Anemia drug rebates challenged

Big Pharma has corrupted everyone with kickbacks and deals. It is disgusting. The long list of “the corrupted” includes Doctors, lawmakers, teaching hospitals and "thought leaders". Many practices are modeled after a successful infusion business. Administering these infusions in the office setting is desirable and certainly cheaper. However in the USA, Biologicals are overused without any dynamic data acquisition about their efficacy, outcomes or comparison with standards of practice where more than one drug is often used in treatment.. Clinical trials with biologicals are usually done with a placebo arm but should be required to include usual multidrug therapy arm combined with careful analysis of cost of treatment, frequency of visits to doctors, days off from work, side-effects of drugs, and quality of life (of patient, not doctor's!). This is particularly true of Biologicals as maintenance therapy, which is where the bulk of expenditure lies. Most insurance companies surprisingly deny payment when biologicals are used in acute emergencies (example a Crohn's patient who walks in to the ED with pain, fever, and acute flare up of the disease who might benefit from a TNF blocker) but will pay for it through their PBMs for maintenance infusion therapy every 6 weeks in an office! It is an alarming trend that most patients are left on these expensive drugs without any attempt to choose less expensive options. This is just one example of excess in medicine. I have used this as an illustration to urge both the insurance companies and citizens to fund clinical outcomes studies, tracking the usage and utility of these expensive drugs as soon as they hit the market. Clinical trials are designed with a bias favoring the drug and manufacturer. The clinical utility of expensive drugs need to be studied by the insurance companies and the patients. This means public finding of research. Is this not what the NIH and FDA were supposed to be doing in the first place?