How has Big Pharma responded to the dire and uncertain circumstances facing American’s health and pocketbooks? By jacking up prescription drug prices and likely jabbing patients not just in the arm but also the wallet for a prospective coronavirus vaccine.

As the online news and politics site Politico reported:

 “Drug makers raised the price of hundreds of medicines during the coronavirus pandemic, even in the face of Trump administration vows to crack down on surging drug costs and efforts to tack price controls on Covid-19 relief packages. Pharmaceutical companies logged more than 800 price increases this year and adjusted the cost of 42 medicines upward by an average of 3.3% so far in July, according to GoodRx, which tracks the prices consumers pay at pharmacies.

“While the size of that increase is not out of line with past years, the number of branded drugs seeing hikes this month was higher than last year … ‘Business as usual is a problem in a pandemic. These price increases contribute nothing to innovation, but greatly to suffering. These aren’t new drugs,’ said Peter Maybarduk, director of the Global Access to Medicines Program at consumer advocacy group Public Citizen.”

Politico says that Big Pharma twice a year reviews its product prices — and typically increases them. The industry has stepped gingerly around President Trump’s volatile reactions, notably on social media. But the White House, which has tried to tried to make prescription drug price reductions a signature political achievement, has failed to make measurable headway on this skyrocketing aspect of the $3.7 trillion that Americans spend on their nation’s health care system — and get poorer outcomes than their counterparts in other western, industrialized nations.

Big Pharma, of course, defends its price increases as reasonable and required, arguing that consumers may not feel the effects of cost hikes because of coupons and other discounting programs. The industry also has sought to burnish its public standing by promoting companies’ furious and seemingly altruistic efforts to benefit the world by developing a fast and effective vaccine to protect patients against the novel coronavirus.

But as Elisabeth Rosenthal, an M.D. and seasoned medical journalist, reported:

 “[A] Covid-19 vaccine will have an actual price tag. And given the prevailing business-centric model of American drug pricing, it could well be budget breaking, perhaps making it unavailable to many … we are looking for viral deliverance when drug development is one of the world’s most lucrative businesses, ownership of drug patents is disputed in endless court battles, and monopoly power often lets manufacturers set any price, no matter how extraordinary. A new cancer treatment can cost a half-million dollars, and old staples like insulin have risen manifold in price to thousands of dollars annually. And the American government has no effective way to fight back.

“Recent vaccines targeting more limited populations, such as a meningitis B vaccine for college students and the shingles vaccine for older adults, have a retail cost of $300 to $400 for a full course. If a Covid-19 vaccine yields a price of, say, $500 a course, vaccinating the entire population would bring a company over $150 billion, almost all of it profit. Dr. Kevin Schulman, a physician-economist at the Stanford Graduate School of Business, called that amount ‘staggering.’ But Katherine Baicker, dean of the University of Chicago Harris School of Public Policy, said that from society’s perspective ‘$150 billion might not be an unreasonable sum’ to pay to tame an epidemic that has left millions unemployed and cost the economy trillions.”

With a prospective vaccine that could prevent Covid-19 infections, as with anti-viral medications that may be useful in treating the coronavirus, Big Pharma outrages many in the medical-scientific community by too often reaping big profits from difficult, costly developmental research — paid for by taxpayers and done by federal researchers, Rosenthal reported.

Even as the federal government is throwing billions of dollars at vaccine developers now, top leaders and lawmakers are not negotiating, too, about the cost to patients of a potential product, she said, adding:

“The industry has made various pledges [before about reasonable pricing], trying to balance corporate citizenship against making eager investors happy: Astra Zeneca has promised 1 billion doses for low- and middle-income countries. Johnson & Johnson says it would make the COVID-19 vaccine available on a ‘not-for-profit basis’ at $10 for ‘emergency pandemic use.’ We’ve heard such offers before. Pharmaceutical companies routinely provide coupons to cover patient copayments for expensive drugs so that we don’t squawk when they charge our insurance company tens of thousands for the medicine, driving up premiums year after year. A naloxone injector to reverse heroin overdoses is given free to some clinics but priced at thousands for the rest.

“And it won’t feel like a bargain if we get free or cheap vaccines during a pandemic but pay dearly for annual Covid-19 shots thereafter. Drug companies deserve a reasonable profit for taking on this urgent task of creating a Covid-19 vaccine. But we deserve a return, too. So, before these invaluable vaccines hit the market, we should talk about an actual price. Otherwise, we will be stuck paying dearly for shots that the rest of the world will get for much less.”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by dangerous and harmful drugs. If patients wonder, too, how and why prescription medications also keep skyrocketing in price, one answer appears to be, sadly: Because. Because Big Pharma will push every boundary possible — and politicians and regulators have been incapable or unwilling to keep the profit-mongering in check.

The Trump Administration, critics say, has further complicated a shambolic federal response to the Covid-19 pandemic with erratic, unfounded, and stubborn approaches to drugs and Big Pharma. Why is an economist and the White House’s top trade official leading a charge, yet again, to get Americans to use anti-malarial drugs for the coronavirus when the evidence shows no benefit and even harms in doing so? Should taxpayers be skeptical of how the White House has thrown billions of dollars at vaccine makers, including two recipients — Moderna and Maryland-based Novavax — that have never delivered a product to market before, much less inoculations at a global scale? How much comfort can patients take from reading that administration officials, rather than pursuing and stockpiling standard vaccine vials and syringes, has turned, instead, to a reluctant supplier of a new and untested inoculation system?

President Reagan, a conservative icon, argued that in dealing with the nefarious Soviet empire, it was critical to “trust but verify.” That may be wise and insufficient counsel for Americans as they watch Big Pharma extract every buck possible from public and private coffers, causing other major harms along the way. We’ve got a lot of work to do.