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As sky-high EpiPen costs show, price gouging of patients by greedy drug companies is one part of our dysfunctional healthcare system. Another is what may appear to be the arbitrary way that insurers decide what co-pay to charge. Santa Ana residents William and Phyllis Stevens encountered this recently when they were both prescribed the same cream for pre-cancerous skin growths. One had a co-pay of $20, the other a co-insurance cost of $300. And the much-higher charge was levied for a version of the medicine that was weaker than the cheaper version — yet had jumped nearly 1,500% in price since 2009. Welcome to Crazy Town. (David Lazarus, 8/30)

Last week, Pfizer announced the $14 billion acquisition of Medivation, whose innovative prostate cancer treatment Xtandi (generic name enzalutamide) generated $2.2 billion in sales last year. The drug retails for $129,000 a year. Not much has changed since my 2004 book on the sources of pharmaceutical and biotechnology innovation. Its conclusion—now over a decade old—was that most of the drug and other medical breakthroughs of the last quarter of the 20th century traced their scientific and medical roots to government-funded research. (Merrill Goozner, 8/27)

Dear Heather, Last week was a train wreck, wasn’t it? The rage over continual price hikes for EpiPen finally exploded. Petitions accusing you of price gouging whizzed around the Internet. A cadre of Washington lawmakers repeatedly vilified you. And Wall Street is edgy that your company, Mylan Pharmaceuticals, is the new poster child for corporate greed. Well, congratulations. You are the new Martin Shkreli. (Ed Silverman, 8/29)

Mylan Pharmaceuticals is at the center of a firestorm of criticism over dramatic price hikes for its lifesaving EpiPen. The problem, says Mylan CEO Heather Bresch, is a broken health system that has let deductibles and copays skyrocket on many insurance policies. She is half right. If deductibles had stayed low, parents and other EpiPen users probably wouldn’t have noticed that Mylan had increased the price of a two-injector set from around $100 seven years ago to more than $600 this spring. But their insurance companies were still getting gouged. (Dana Goldman, 8/26)

Republican voters hate Obamacare, but they hate high prescription drug prices even more. Health care scholar Avik Roy recently pointed to the polls as a reason the GOP must develop a “clear plan to tackle the high and rising price of branded prescription drugs.” He proposed a number of measures aimed at reining in supposedly greedy pharmaceutical firms. But Roy, like many others who have weighed in on the cost of medicines, overlooks two key points. First, the very real financial pain many Americans feel at the pharmacy counter is the fault of insurers – not drug companies. Second, the obsessive focus on cost obscures the vastly higher value of new drugs. (Peter J. Pitts, 8/29)

Of roughly $250 million raised for and against 17 ballot measures coming before California voters in November, more than a quarter of that amount — about $70 million — has been contributed by deep-pocketed drug companies to defeat the state’s Drug Price Relief Act. Contributions aimed at killing the initiative are on track to be the most raised involving a single ballot measure since 2001, the earliest year for which online data are available, according to MapLight, a nonpartisan organization that tracks money in politics. (David Lazarus, 8/26)

Prescription drugs costs are a perennial political piñata, and this cycle is no different. Both presidential candidates are hurling rhetoric about “skyrocketing” and “runaway” drug prices and offering half-baked solutions to address them. The truth is that the best chance in controlling drug prices rests in leveraging a powerful mechanism that already exists - market competition. Here’s why the candidates’ proposals to negotiate Medicare drug prices, and in the case of Hillary Clinton, demand Medicaid-style rebates in Medicare, are more rhetoric than real solutions. To begin, these proposals are hardly what the public wants. (Douglas Holtz-Eakin, 8/25)

Mylan’s pricing of the EpiPen and last year’s high-profile reporting on Turing’s pricing of Daraprim are just the most egregious examples of a systemic problem in drug pricing — when a company is the sole producer of a lifesaving product for which there are no alternatives. Free-market economics leads to exorbitant prices, a result we should find completely unacceptable. In the proverbial case of the better mousetrap, the price is limited by customers who buy old mousetraps rather than pay the premium price for the better one. With lifesaving products that don’t have an alternative, the free market, as we have seen, produces outrageous prices and profits. Our patent system produces a similar result for new game-changing drugs. (8/28)

Last year, Turing Pharmaceuticals drew national ire after it bought the anti-parasite drug Daraprim and then increased its price by fiftyfold. That the drug is often used in combination with other medicines to treat those infected with HIV seemed to have no significance to the firm’s then-CEO Martin Shkreli, beyond the opportunity to take advantage of people with little choice but to pay the exorbitant price. If Turing’s greedy stance on Daraprim was appalling, it was, at least, a step removed from the image of a rescuer negotiating price with a drowning man, if only because there are other HIV “cocktail” combinations available and the disease kills more slowly than, say, anaphylactic shock. (8/30)