> backroom deals by assorted players in the healthcare food chain The articles dances around the details of who these players are and how they conspire to push

> backroom deals by assorted players in the healthcare food chain The articles dances around the details of who these players are and how they conspire to push up drug prices in America. This article captures the dynamics very well: http://www.diabetesforecast.org/2016/mar-apr/rising-costs-insulin.html http://www.diabetesforecast.org/2016/mar-apr/rising-costs-in... and the accompanying graphic is the picture that is worth a thousand words: http://www.diabetesforecast.org/2016/mar-apr/images/insulin-costs-infographic.gif http://www.diabetesforecast.org/2016/mar-apr/images/insulin-... A good summary from a more recent article on insulin prices: https://medium.com/insulin-report/why-does-insulin-cost-so-much-in-america-4e6b2f598596 https://medium.com/insulin-report/why-does-insulin-cost-so-m... Drug manufacturers make insulin available to insurance companies at a much lower price via middlemen called pharmacy benefit managers. The difference between the list price and the lower price negotiated by the pharmacy benefit managers is called the spread. Part of the spread is pocketed by the pharmacy benefit managers, leading to a perverse incentive in which the higher the list price of the drug, the higher the earnings of the pharmacy benefit managers. The price rise affects the uninsured and under-insured the most, many of whom can no longer afford to buy insulin at its list price any more.