A special report on the thorny issue of drug prices

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Deep Dive - Drug Pricing

The drug pricing maze

A maze with a pill in the middle
Illustration: Sarah Grillo/Axios

The system for setting drug prices in the U.S. is a labyrinth. It can be enormously frustrating for patients — and enormously rewarding for the drug companies, pharmacies, doctors, hospitals and assorted middlemen that profit along the way.

The big picture: The cost of a drug depends on many factors: whether it’s a brand-name product or a generic; secretive industry negotiations; even the way the drug is administered. Each patient's price may be different.

Why drug prices matter: Lives and livelihoods are at stake

Illustration of syringe with tears
Illustration: Sarah Grillo/Axios

Drug prices are a big deal politically because they’re a big deal personally. Time after time, the issue is thrust back into the spotlight by virtue of giant price increases on drugs that aren’t new or innovative, but are still life-savers for millions of people.

It happened when “pharma bro” Martin Shkreli bought Daraprim, a drug to treat AIDS, and raised the price by 5,000%. It happened when Mylan raised the price of the Epi-Pen by about 500% over 6 years. It has been happening for years with insulin, where prices keep creeping higher, adding up to increases of more than 200% for some products.

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