Wal-Mart.

Looks like lawyers and physicians can agree on some things, and one of those is the abuse of power of pharmaceutical companies. MDs and JDs come together in this viewpoint to explain how Big Pharma is enjoying market exclusivity long after FDA approval for such, namely through exclusive dealing and bundling. Exclusive dealing means purchasers (i.e., insurance companies) commit to buying from only one drug competitor in return for big time discounts...which big drug companies can swing for just long enough to squash all competition. Bundling means purchasers commit to buying multiple drugs across a single drug company’s portfolio, again in return for big discounts. If you still don’t get the repercussions, think Wal-Mart. And the slow—sometimes swift—death of every small business in its radius, independent of product quality. TBL: Lawyers have a simple two-word solution to climbing drug prices, and you can probably guess the second: antitrust litigation. | Sinha, JAMA 2018