
by James A. Bacon
“All over this country, the American people are asking why it is that they pay, by far, the highest prices in the world for prescription drugs?” Vermont Senator Bernie Sanders noted in a screed published a couple of years ago. “Why is it that nearly one out of every four adults in America cannot afford their prescription medication?”
Sanders’ answer: greedy Big Pharma companies and the gutless politicians who won’t stand up to them.
Insulin, a compound for which American diabetics pay many multiples of what it costs to manufacture, has been singled out for special attention. In this case, according to the populist narrative, greedy pharmaceutical companies share the blame with greedy middlemen known as pharmaceutical benefit managers.
Whatever morsels of truth these characterizations might contain, there is very much more to the explanation of why drug costs are so high in the U.S.
Consider, the story of Civica, Inc., which was formed to make insulin and other generic drugs more affordable. The company opened a manufacturing facility in Petersburg in 2022, inked a deal in 2023 to produce injectable insulin for the state of California under the brand of CalRx, and planned to start shipping in 2024. The company CEO now concedes that goal was “ambitious.”











