In this timely follow-up to last week's breakdown of the prescription drug pricing crisis, Chuck dives even deeper into the root causes—and policy battles—behind the price tags we all feel.
From patent games that block generics to the ripple effects of President Trump’s recent executive order, Chuck breaks down the complex ecosystem of drug pricing like only an insider can. If you thought the system was rigged before… just wait until you hear how long some patents last (spoiler: Humira had a 25-year run). This episode hits everything from global price benchmarks to why Florida can’t just import meds from Canada.
What You’ll Learn
How drug companies extend patents through “patent thickets” – keeping generics off the shelves
Why “list price” transparency in drug ads might be the next big push
The truth about importing cheaper drugs from other countries—and why it’s not that simple
How price controls differ from negotiations (and why it matters for Medicare patients)
Why insurers may block access to government-negotiated drugs (yes, they really can)
The unintended consequences of the Inflation Reduction Act—higher premiums and limited access
What happens when cutting-edge drugs come with 18-year post-approval monitoring costs
Why obesity drugs may require government subsidies to drive true healthcare savings
Quotes of Note
“Humira was approved in 2002. It didn’t go off patent until 2023. That’s not innovation—that’s strategy.”
“Three in ten Americans skipped doses or prescriptions last year due to cost. That led to 125,000 deaths and $300 billion in system waste.”
“We’re negotiating prices, but insurers are saying, ‘We’re not putting those drugs on the formulary—there’s no rebate in it for us.’”
“You can’t just say ‘Let’s import from Canada.’ Canada doesn’t have the supply—and drug makers won’t just sit back and take the hit.”
“Insurers, PBMs, and some hospitals—answer to shareholders, not patients. That’s the root of the problem.”
Resources Mentioned
1. President Donald J Trump’s 2025 Executive Order addressing Drug Pricing
2. “Unintended Consequences of IRA Drug Price Negotiations” by Mark Fendrick and Real Clear Health. October 7, 2024. A. Mark Fendrick, M.D.
3. ”Pioneer Institute Launches Tracker Showing Drug Price Controls Are Raising Out-of-Pocket Costs for Medicare Patients. American First Policy Institute
4. “Trump’s US Drug-Pricing Plan Would Cost the Rest of the World” by Naomi Kresge and Ashleigh Furlong
5. “Put Americans First by Ending Global Freeloading” by Charlie Katebi, March 21, 2025. Issue Brief from America First Policy Institute. This makes the case against what it calls pharmaceutical "global freeloading" and outlines various policy measures to address it.
6. F.D.A. Issues First Approval for Mass Drug Imports to States From Canada https://www.nytimes.com/2024/01/05/health/drug-imports-canada-florida.html - New York Times by Christine Jewett & Sheryl Gay Stolberg
7. The weight-loss drug revolution exposes the weakest links in our health care system - drug pricing and insurance. September 2024 article
Additional Resources that inform this episode:
Inflation Reduction Act (2022)
U.S. drug patent records for Humira and Enbrel
Taiwanese study on obesity drugs and mortality reduction
FDA regulations on post-market drug monitoring
Florida’s drug importation legislation and Canadian export restrictions
Take Action!
📣 Share this episode with someone who’s frustrated with high drug costs🗳️ Contact your legislators—demand guardrails on insurers and PBMs, not just manufacturers
💻 Visit disruptivedialogue.org for podcast resources & ways to get involved
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💥 Don’t hate the player—hate the game. Demand transparency.
