The Specialty Pharmacy Blind Spot
The drugs that cost the most are the drugs we know the least about — at least when it comes ...
Ain’t What’s Paid — And Never Was
A pricing benchmark that the industry itself nicknamed "Ain't What's Paid" would seem unlikely to survive the reputational damage. Average ...
The Gross-to-Net Bubble
There is a number that pharmaceutical executives discuss constantly in private and reference obliquely in public. It is not a ...
The Dosing Assumptions Hiding in Plain Sight
Comparing the cost of two drugs that treat the same condition sounds like a straightforward exercise. It is not. Drug ...
The Gold Standard That Comes with Caveats
If you have read an academic paper, policy brief, or investor report that estimates a drug's net price in the ...
Twenty-Eight Times Wrong
Somewhere in the processing pipeline between a pharmacy dispensing a drug and a payer adjudicating the claim, there is a ...
The Six Percent That Built an Industry
The formula is elegant in its simplicity and far-reaching in its consequences. Medicare Part B reimburses most physician-administered drugs at ...
The List Price Is a Lie Everyone Agrees to Tell
Every branded drug in America has a price that virtually no one pays. It is published, cited in earnings calls, ...
The Unit Problem Nobody Wants to Fix
A twenty-eight-fold error is not a rounding discrepancy. It is not a minor data-entry artifact or an acceptable margin of ...
The Rate Data Arms Race: How MedPricer.org Is Reshaping the Information Asymmetry That Built Hospital Market Power
The history of commercial healthcare pricing is, in large part, a history of managed ignorance. Hospitals did not know what ...
The No Surprises Act’s Hidden Arbitrage: Rate Data, Arbitration Outcomes, and the Valuation of Surprise Billing Exposure
The No Surprises Act was designed to protect patients from unexpected out-of-network bills. Its dispute resolution mechanism, almost accidentally, created ...
Against the Reference Price: Why the Most Popular Employer Strategy May Backfire in Concentrated Markets
Reference pricing has the appeal of economic elegance: identify what efficient providers charge for a procedure, pay only that amount, ...
FDA Evaluation of Certain Bulk Drug Substances in Compounding: Clinical Interpretation
Clinicians increasingly encounter patients using or requesting peptide-based therapies sourced through compounding pharmacies. The U.S. Food and Drug Administration has identified a subset of bulk drug substances, including certain peptides, that may present significant safety risks when used in compounded formulations. The clinical question is whether these regulatory signals reflect meaningful patient-level risk and how they should influence prescribing behavior. This matters because compounded peptides often sit outside traditional approval pathways, creating uncertainty around quality, dosing consistency, and safety. Understanding...
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