Trial Magazine

Drugs, Money, and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices

Robin Feldman

Cambridge University Press

www.cambridge.org

186 pp., $29.95

In this behind-the-scenes look at pharmaceutical drug pricing, Robin Feldman, a University of California Hastings law professor, considers why lifesaving drugs remain financially out of reach for so many Americans. Feldman explores what maintains and even encourages high drug pricing—from the practices of pharmacy benefit managers and insurers to the drug companies’ relationships with pharmacies, doctors, and patient groups. The federal drug approval process compounds the issue, she explains, as drug companies make insubstantial formulation changes and repurpose drugs to extend their patent exclusivity periods. Feldman offers some solutions, including adopting laws to mandate pricing ­transparency, increasing competition in the drug delivery chain, and limiting patent periods of exclusivity.