The Atlantic

How Two Common Medications Became One $455 Million Specialty Pill

After I was prescribed a brand-name drug I didn’t need and given a coupon to cover the out-of-pocket costs, I discovered yet another reason why Americans pay too much for health care.
Source: Paul Spella / The Atlantic

Everything happened so fast as I walked out of the doctor’s exam room. I was tucking in my shirt and wondering if I’d asked all my questions about my injured shoulder when one of the doctor’s assistants handed me two small boxes of pills.

“These will hold you over until your prescription arrives in the mail,” she said, pointing to the drug samples.

Strange, I thought to myself, the doctor didn’t mention giving me any drugs.

I must have looked puzzled because she tried to reassure me.

“Don’t worry,” she said. “It won’t cost you any more than $10.”

I was glad whatever was coming wouldn’t break my budget, but I didn’t understand why I needed the drugs in the first place. And why wasn’t I picking them up at my local CVS?

At first I shrugged it off. This had been my first visit with an orthopedic specialist, and he, Dr. Mohnish Ramani, hadn’t been the chatty type. He’d barely said a word as he examined me, tugging my arm this way and bending it that way before rotating it behind my back. The pain made me squirm and yelp, but he knew what he was doing. He promptly diagnosed me with frozen shoulder, a debilitating inflammation of the shoulder capsule.

But back to the drugs. As an investigative reporter who has covered health care for more than a decade, the interaction was just the sort of thing to pique my interest. One thing I’ve learned is

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