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    How NADAC, WAC, and ASP Shape Drug Costs

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    The Hidden Costs Employers Don’t See in Traditional Health Plans

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Home Featured

Burden of Pain, Available May 16th

At long last, Burden of Pain: A Physician's Journey through the Opioid Epidemic is available for sale.

Daily Remedy by Daily Remedy
May 13, 2023
in Featured
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Burden of Pain

Book Cover

It’s almost Mother’s Day. On May 16th, Burden of Pain will be available for sale. The book is the culmination of my journey through the opioid epidemic.

It began when I opened the first primary care practice in NW Indiana to offer telepsychiatry for patients struggling with behavioral health. It was supposed to end when I was sentenced to prison, the final salvo in the DEA’s onslaught against me. Only it didn’t.

I kept fighting when all was lost. Somehow I survived when I had nothing to live for. I lost everything: my clinical practice, my reputation, my family, and my freedom. But something inside of me wouldn’t quit – wouldn’t allow me to quit. I had to fight.

So when I went away – into the darkness, let’s call it – for eleven months, one week, and three days, I was determined to keep fight, no matter what. I just didn’t know how. At first, nothing came to mind. In those moments, I felt tempted to fall into self-despair. I had everything taken from me; at least that’s what I thought. But I kept at it, looking for ways to fight. In the darkness, I found two weapons that will forever remain with me – the truth and my voice.

It may not seem like much, especially when going against powerful federal agencies. But those two weapons have interesting properties. They’re as powerful as you believe them to be. If you believe what you say matters and it proves to be truthful, then people will listen. Maybe not at first, but eventually they will. Your story becomes your power.

It’s with this belief that I set out to write what had happened to me. When I put pen to paper, I realized my writing skills were severely lacking. Yes, I could write. I have written numerous essays, manuscripts, and clinical studies over my academic and professional career.

But that’s a type of different writing. It’s writing as a means to an end. What I was aiming for was different – I was looking at my words as the end itself. It’s a subtle cognitive shift, but it’s the essence of word crafting.

Anyone can memorize the rules of grammar, the appropriate verb tense, and the ways to structure sentences to emphasize the active verb. But writing, in its purest form, is self-expression. It’s a coordinated release between mind and hand, and thoughts and words. It’s a dance.

It’s hard to understand if you’ve never experienced it. But after reading 250 books, going through daily writing drills, and writing 75 short stories, I began to see glimpses of it. The darkness became my proving ground.

Darkness does funny things to you. It distorts your sense of time. You either become amazingly productive or you succumb to wallowing in languor. I chose the former. With few daily obligations, little to distract me, and a pervasive belief in the strength of my two weapons, I began writing.

I wrote despite realizing I need to improve my writing. I wrote until I enjoyed rewriting more than simply writing. Most original words are unfettered self-expression. It feels good coming out, but it’s more for you, the writer, than the reader. The revisions sculpt the thoughts – so the reader appreciates the words, making the expression ready to be shared.

True writers breathe the air given by their readers. It’s a visceral symbiosis. Once I saw this, my words changed. The sentences grew depth. Each word, sculpted by shame and humiliation, one after another, transformed into a flowing river of thoughts and emotions.

I wrote the first version by entirely by hand while in the darkness. When I returned, I typed out the entire manuscript, all 120,000 words. I thought it was good. I was wrong. It needed revisions and I needed tough love. Eventually, I appreciated the rewriting and smiled at the subtle points of clarity that make a sentence more readable and my voice my relatable. Revision after revision trimmed it to a manageable 72,000 words. Now it’s ready for public consumption.

I hope you appreciate the pain in my voice and the struggle in my words. It’s meant to evoke complex, uncomfortable emotions. The ones we hide – the secret burdens we carry. Hence the name, Burden of Pain.

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Daily Remedy

Daily Remedy

Dr. Jay K Joshi serves as the editor-in-chief of Daily Remedy. He is a serial entrepreneur and sought after thought-leader for matters related to healthcare innovation and medical jurisprudence. He has published articles on a variety of healthcare topics in both peer-reviewed journals and trade publications. His legal writings include amicus curiae briefs prepared for prominent federal healthcare cases.

Comments 0

  1. Helen Borel, RN,PhD says:
    3 years ago

    Dear Dr. Joshi: I am glad you have written your book. And I’m sure it will reach a very wide audience…for, as you know, there are over 50,000,000 (possibly 100,000,000) Americans in pain, untreated or undertreated due to that cabal of DOJ/DEA OxyMORONS and COLD TURKEYS.
    I’m sure, by now, you’ve heard of my book (at AMAZON) “AMERICAN AGONY: THE OPIOID WAR AGAINST PATIENTS IN PAIN” which also heavily covers :”THE PLIGHT OF THE PAINCARE PHYSICIANS”, NAZI–RAIDS BY DEA POLICE on practices of innocent physicians like yourself. I, having heard of these gov’t interferences in PainPatientCare, dictating 90mme, even 50mme, of an opiate or opioid (not enough to treat the pain of a flea) got very angry…and although (at the time I noticed pain patients’ reports scattered all over Twitter and decided to consolidate this info in one compendium) in 2018 I was undergoing 21 radiation treatments for Stage 3 Breast Cancer, I as an R.N. and published medical writer, felt it my duty to heavily research and write “AMERICAN AGONY” before I died (as a kind of magnum opus) bec I had all the medical and professional writing/publishing knowledge and skills and I felt it my duty to do so. Ergo, Dr. Joshi, I am still suffering about all those, and these, pain patients and paincare physicians who have not yet received the justice you deserve. We need to see those responsible for this holocaust against physicians and patients (and related other professionals) indicted and imprisoned for their lies, entrapments, practicing medicine without a license (since when did DEA police and DOJ lawyers graduate medical school. Well, you see how upset I am as an RN used to collaborating successfully with physicians in hospital settings re the best treatments and medications for our patients. Gov’t needs to butt their glutei maximi out of medical…free all medical professionals jailed for giving the best patient care. I’m going to fight for this change ’til the day I die. Like a dog with a bone, I won’t let go of it…patients are suffering, becoming more seriously ill, and suiciding due to lack of their opioid analgesic; MDs, DOs, NPs,, PAs, PharmDs, PhGs, RNs<-professionals from all these professions are in jail across America. I'm livid about this. Where are the medical association journalists (from so many medical associations)? Where are the mainstream journalists? Where is the ACLU? These 3 latter groups could help patients get their opioid meds restored; could help free all imprisoned medical professionals. Sorry to go on and on, but, although I am ill, very ill, I cannot let this subject go. I will keep fighting for patients and physicians.

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Videos

summary

An in-depth exploration of drug pricing, including key databases like NADAC, WAC, and ASP, and how they influence the pharmaceutical supply chain, policy, and patient advocacy. The episode also introduces MedPricer's innovative pricing intelligence platform, offering valuable insights for healthcare professionals, policymakers, and patients.

Chapters

00:00 Understanding Drug Pricing Dynamics
03:52 Exploring the Drug Pricing Database
10:07 Patient Advocacy and Drug Pricing
13:56 Market Intelligence in Drug Pricing
How NADAC, WAC, and ASP Shape Drug CostsDaily Remedy
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Policy Shift in Peptide Regulation

Clinical Reads

FDA Evaluation of Certain Bulk Drug Substances in Compounding: Clinical Interpretation

FDA Evaluation of Certain Bulk Drug Substances in Compounding: Clinical Interpretation

by Daily Remedy
April 19, 2026
0

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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