An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

It is common for different healthcare sectors to work together to keep each other wealthy, as exemplified by the constant price fluctuations in the hemophilia treatment market. Hemophilia, a disorder in which victims’ blood does not clot properly, is incredibly rare.

In 1993, the gene for factor VIII, a natural clotting agent, was successfully sequenced for the first time using recombinant DNA technology. Factor VIII was previously extracted from blood plasma through procedures that were more difficult and higher risk, so patients initially rejoiced in this discovery. Wholesale treatments for the new products were initially priced at $1 per unit, which would amount to $4,000 per hemophilia episode. Thanks to the ease at which drug manufacturers could create factor VII, hemophiliacs finally had access to preventative treatments. The average patient taking three infusions per week would often pay $300,000-$600,000 for treatment over the course of a year.

A distinct hemophilia industry quickly grew as a result of patients’ increased access to care, and hemophilia businesses began chasing profits. They adopted a model where “home care compan[ies] allied with a particular manufacturer and got paid by the drugmaker per unit of factor VIII delivered into patients’ veins” (227). Since this is all covered by a drugmakers’ co-pay assistance plan, many hemophiliacs were not aware what they were paying.