vulnerable Medicare patients. In an effort to lower drug spending, CMS has devised a plan to incentivize physicians to prescribe less expensive drugs under the Medicare Part B program. But the unfortunate reality -- one that CMS has yet to acknowledge -- is that there are no "cheap" yet clinically equivalent alternatives for some of the most advanced and expensive drugs available today. (Joan M. Von Feldt and Michael Seiden, 7/12)

As the biological basis of more diseases are fully revealed, and the drugs targeting medical problems become more focused and effective, more patients are finding themselves on costlier specialty medicines. At the same time, consumers find themselves paying a growing portion of their drug bills out of pocket as the structure of insurance changes. These two developments have combined to result in significant consumer hardship. In response to these trends, there has been political pressure to enact policies giving federal and state governments authority to set drug prices or limit price increases. However, these policies could have the unintended consequence of reducing the incentive to develop more effective drugs. (Scott Gottlieb and Kavita Patel, 7/11)

Blaming pharmaceutical companies for high drug prices is a bipartisan affair. If lawmakers like Sen. Chuck Grassley want to hold the responsible culprits accountable, they need to look at all sectors of the health care industry, including the insurance companies. The Affordable Care Act should curb an insurer’s profit maximization strategy, which hurts patients. But that hasn’t happened. (Seth Ginsberg, 6/7)