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Ten Worst Actors in U.S. Health Care Named

The U.S. Food and Drug Administration (FDA) was responsible for the worst example of profiteering and dysfunction in the U.S. health care system in 2021, says a health policy reform group.

The FDA, various hospitals, and several drug companies have won Shkreli Awards, states the Lown Institute, a nonprofit group in Massachusetts, in a press release on January 11.

The awards are named after Martin Shkreli, whose company, Turing Pharmaceuticals, hiked the price of a generic drug that is the only treatment for parasitic infections in infants and HIV patients by 5,000 percent in 2015.

The annual honors recognize the 10 worst actors in health care.

Judges for the awards include academics, physicians, health care research fellows, and writers states the Lown Institute website.

FDA Approves Unproven Drug

The FDA was named the worst of the 10-worst entities identified by the judges, for its approval of an ineffective and potentially harmful Alzheimer’s drug, states the Lown Institute website.

“Though not one member of its advisory committee supported approval of Biogen’s drug for Alzheimer’s Disease, the [FDA] gave it the green light anyway, using a regulatory shortcut to accelerate the process,” writes the group. “The drug, Aduhelm, has not been shown to significantly reduce memory loss or cognitive decline.”

As an approved drug to treat Alzheimer’s, Aduhelm could be prescribed to many seniors, says the group.

“The high price of the drug and large eligible population means Medicare could spend hundreds of billions each year just on Aduhelm,” states the website. “An independent group of Alzheimer’s experts and advocates recently called for the FDA to take the drug off the market.”

Opioid Drug Deal

The Sackler family, owners of Purdue Pharma, were named the second-worst actors for a $4.3 billion bankruptcy deal a judge approved in September 2021 that granted them immunity from future lawsuits and any requirement to admit wrongdoing for their promotion of pain medications.

The 2021 deal was rejected by another judge.

Purdue Pharma sought bankruptcy after it was sued by several states for its aggressive marketing of opioids.

‘Classic Case of Price Gouging’

Another group making the list includes the owners of Indocin, an arthritis suppository treatment, who raised the price of the drug from less than $200 for a box of 30 suppositories in 2008 to $10,350 as of October 1, 2021.

Physicians could help patients avoid paying such prices, says Devon M. Herrick, a health economist and policy advisor to the Heartland Institute, which co-publishes Health Care News.

“The Indocin (indomethacin) suppositories are a classic case of price gouging doctors could put a stop to but won’t,” said Herrick. “Patients can take up to four 100mg suppositories a day at discounted prices of $231 to $282 apiece. Yet, Costco sells 60 generic indomethacin 50mg capsules for $11.98. That suggests doctors and patients willing to get creative could save $1,000 a day.”

The drug maker Merck received an award for charging $712 for a five-day course of its COVID-19 early treatment drug. The judges note the drug costs $18 to make and was developed using millions of dollars in government funding.

Companies Covering Copays

Drug companies overall received an award for setting up charitable funds to help consumers cover insurance co-pays for their expensive treatments.

The U.S. Department of Justice has sued at least one company, Teva, charging that the charitable assistance is a kickback scheme.

Covering patients’ copays increases sales of overpriced drugs, says Herrick.

“Drug makers donating to their own fake charities to offset drug copays so they can charge inflated prices is already illegal in public programs like Medicare and Medicaid,” said Herrick. “It should be illegal in all plans.”

Hospitals Behaving Badly

Hospitals on the award list include Lennox Hill Hospital in New York, for charging $3,000 to administer a $100 COVID-19 swab test, and Emory Decatur Hospital in Atlanta for charging $700 to an emergency room patient with head trauma who was left untreated after a seven-hour wait.

Community Health Systems, Inc., a hospital chain, was recognized for filing at least 19,000 lawsuits against patients for nonpayment of bills in 2021, despite receiving more than $700 million in federal COVID-19 bailout funds. Parkview Regional Medical Center in Fort Wayne, Indiana was acknowledged for raiding a Medicaid patient’s accident settlement fund to cover lower government reimbursement rates.

The pandemic has magnified pre-existing problems with pricing and billing, says Herrick.

“COVID-19 is an area that Congress should aggressively act to stop price gouging,” said Herrick. “Nobody should pay emergency room prices for a COVID-19 test after hospitals received huge bailouts.”

Ascension, the nation’s largest Catholic nonprofit health system, made the list for straying beyond its mission to serve the “poor and vulnerable” by creating a $1 billion private equity operation that invested in a debt collection company.

Missing Ingredient

The health care system is broken, and the Shkreli Awards are a good way to illustrate the fallout, says John C. Goodman, president of the Goodman Institute and co-publisher of Health Care News.

“In our health care system, the patient is not the real customer,” said Goodman. “Third-party payers are the customers. Providers view patients as an excuse to get money out of insurers, including Medicare and Medicaid. Providers don’t compete for patients on price or on quality—the way they do in a normal market. Bad things happen because normal market incentives to meet consumer needs have been dismantled.”


Kevin Stone (kevin.s.stone@gmail.com) writes from Arlington, Texas

Internet info:

2021 Lown Institute Shkreli Awards, January 11, 2022:


This article was updated on March 4, 2022.

Kevin Stone
Kevin Stone
Kevin Stone writes from Dallas, Texas.


  1. […] #10 Indocin suppositories are used to relieve the pain and inflation of arthritis. In 2008 a box of 30 sold for less than $200. That’s still an outrageous price for a nonsteroidal anti-inflammatory drug (NSAID), many examples of which are available over the counter. The current price for Indocin suppositories is $10,350 for a box of 30 or about $345 for each suppository. Here is what I told Health Care News: […]


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