Prescription for Profit


Book Description

"A sound, well written, and highly interesting examination of how Medicaid . . . has given far too many physicians an opportunity to 'mop up' fraudulently, for their own financial gain, some of the $61 billion annual cost of the program."--Marshall B. Clinard, author of "The Abuse of Corporate Power" "A searching analysis of a problem that is of enormous concern to every nation. It is a lively, insightful treatment of the Medicaid malady, using the best diagnostics available to contemporary criminology."--John Braithwaite, Australian National University




Making Medicines Affordable


Book Description

Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.




Drugs, Money, and Secret Handshakes


Book Description

In the warped world of prescription drug pricing, generic drugs can cost more than branded ones, old drugs can be relaunched at astronomical prices, and low-cost options are shut out of the market. In Drugs, Money and Secret Handshakes, Robin Feldman shines a light into the dark corners of the pharmaceutical industry to expose a web of shadowy deals in which higher-priced drugs receive favorable treatment and patients are channeled toward the most expensive medicines. At the center of this web are the highly secretive middle players who establish coverage levels for patients and negotiate with drug companies. By offering lucrative payments to these middle players (as well as to doctors and hospitals), drug companies ensure that inexpensive drugs never gain traction. This system of perverse incentives has delivered the kind of exorbitant drug prices - and profits - that everyone loves except for those who pay the bills.




Prescription for the People


Book Description

In Prescription for the People, Fran Quigley diagnoses our inability to get medicines to the people who need them and then prescribes the cure. He delivers a clear and convincing argument for a complete shift in the global and U.S. approach to developing and providing essential medicines—and a primer on how to make that change happen. Globally, 10 million people die each year because they are unable to pay for medicines that would save them. The cost of prescription drugs is bankrupting families and putting a strain on state and federal budgets. Patients’ desperate need for affordable medicines clashes with the core business model of the powerful pharmaceutical industry, which maximizes profits whenever possible. It doesn’t have to be this way. Patients and activists are aiming to make all essential medicines affordable by reclaiming medicines as a public good and a human right, instead of a profit-making commodity. In this book, Quigley demystifies statistics and terminology, offers solutions to the problems that block universal access to medicines, and provides a road map for activists wanting to make those solutions a reality.




Prescription for Profit


Book Description

In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing. How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment. The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity. Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.




Prescriptions for Profit


Book Description




Prescription Games


Book Description

The major pharmaceutical companies, according to John le Carré – who has based his novel The Constant Gardener on their depredations – “are engaged in the systematic corruption of the medical profession, country by country.” Jeffrey Robinson can back up that charge. In Prescription Games, Jeffrey Robinson exposes the yawning abyss between the claims to altruism made by pharmaceutical companies and the harsh reality of their everyday practice. When the industry claims that the enormous markup they charge for new drugs pays the cost of developing new ones, they don’t say that as much as 80 per cent of R&D money is actually directed at developing drugs designed to compete with existing brands, or at creating variations on drugs whose patents are about to expire – expenditures only the industry itself (and its shareholders) will benefit from. Within the industry, there are “blockbuster” drugs that create vast wealth for the companies that manufacture them. Most are designed to treat conditions that are endemic among prosperous, western populations that can afford them. But there are no blockbuster drugs to treat diseases like tuberculosis, cholera, and malaria that ravage the Third World, because Third World countries can’t afford the prices. People in Africa and Asia die from new strains of tuberculosis while people in Europe and North America are offered expensive treatments for obesity, hair loss, and sexual dysfunction. In this hard-hitting exposé, Robinson also examines the extension of patent protection, the end of generic drug competition in Canada, the Nancy Olivieri scandal (how a drug manufacturer fought to conceal research findings that would damage sales of its product), the illicit drug trade, and espionage among drug manufacturers.




Prescription for Profit


Book Description

In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing. How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment. The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity. Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.




The Profit in Pills


Book Description