Friday, March 18, 2016

Hillary Clinton Vows to Expand Obama's LA RAZA FASCIST Welfare State In Our Open Borders.................. Along the way she will suck in some mighty big bribes from big pharma!


HILLARY CLINTON SAYS MILLIONS MORE VOTING ILLEGAL SHOULD BE HANDED OBAMACARE!

CLINTON'S PLATFORM IS SIMPLE: BUILD THE MEX WELFARE STATE ON AMERICA'S BACK TO BUY THEIR ILLEGAL VOTES.

THEY ALREADY GET MILLIONS OF OUR JOBS AND BILLIONS IN WELFARE!


THE AMERICAN THINKER

 MORE HERE

More free stuff for people who violate our immigration laws! Hillary Clinton and her daughter have teed up a ball for the Republican nominee, whether Trump or Cruz, to hit 400 yards down the fairway.  Just over a week ago, Hillary reversed her f...

NO ONE SERVES HIS PAYMASTERS ON WALL STREET MORE THAN BARACK OBAMA! 

HE SMELLS THOSE SPEECH FEE BRIBES ALREADY!

AND HILLARY IS OBAMA'S CLONE!

Drug prices have also been a theme in the presidential campaign. The Democratic frontrunner Hillary Clinton, for example, released a campaign advertisement earlier this month attacking the “predatory pricing” of Valeant Pharmaceuticals. Like the congressional hearing, this is all for show. Of all the presidential candidates, Clinton is the top recipient of donations from the pharmaceutical and health products industry, taking in $410,460 according to data from the Center for Responsive Politics.

US drug prices doubled since 2011

By Brad Dixon
18 March 2016
According to a new report by the pharmacy benefits manager Express Scripts, the average price of brand-name drugs increased by 16.2 percent last year. Between 2011 and 2015, branded prescription drug prices have nearly doubled, rising 98.2 percent. Since 2008, the prices have increased by a whopping 164 percent.

Drug spending rose by 5.2 percent in 2015. This was about half the increase seen in 2014, the year of the largest hike since 2003.

The report is based upon prescription use data for members with drug coverage provided by Express Scripts plan sponsors. In assessing changes in plan costs, the report distinguishes between the relative contributions from changes in patient utilization (e.g. more patients being prescribed the drug) and changes in the unit price of the drug (e.g., price hikes).

In the late 1980s and early 1990s, most drug spending was on traditional drugs (small-molecule, solid drugs) to treat conditions such as heartburn, depression and diabetes. The recent trend has been a shift to specialty drugs. Still, within traditional therapy categories there were significant increases in spending on medications to treat diabetes, heartburn and ulcers, and skin conditions.

Diabetes medications remain the most expensive of the traditional drug categories. Drug spending in this category increased by 14 percent, with the hike being equally influenced by increased utilization of the drugs and rise in unit cost. Three diabetes treatments—Lantus, Januvia and Humalog—were among the top five drugs in terms of spending across all traditional therapy classes.

Although not discussed in the report, an investigation by Bloomberg News last year found evidence of “shadow pricing” by drug manufacturers, where companies raise their prices immediately after their competitors do so. The investigation found that the prices of diabetes drugs Lantus and Lemivir had increased in tandem 13 times since 2009, and evidence of similar shadow pricing for the drugs Humalog and Novolog.

Heartburn and ulcer drugs saw a 35.6 percent increase in spending, almost solely due to the rise in unit cost. Although 92.3 percent of the medications filled in this category were generic, the price unit trend was heavily influenced by the increase in prices of branded drugs such as Nexium, Dexilant and Prevacid.

Treatments for skin conditions also saw a significant increase of 27.8 percent in spending, again due almost completely to rises in the unit costs of the medications. The report notes that these increases occurred for both generic and branded therapies, largely due to industry consolidation through mergers and acquisitions leading to less competition in the market. While 86.3 percent of the drugs filled were generic, many of the generic versions saw sharp increases in unit cost, including the two most widely used corticosteroids, clobetasol (96.2 percent) and triamcinolone (28 percent).

While the overall spending increase for traditional therapy classes was nominal (0.6 percent), the primary factor for the increase in spending came from specialty medications. Specialty medications require special education and close patient monitoring, such as drugs to treat cancer, multiple sclerosis or cystic fibrosis. Spending on specialty drugs rose by 17.8 percent in 2015. The report found that 37.7 percent of drug spending was for specialty drugs in 2015, and the figure is expected to rise to 50 percent by 2018.

Spending in this category was topped by inflammatory conditions—such as rheumatoid arthritis, inflammatory bowel diseases and psoriasis—which rose by 25 percent, driven by a 10.3 percent increase in utilization and 14.7 percent rise in unit cost. The average cost per prescription in 2015 was $3,035.95. The medications Humira Pen and Enbrel, which captured more than 66 percent of the market share for this class, saw unit cost increases of more than 17 percent.

Spending on oncology therapies increased by 23.7 percent, due to both increased use (9.3 percent) and increased unit cost (14.4 percent). New cancer therapies average $8,000 per prescription and the average cancer regimen is around $150,000 per patient. Between 2005 and 2015, the anti-cancer drug Gleevec, manufactured exclusively by Novartis, has seen its price more than triple, with an annual cost of $92,000. In 2015, the year prior to the drug’s patent expiration, Novartis increased the unit cost of the drug by 19.3 percent. This is a common practice for companies facing patent expiration.
Drug spending on cystic fibrosis treatments rose by a significant 53.4 percent, largely based on increases in unit cost (40.9 percent vs. 13.3 percent from patient utilization). This rise was largely due to use of the new oral combination therapy, Orkambi, which became available in mid-2015. The drug costs more than $20,000 per month.

The report forecasts that between 2016 and 2018 spending will increase annually by 7-8 percent for traditional drugs and around 17 percent for specialty drugs.

The prices of generic drugs have on average decreased, although there are notable exceptions. Pharmaceutical companies like Horizon Pharma, Turing Pharmaceuticals, and Valeant Pharmaceuticals have purchased generic drugs and then significantly hiked their prices.

The report notes the emergence of “captive pharmacies” in 2015 as another factor responsible for higher drug spending. Captive pharmacies are owned or operated by pharmaceutical manufacturers and tend to promote their manufacturer’s drugs, rather than generic or other low-cost alternatives. The report gives as examples the arrangements between Valeant Pharmaceuticals and Philidor Rx Services, and between Horizon Pharma and Linden Care Pharmacy.

The Express Scripts data matches the findings released earlier this year by the Truveris OneRx National Drug Index, which found that branded drugs rose by 14.8 percent in 2015.

Despite the widespread media publicity of the notorious drug price hikes by companies like Turing and Valeant, pharmaceutical companies have continued to inflate prices in 2016, with Pfizer leading the way with an average price hike of 10.6 percent for 60 of its branded drugs.

Workers are rightly outraged at the skyrocketing price of drugs. A Kaiser Family Foundation poll conducted last year found that 74 percent of respondents felt that the drug companies put profits before people.

The political establishment, however, has sought both to exploit this anger for electoral support and to direct it into safe channels that do not disrupt the status quo.

A congressional hearing held in January placed a spotlight on the price-gouging practices of HYPERLINK Valeant Pharmaceuticals and Turing Pharmaceuticals, whose dubious activities were highlighted in a pair of congressional memos. The purpose of the hearing, however, was not probe the underlying causes of the sharp rise in drug prices. Instead, legislators sought to safeguard the profits of the pharmaceutical industry as a whole through a verbal lambasting of the industry’s most notorious culprits.

Drug prices have also been a theme in the presidential campaign. The Democratic frontrunner Hillary Clinton, for example, released a campaign advertisement earlier this month attacking the “predatory pricing” of Valeant Pharmaceuticals. Like the congressional hearing, this is all for show. Of all the presidential candidates, Clinton is the top recipient of donations from the pharmaceutical and health products industry, taking in $410,460 according to data from the Center for Responsive Politics.

Clinton’s rival, Bernie Sanders, who has stated that he will support Clinton if he loses the Democratic nomination, received $82,094 in donations from the industry. Sanders has proposed a series of minor reforms to address drug prices, such as the re-importation of drugs from Canada, allowing Medicare to negotiate prices with drug manufacturers, and decreasing the patent life of branded drugs.
None of the candidates, including the “democratic socialist” Sanders, challenge the private ownership of the pharmaceutical industry in which everything from research and development and clinical testing to drug pricing and promotion are subordinated to the profit interests of corporations.







Largest Civil Disobedience Action of the Century isn’t Anti-Trump, It’s Pro-Democracy

1

In an article published here Wednesday, Aaron Klein wrongly characterized Democracy Spring as an “Anti-Trump” campaign organized by “radicals…involved in shutting down Donald Trump’s Chicago rally.”

We want to set the record straight, make it clear where we stand on Trump, and reach out to the all the conservatives who agree with us that big money is corrupting our political system.
First, setting aside any opinions on it, the assertion that the Chicago disruption was the work of Democracy Spring is simply untrue. Over 100 organizations have endorsed Democracy Spring. Their independent actions (and funders – George Soros hasn’t given us a dime) are distinct from our collective effort.
Second, while the leaders, organizations, and the vast majority of participants in Democracy Spring have profound and severe disagreements with Donald Trump, our nonviolent, non-partisan campaign is not a response to him.
Nor is it a response to any single candidate, party, or election. Democracy Spring is a response to the corruption of our entire political system, a system dominated by big money and inaccessible to many Americans who face growing barriers to the ballot box.
No matter who you support for president this year, surely we can all agree that our elected officials should work for all of us – not just wealthy special interests and big campaign contributors. In fact, we know many voters support Trump because he calls out this corrupt system and claims to stand outside of it as a self-financing candidate.
To this, we say: we hear you. The 
system is corrupt. The economy is rigged. Big 
campaign contributors do pull the strings in 
Washington. Working people are right to be 
angry about trade policy and the betrayal of 
the middle class, working families, and the 
poor by an elite establishment that profits 
from the status quo.
But we also challenge Trump supporters to consider a few things. Our corrupt campaign finance system goes far beyond presidential races and will not change by simply electing a president who supposedly can’t be bought. Without serious policy solutions, whoever we elect Commander-in-Chief will still have to deal with 435 members of Congress who are more eager to appease their donors than their own constituents.
Trump has yet to propose any solutions that would ensure every member of Congress and candidate for local and state office in America are elected in a way that makes them, as James Madison wrote, “solely dependent upon the People as whole – not the rich more than the poor.” If our system only allows us to choose between candidates who are bought by billionaires and billionaires themselves, then it is not a democracy. It is plutocracy.
That is why more than 2,600 American patriots have pledged to risk arrest in Democracy Spring, a massive nonviolent sit-in at the U.S. Capitol this April. The campaign will force Congress to choose between putting hundreds of peaceful defenders of the republic in handcuffs, or simply doing their job and passing reforms to fix our broken system.
It’s true Democracy Spring is led by many organizations associated with the left. But there’s no reason it must remain that way. We are a nonpartisan campaign open to all. And conservatives and liberals agree when it comes to the urgent need for solutions to rebalance the system.
Last year, John Pudner, the political strategist who helped lead 
Rep. Dave Brat (R-VA)
100%
’s 2014 upset over former House Majority Leader Eric Cantor, launched Take Back our Republic to advance conservative solutions to the problem of money in politics. For example, Take Back supports tax credits for small donations to political candidates to encourage more people to become involved in the political process. The group also supports more disclosure of large donors to ensure voters’ right to know who is trying to influence their vote and their lawmakers.
In a recent column, Richard Painter, President George W. Bush’s chief White House ethics lawyer, explained why the current system fails to address the needs and concerns of conservatives. He wrote, “campaign contributions drive spending on earmarks and other wasteful programs — bridges to nowhere, contracts for equipment the military does not need, solar energy companies that go bankrupt on the government’s dime and for-profit educational institutions that don’t educate.” Moreover, he writes, “campaign contributions breed more regulation” as companies use campaign cash to win special legal advantages over their competitors.
Progressives would disagree on public funding to spur clean energy innovation and the characterization of more regulations as necessarily bad, but we stand fully with Painter on his core point: “[Today’s] system is a betrayal of the vision of participatory democracy embraced by the founders of our country.”
Indeed, there is an opportunity today for progressives and conservatives to stand together to defend our republic and win reform that will let us settle our other differences on an even, open playing field where the best ideas and the broadest support are what count – not the backing of a moneyed elite.
Yet – and allegiance to the values that truly make America a great country demand that we make this crystal clear – Donald Trump’s candidacy is making this kind of unity across differences incredibly difficult. We are a nonpartisan campaign but not an amoral one. We are compelled to speak (and I am confident that I can speak for us all) when I say that Trump’s statements, proposed policies, and threats of violence concerning undocumented immigrants, Muslims, the KKK, protesters exercising their First Amendment rights, and others have crossed a very serious line into the territory of fascism and hate speech.
America is better than this. Conservatives are better than this.
Democracy Spring is a nonviolent campaign and, in the tradition of the civil rights movement, will strive to reach out to our most bitter opponents. We will seek unity with all who agree that every American deserves an equal voice and a government of, by, and for the people. Rather than letting our differences divide us, conservatives and progressives of conscience should come together on this common ground and renew our republic.
Politicians from both parties broke the system. It’s going to take voters from both parties — and independents committed to neither — to force our representatives to fix it.
It’s time to demand that Congress listen to the people and pass common-sense solutions to return our government to us all.
Kai Newkirk is lead organizer of Democracy Spring.



DHS says administration has 'no 

intention' of deporting most illegals

They're not even trying to hide their lack of 

enforcement of immigration law.

The president of the National Border Control Council testified before Congress that a top Homeland Security official told agents that the Obama administration has "no intention of deporting" most illegal aliens.
This "catch and release" policy amounts to a de facto amnesty for the tens of thousands of illegals who jump the border every year.

DHS claims that the policy is in place because immigration courts are clogged up.  So instead of expanding the number of judges and courts, they simply give up and allow the illegals to disappear into the underground.

Washington Times:
Mr. Judd provided his testimony in written answers released Monday by the House Judiciary Committee, saying that even in some criminal cases, agents are ordered to let illegal immigrants go without ever issuing them a Notice to Appear, or NTA, which is what puts them into deportation proceedings.

Mr. Judd said they took their case directly to Deputy Homeland Security Secretary Alejandro Mayorkas, who told them not to bother.

“Deputy Secretary Mayorkas told us that the Border Patrol needs to focus its resources towards the worst of the worst. He said that by prioritizing those we choose to deport, we will help alleviate the burden on an already overburdened court system,” Mr. Judd recalled.

“He further stated, ‘Why would we NTA those we have no intention of deporting?’ He also stated, ‘We should not place someone in deportation proceedings, when the courts already have a 3-6 year backlog,’” Mr. Juddrecounted. “Since the day of this meeting, we have seen no improvements in our enforcement efforts and the morale of the Border Patrol agents is one of, if not the lowest in the entire federal government.”

Immigration agents have complained for several years that Mr. Obama has tied their hands, forcing them to release illegal immigrants who should have been easy deportation cases.

Customs and Border Protection, the agency that oversees the Border Patrol, declined to comment on Mr. Judd’s testimony.

But CBP Commissioner R. Gil Kerlikowske, testifying to Congress earlier this month, brushed aside Mr. Judd’s comments, saying he didn’t believe agents were releasing people without putting them through the full process.

Mr. Kerlikowske said Mr. Judd was “probably not the most knowledgeable organization about what’s actually going on” in the field with Border Patrol agents, and he said agents that object to Mr. Obama’s policies should quit.

The backog of immigration court cases is 

meaningless.  Seventy-five percent of illegals fail 

to show up for their hearings anyway.  And DHS 

has under this policy.

President Obama's policies have made it only 

more difficult to fix this broken system.  Adding 

to the problem by increasing the number of 

illegals is irresponsible governance – which just 

about sums up the president's terms in office.

Read more: http://www.americanthinker.com/blog/2016/03/dhs_says_the_administration_has_no_intention_of_deporting_most_illegals.html#ixzz43eVQskH2
Follow us: @AmericanThinker on Twitter | AmericanThinker on Facebook

The Riseof Barack Obama and the Final Fall of America


"Many people lament that “Obama has destroyed America these last eight years” or, alluding to same, will say “I don’t recognize my country anymore."




Death of America: Why This Presidential Election isn’t as Important as People Think

By Selwyn Duke

BLOG: WE ALL KNOW WHAT THE "Hope & Change" HUCKSTER FROM CHICAGO PULLED ON US!

It’s easy to get wrapped up in men and moments. In the current election season, for instance, we may see a candidate appearing to embody all our hopes and dreams (or at least many) and come to assign him country-savior status. Even the great Thomas Sowell — a man for whom I have tremendous respect — has called the November choice “the last chance for America.” Yet even if we do choose the “right” president, it will only amount to a stay of execution.

Many people lament that “Obama has destroyed America these last eight years” or, alluding to same, will say “I don’t recognize my country anymore.” This is much like viewing a woman who marries a greasy-haired, dope-smoking, heavily tattooed and pierced, unemployable reprobate and saying that her matrimonial decision destroyed her, when the real problem was that she was the kind of person who could make such a choice in the first place. Do you really think Obama isn’t a symptom at least as much as a cause? Do you think the 2008 A.D. 

America that elected him would have been recognizable to 1950 Americans?

And even if the next president is an anomalous good result, he won’t even be a pause that refreshes, but will at best slow down the runaway train racing toward the precipice. This is because our main problems aren’t illegal migration, trade deals or health care, as significant as those things are. Our problems are more fundamental.

Do you really want to save America? Okay, then completely transform the media, academia and entertainment so they’re not brainwashing citizens 24/7 with anti-American, anti-Christian, multiculturalist, socialist, feminist and a multitude of other lies. End legal immigration, which, via the importation of massive numbers of Third Worlders, is changing our country into a socialistic non-Western culture. Even more significantly, convince the 70-plus percent of Americans who are moral relativists to believe in Truth; these are people who, as the Barna Group research company put it, believe that what we call “truth is always relative to the person and their situation” and whose most common basis for moral decision-making is “doing whatever feels right….”

Why does this matter? Well, if we saw a child who didn’t obey rules and simply made up his own “rules” — changing them as was convenient — would we say that he was governed by anything worthy of being called “rules” (principles)? Or would we conclude that the word had simply become a euphemism for flights of fancy and feelings-based decisions?  Alright now, is it any different when an adult does it? Furthermore:
Is it any different when large groups of adults do it — even country-size groups?

We can put as much lipstick on this pig of preference-oriented decision-making as we want, but it amounts to this striking reality: we are a people that, to a great extent, now operates by the credo “If it feels good, do it.” Yet there’s another way of putting it, one clarifying matters even more.

Many of us now believe, in essence, there are no rules governing man.

And we often behave that way.

Oh, we know there are things called laws, regulations, social codes and “values,” but too many of us don’t believe they could have a basis in anything objective (God’s law), anything beyond our own collective desires. I know of a seemingly sociopathic man who once said to someone close to me, “Murder’s not wrong; it’s just that society says it is.” How could the relativistic majority among us answer him? “Well, yeah, I guess. But most of us really, really, really don’t like it”?

To understand the effects of this no-rules mentality, a little analogy is instructive. Imagine that baseball players came to believe there were no rules governing the sport, that it was “whatever works for you.” A pitcher might decide there should be only one strike, while a batter might reckon there should be five. A first baseman might insist that the hitter shouldn’t be able to run past first base, while the hitter might say he should be able to run past all of them. And things would continue degenerating, with everyone writing his own ticket and battling over standards, until, perhaps, players began tackling one another and sometimes wielding the bats as weapons. Games can’t work without agreed-upon rules.

Civilizations can’t work without them, either. And there won’t be agreement when people believe everything is “relative.” This is our lot, and we see the effects all around us. Far from Middle Age Europe, where, as G.K. Chesterton put it, everyone agreed “on what really mattered,” today we agree on nothing that matters. We’re not just balkanized racially and ethnically, but ideologically, philosophically and spiritually. There are conservatives, liberals, libertarians, Christians, Hindus, Buddhists, Muslims, existentialists, Wiccans, atheists, just to name a handful, and a multitude of variations within most of the categories; reflecting this disagreement on “First Things,” other things are equally fractured. There are nationalists and internationalists, feminists and male-rights activists, multiculturalists and cultural defenders, patriots and perfidious scoundrels, activists and the apathetic, Marxists and free-market defenders, etc., etc., etc., ad infinitum. Heck, many of us don’t even know what marriage or sexual propriety is anymore, the difference between a tissue mass and a baby, or even what boys and girls are, as we dial back our maturity level to the infantile stage during which a child can’t distinguish between male and female.
With our agreeing on almost nothing, it’s not surprising most everything ends up in court, as we enrich lawyers and empower judges to become the Ultimate Arbiters of All Things. Meanwhile, not-so-huddled masses, Muslim jihadists and perhaps weapons of mass destruction pour across a border that’s still not porous enough for the miles-wide fifth column in our midst. And the same people tell us voter-ID is oppressive, as our government prints official documents in dozens of languages and we press one for English and hope the customer service representative we get to help us with our crummy Chinese-made product will have a decipherable accent.

Speaking of which, why is China often called the “world’s oldest civilization”? It has seen governments come and go, endured tyranny, disease and starvation, but certain things have remained: the Chinese people, language and culture. China truly is a nation, meaning, an extension of the tribe, which itself is an extension of the family (hence, there’s no such thing as a “nation of immigrants” — unless they’re all from the same country). We’re now the opposite, a federation of competing sub-cultures — some imported, some domestically made — not all of which are trying to coexist within the same borders. Many of us simply hate each other’s guts.

Given that all civilizations rise and fall, being able to determine when yours is close to its terminus may be helpful. Imagine you knew a man who was drinking, taking drugs and indulging sexual misbehavior more and more over time. It was increasingly difficult for him to retain employment, act responsibly, pay his bills and get along with others, as his devolving mindset led to accidents and violent outbursts. You’d recognize that his life was spinning out of control and wouldn’t be surprised to later hear he was in prison or dead. Such is the last stop on the road of inexorable moral decay. Now, would your expectations be any different if it were a group of people exhibiting such self-destructive behavior?

Okay, what about an even larger group — let’s say, a country?

Of course, not all of us are that nigh-to-the-grave reprobate. But America’s collective face does increasingly resemble him.

We can also hark back to the baseball analogy. With people tending to make up their own rules, our “game” is breaking down. Why do you think we have candidates who scoff at enforcing immigration law and a president and judges who wipe their paws and claws on the Constitution? In a land where all is relative, laws are relative to the men; then you become a nation of men, not laws.

This is why none of our “solutions” will solve anything. We can talk about Ted Cruz and constitutionalism. But was John Adams a fool when warning in 1798, “Our Constitution was made only for a moral and religious people. It is wholly inadequate to the government of any other”? We are now the “other.”

We can echo Donald Trump echoing Ronald Reagan and say “Make America great again!” But as an apocryphal quotation oft repeated by Reagan goes, “America is great because America is good, and if America ever ceases to be good, she will cease to be great.”

And we can bellow “Freedom!” Braveheart-style. But as British philosopher Edmund Burke noted, “It is written in the eternal constitution of things that men of intemperate minds cannot be free. Their passions forge their fetters.”
Intemperate minds abound. Passions we’ve got. Fetters we’re getting. Of course, I’ll choose to, if possible, add a few more pages to the American republic’s story. But I know that, even now, her last chapter is being written.


Contact Selwyn Duke, follow him on Twitter or log on to SelwynDuke.com

OBAMA'S BIG PHARMA - NO ONE HAS FRONTED FOR WALL STREET GREED MORE THAN THE "Hope & Change" HUCKSTER FROM CHICAGO - US drug prices doubled since 2011

NO ONE SERVES HIS PAYMASTERS ON WALL STREET MORE THAN BARACK OBAMA! 

HE SMELLS THOSE SPEECH FEE BRIBES ALREADY!

AND HILLARY IS OBAMA'S CLONE!

Drug prices have also been a theme in the presidential campaign. The Democratic frontrunner Hillary Clinton, for example, released a campaign advertisement earlier this month attacking the “predatory pricing” of Valeant Pharmaceuticals. Like the congressional hearing, this is all for show. Of all the presidential candidates, Clinton is the top recipient of donations from the pharmaceutical and health products industry, taking in $410,460 according to data from the Center for Responsive Politics.

US drug prices doubled since 2011

By Brad Dixon
18 March 2016
According to a new report by the pharmacy benefits manager Express Scripts, the average price of brand-name drugs increased by 16.2 percent last year. Between 2011 and 2015, branded prescription drug prices have nearly doubled, rising 98.2 percent. Since 2008, the prices have increased by a whopping 164 percent.

Drug spending rose by 5.2 percent in 2015. This was about half the increase seen in 2014, the year of the largest hike since 2003.

The report is based upon prescription use data for members with drug coverage provided by Express Scripts plan sponsors. In assessing changes in plan costs, the report distinguishes between the relative contributions from changes in patient utilization (e.g. more patients being prescribed the drug) and changes in the unit price of the drug (e.g., price hikes).

In the late 1980s and early 1990s, most drug spending was on traditional drugs (small-molecule, solid drugs) to treat conditions such as heartburn, depression and diabetes. The recent trend has been a shift to specialty drugs. Still, within traditional therapy categories there were significant increases in spending on medications to treat diabetes, heartburn and ulcers, and skin conditions.

Diabetes medications remain the most expensive of the traditional drug categories. Drug spending in this category increased by 14 percent, with the hike being equally influenced by increased utilization of the drugs and rise in unit cost. Three diabetes treatments—Lantus, Januvia and Humalog—were among the top five drugs in terms of spending across all traditional therapy classes.

Although not discussed in the report, an investigation by Bloomberg News last year found evidence of “shadow pricing” by drug manufacturers, where companies raise their prices immediately after their competitors do so. The investigation found that the prices of diabetes drugs Lantus and Lemivir had increased in tandem 13 times since 2009, and evidence of similar shadow pricing for the drugs Humalog and Novolog.

Heartburn and ulcer drugs saw a 35.6 percent increase in spending, almost solely due to the rise in unit cost. Although 92.3 percent of the medications filled in this category were generic, the price unit trend was heavily influenced by the increase in prices of branded drugs such as Nexium, Dexilant and Prevacid.

Treatments for skin conditions also saw a significant increase of 27.8 percent in spending, again due almost completely to rises in the unit costs of the medications. The report notes that these increases occurred for both generic and branded therapies, largely due to industry consolidation through mergers and acquisitions leading to less competition in the market. While 86.3 percent of the drugs filled were generic, many of the generic versions saw sharp increases in unit cost, including the two most widely used corticosteroids, clobetasol (96.2 percent) and triamcinolone (28 percent).

While the overall spending increase for traditional therapy classes was nominal (0.6 percent), the primary factor for the increase in spending came from specialty medications. Specialty medications require special education and close patient monitoring, such as drugs to treat cancer, multiple sclerosis or cystic fibrosis. Spending on specialty drugs rose by 17.8 percent in 2015. The report found that 37.7 percent of drug spending was for specialty drugs in 2015, and the figure is expected to rise to 50 percent by 2018.

Spending in this category was topped by inflammatory conditions—such as rheumatoid arthritis, inflammatory bowel diseases and psoriasis—which rose by 25 percent, driven by a 10.3 percent increase in utilization and 14.7 percent rise in unit cost. The average cost per prescription in 2015 was $3,035.95. The medications Humira Pen and Enbrel, which captured more than 66 percent of the market share for this class, saw unit cost increases of more than 17 percent.

Spending on oncology therapies increased by 23.7 percent, due to both increased use (9.3 percent) and increased unit cost (14.4 percent). New cancer therapies average $8,000 per prescription and the average cancer regimen is around $150,000 per patient. Between 2005 and 2015, the anti-cancer drug Gleevec, manufactured exclusively by Novartis, has seen its price more than triple, with an annual cost of $92,000. In 2015, the year prior to the drug’s patent expiration, Novartis increased the unit cost of the drug by 19.3 percent. This is a common practice for companies facing patent expiration.
Drug spending on cystic fibrosis treatments rose by a significant 53.4 percent, largely based on increases in unit cost (40.9 percent vs. 13.3 percent from patient utilization). This rise was largely due to use of the new oral combination therapy, Orkambi, which became available in mid-2015. The drug costs more than $20,000 per month.

The report forecasts that between 2016 and 2018 spending will increase annually by 7-8 percent for traditional drugs and around 17 percent for specialty drugs.

The prices of generic drugs have on average decreased, although there are notable exceptions. Pharmaceutical companies like Horizon Pharma, Turing Pharmaceuticals, and Valeant Pharmaceuticals have purchased generic drugs and then significantly hiked their prices.

The report notes the emergence of “captive pharmacies” in 2015 as another factor responsible for higher drug spending. Captive pharmacies are owned or operated by pharmaceutical manufacturers and tend to promote their manufacturer’s drugs, rather than generic or other low-cost alternatives. The report gives as examples the arrangements between Valeant Pharmaceuticals and Philidor Rx Services, and between Horizon Pharma and Linden Care Pharmacy.

The Express Scripts data matches the findings released earlier this year by the Truveris OneRx National Drug Index, which found that branded drugs rose by 14.8 percent in 2015.

Despite the widespread media publicity of the notorious drug price hikes by companies like Turing and Valeant, pharmaceutical companies have continued to inflate prices in 2016, with Pfizer leading the way with an average price hike of 10.6 percent for 60 of its branded drugs.

Workers are rightly outraged at the skyrocketing price of drugs. A Kaiser Family Foundation poll conducted last year found that 74 percent of respondents felt that the drug companies put profits before people.

The political establishment, however, has sought both to exploit this anger for electoral support and to direct it into safe channels that do not disrupt the status quo.

A congressional hearing held in January placed a spotlight on the price-gouging practices of HYPERLINK Valeant Pharmaceuticals and Turing Pharmaceuticals, whose dubious activities were highlighted in a pair of congressional memos. The purpose of the hearing, however, was not probe the underlying causes of the sharp rise in drug prices. Instead, legislators sought to safeguard the profits of the pharmaceutical industry as a whole through a verbal lambasting of the industry’s most notorious culprits.

Drug prices have also been a theme in the presidential campaign. The Democratic frontrunner Hillary Clinton, for example, released a campaign advertisement earlier this month attacking the “predatory pricing” of Valeant Pharmaceuticals. Like the congressional hearing, this is all for show. Of all the presidential candidates, Clinton is the top recipient of donations from the pharmaceutical and health products industry, taking in $410,460 according to data from the Center for Responsive Politics.

Clinton’s rival, Bernie Sanders, who has stated that he will support Clinton if he loses the Democratic nomination, received $82,094 in donations from the industry. Sanders has proposed a series of minor reforms to address drug prices, such as the re-importation of drugs from Canada, allowing Medicare to negotiate prices with drug manufacturers, and decreasing the patent life of branded drugs.
None of the candidates, including the “democratic socialist” Sanders, challenge the private ownership of the pharmaceutical industry in which everything from research and development and clinical testing to drug pricing and promotion are subordinated to the profit interests of corporations.