One pharmacist drew attention to a massive pricing disparity on a key cancer drug, and that disparity may help to explain why our healthcare system here in America is known to be so expensive.
Brad Hart of Forest Park Pharmacy said in a viral social media post shared last week that the drug imatinib, also known as Gleevec, which is used to treat chronic myelogenous leukemia, costs a mere $7 for his business to purchase.
His pharmacy then adds $10, meaning customers can get the drug for only $17.
But Medicare pays a shocking $2,400 for the same drug, which is 34,000 percent more than what Forest Park Pharmacy is paying.
According to a report from the National Cancer Institute, Gleevec is nothing short of a “landmark drug that has vastly improved the outcomes of patients” with chronic myelogenous leukemia.
The drug was therefore filled 250,000 times in a single year, costing Medicare a massive $600 million, according to Hart.
“If every one of those scripts was filled at our pharmacy, instead of through Medicare, it would’ve cost $4 million,” Hart described in the video.
???? To Elon Musk and the DOGE team looking at Medicare:
Pharmacist says
– Cancer Medicine Imatinib costs them $7 to buy. They add $10, so you’re out the door for $17
– When Medicare pays for this drug, IT COSTS THEM $2,400
– This drug was filled 250,000 times in 1 year costing… pic.twitter.com/KhlJ6NczTD— Wall Street Apes (@WallStreetApes) February 21, 2025
“That means that we are $596 million cheaper than the insurance. That’s crazy.”
Hart explained that there is a specific reason why the medication is that expensive.
“Insurance companies pay a middleman, the pharmacy benefits manager, and that person decides how much that medication’s gonna cost,” he said.
Because they get paid a percentage, and not a flat fee, the middlemen are incentivized to increase the prices as much as possible.
Hart is hardly the first person to notice the ways in which pharmacy benefit managers increase costs for Medicare.
A report from the House Oversight Committee published last year noted that the three largest pharmacy benefit managers are “vertically integrated with health insurers, pharmacies, and providers.”
CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx control over 80 percent of the market.
“As large health care conglomerates, some have argued that these PBMs’ vertical integration with insurers and pharmacies would better position them to improve patient access and decrease the cost of prescription drugs,” the report noted.
“Instead, the opposite has occurred: patients are seeing significantly higher costs with fewer choices and worse care.”
The damning report added that even as the pharmacy benefit managers tout “the savings they provide for payers and patients through negotiation, drug utilization programs, and spread pricing,” the evidence indicates that “these schemes often increase costs for patients and payers.”
Specifically with respect to Medicare, the lawmakers were able to identify more than 300 examples of those three behemoth pharmacy benefit managers “preferring medications that cost at least $500 per claim more than the alternative medication they excluded on their formulary.”
There is a clear disconnect between the amazing innovations drug companies are able to produce and the often excellent engine of efficiency that is American capitalism.
As usual, that disconnect seems to have been worsened by the federal government.
That means we need to take a serious look at the way we pay for medical care, for the well-being of our nation’s budget and, more importantly, for the well-being of ourselves and our families.
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