UnitedHealth overcharged cancer patients for drugs by over 1,000% (fortune.com)

Article summary

UnitedHealth Group's pharmacy benefit manager, OptumRx, has been found to have overcharged cancer patients for drugs by over 1,000%, according to a report by the Federal Trade Commission. The report also found that OptumRx, along with its peers Express Scripts and CVS Caremark Rx, collectively pocketed $7.3 billion in added revenue above cost over a five-year period. The markup rates applied to numerous specialty generic drugs, including those used to treat leukemia and HIV. The findings have sparked criticism of the US healthcare system and the role of pharmacy benefit managers in driving up costs.

Main themes

• Healthcare costs
• Pharmacy benefit managers
• Price gouging
• US healthcare system
• Regulation and oversight
• Markup rates and pricing

What commenters say

• The current healthcare system is broken and allows companies like UnitedHealth to take advantage of patients with excessive markups.
• There is no clear definition of what constitutes 'overcharging' for essential medications, and a more nuanced discussion is needed to determine fair pricing.
• The ownership structure of pharmacy benefit managers, such as OptumRx, creates conflicts of interest and allows for price gouging.
• A functioning government would regulate or break up companies that engage in price gouging and anti-competitive practices.
• The US healthcare system's reliance on employer-provided insurance creates inefficiencies and drives up costs for patients.
• A more transparent and predictable pricing system, such as that used by Medicaid, could help to reduce costs and prevent price gouging.
• The lack of competition in the healthcare industry, due to regulations and market dynamics, allows companies to charge excessive prices without consequence.
• Determining a 'fair' markup rate for essential medications requires a more detailed analysis of production costs, administrative expenses, and profit margins.