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The high cost of prescription drugs is a huge problem. It was a central topic in last year’s presidential election and continues to remain a pressing issue for legislators, policymakers, and the public. One of the major challenges is that it is often unclear exactly what drugs cost. Currently, we see a kind of shell game taking place between pharmaceutical companies (who set the initial price), insurance companies (who pay the bill and set premiums), and pharmacy benefit managers (who negotiate secret rebates on behalf of the insurance company). Each party is now pointing fingers at the others for concealing the true price of medications and putting profits ahead of patient benefits and the public good.

But one group that has a large stake in the cost of drugs has been largely overlooked in this discussion: those brave individuals who participate in drug trials. Although our system of research oversight and regulation has long emphasized the vulnerability of trial participants, I believe that they are also in a potentially powerful position.

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Image: By Tom Varco – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=1031875

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