Across Europe, at home in the United States, and around the world, countries are struggling with the high and growing costs of pharmaceuticals and with cash or co-payments as a barrier that keeps patients from taking what their doctor prescribes. Doctors without Borders (Médecins Sans Frontières 2013) recently reported that the cost of a basic vaccine series in developing countries has risen 2,700 percent. In the United States, more than one hundred oncologists united to protest the high, monopoly prices of new cancer drugs, most of which offer few advantages. They point out that drug co-payments alone cost their insured patients $20,000–$30,000 a year out of their household budget (Pollack 2013). Indeed, problems in the United States abound, as the vast majority of new, highly priced drugs offer only minor innovations rather than clinically superior drugs for patients (Light and Lexchin 2012), and they are producing an...

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