Drug markets are not driven by market forces, with or without government interference. As a Pharmacist for over 2 decades, I've seen drug economics from multiple perspectives. If you want to have a market condition for drug prices, and I'm all for that, then all the third party payers need to be cut out of the picture and nothing should be between the patient and the true price of drugs.

Nobody in this game wants that. With Lipitor being sold for over $150 a month and standard diabetic drugs pushing the $300.00 a month threshhold, nobody can afford this. I'm all for making people pay cash on the barrel head for all drugs. That would drive the cost of drugs down. Right now all intermediates are driving drug prices through the ceiling, and why should it be so? Right now the only downward pressure on drug costs is how much money can be extorted from the general public through third party payers who have no interests in controlling costs. They extort on Pharmacy Company against the other to extract a the best kickback, regardless of the costs to the patients. But anything can be an excuse for increasing prices. When Zyprexea sells for nearly $20.00 a tablet and patients who takes the drug are completely dependent upon the drug to even live outside of a hospital – please tell, what exactly is the economic model which can describe the relationship between Lilly and my patients?

They're all crooks, the Drug Companies, the Pharmacy Benefit Management Companies, and the Doctors who refuse you consider the costs to any medical decision. As it is now, the costs of drugs are priced strictly according to how close the patient is to death, nothing more or less.

In Canarsie we didn't call that not market economics. We called it extortion.

Right now, my patients have to decide between healthcare and eating every day. This is worse than rationing. Aside which, frankly healthcare at the VA is far better than the general public. Is it really expected that the VA should give drugs without rationing, anything and any Doctor can think for which they receive tangible benefits from the sales reps, and in which they have no consequence to prescribing for what so ever? Here is another idea. Give each Physician 5 million dollars and so many patients. The Physician pays for everything he prescribes. At the end of the year he can keep whatever he doesn't spend....now that should do it.

Ruben Safir