American Medicine God: Starting by Inheriting a Pharmaceutical Company and Selling Medicine

McDowell County, West Virginia. It's been raining continuously.

"Old George's Pharmacy" is usually the busiest place in town, where miners chat, buy cigarettes, and pick up their painkillers. But today, a long line has formed in front of the counter.

"What did you say? One hundred dollars?!"

A roar shattered the silence.

A veteran wearing a worn-out work jacket angrily pounded on the glass of the counter. His fingers were twisted and deformed from long-term rheumatism and arthritis, and his fingernails were filled with indelible soot.

"It was ten dollars last month! Ten dollars!" The veteran's face flushed red. "This is robbery! This is extortion!"

The pharmacist behind the counter was a young, recent graduate, trembling with fear. Her voice trembled with tears: "I'm so sorry, Mr. Smith... it really isn't us raising prices. It's the insurance company! Your insurance company has removed OxyContin from its Tier 2 list. Now it's a Tier 3 drug, and it requires pre-authorization. Without approval, you'll have to pay full price."

"To hell with Tier 3!" the veteran roared, forcing a fit of rage. "I don't care about Tier! My back is burning! Without that medicine, I can't even get out of bed! I fought for this country, served five years, and paid into the pension system for thirty years after my discharge. Now you're telling me my monthly pension can't even buy ten bottles of that medicine?"

A commotion began to rise at the back of the line.

"Hurry up, old man, don't block the way!"

"I can't afford it anymore, what's going on?"

"Damn insurance company!"

"No, it's that damn pharmaceutical company! They're money-hungry!"

The veteran's hands trembled as he pulled a wad of crumpled banknotes from his pocket. It was the money he had intended to use to repair the roof.

He counted the bills one by one, each one bearing the marks of sweat and hardship.

Finally, he slammed the money on the counter, grabbed the small orange medicine bottle, and clutched it like a lifeline.

He turned and left, his eyes filled not only with pain, but also with a deep, betrayed despair. He felt betrayed by the country he had fought for!

...

Three days later. New York, Vought Pharmaceuticals headquarters.

At the far end of the conference table, Victor Corleone stood with his back to the others, gazing out at the Manhattan skyline. The sky outside was gray, like a crumpled old newspaper.

"This is a disaster!"

A gray-haired director slammed a financial statement onto the table.

"One week! Just one week!"

"Sales have plummeted by 30%! Stock price has dropped by 12%! Wall Street analysts are downgrading our ratings. They say Vought Pharmaceuticals has offended the 'gatekeepers' and is doomed!"

"Victor, we have to compromise." Another director representing the investors spoke in a slightly more conciliatory tone. "UHM has told us that if we agree to pay a 45% rebate and make up for the previous debts, they might consider putting us back in Tier 2. Although the profit margin will be thinner, at least we can maintain our market share."

"Yes, Johnson & Johnson and Pfizer both pay this fee. It's standard practice in the industry."

"We can't go head-to-head with PBMs; they hold the prescription rights of tens of millions of people in their hands."

The directors' murmurs buzzed like flies.

Victor turned around.

"compromise?"

"If I bow down to them today, they'll demand 50% tomorrow, and 60% the day after. We're a pharmaceutical company, not slaves working for an insurance company."

"Then what are you going to do? Watch the company go bankrupt?" the gray-haired director roared. "There are already protests outside! Those patients who can't afford the medicine won't blame the insurance company; they'll only curse us for being heartless!"

Victor walked to the window and pointed downstairs.

Although the details were unclear, dozens of people could be seen gathered at the entrance of the company building. They were holding signs, and because of the distance, only the red paint was vaguely visible, looking as glaring as blood.

"Look," Victor said softly, "what vibrant anger."

"They're coming for us!"

"No."

"Those are our 'allies.' They are the 'fruits' carefully cultivated at the grassroots level by the doctors we fund."

His lecherous gaze swept over everyone present, and his voice suddenly turned cold and hard.

"Since the PBM has taken the patient hostage to threaten me, I will turn the hostage into a traitor."

"What?" The board members looked at each other, thinking they had misheard.

"Thor," Victor called out.

"Yes...yes!" Thor quickly stood up.

"Introduce our new project to the board of directors—NAPPA."

"Uh... the National Alliance for Pain Patients Action (NAPPA)." Saul opened his briefcase and pulled out a huge organizational chart. "This is a network we've secretly built up over the past six months through collaborating doctors across the country. It currently covers 23 states and has hundreds of grassroots support groups."

"This is a non-profit patient support organization. Its mission is to 'defend the right of pain sufferers to be free from suffering.'"

"What's the use of this? Can charity save the stock price?" one director asked dismissively.

“No, this isn’t charity,” Victor interrupted him. “This is a war machine.”

"I have approved a $1000 million 'unrestricted donation' to NAPPA. This money will not be used for new drug development, nor will it be used for GG."

"We need to use this money to organize all the veterans who can't afford medicine at the pharmacy, the housewives who can't sleep because of the pain, and the miners who have lost their jobs because of the pain."

"We'll buy them bus tickets, provide them with free lunches and T-shirts, and even pay them for lost work time. We'll transport them to Washington, to the UHM headquarters, and to Capitol Hill."

Victor took a cigarette out of his pocket and lit it.

"We need to teach them to chant slogans. Not 'The medicine is too expensive,' but 'The insurance company is murdering people.' Not 'We need discounts,' but 'Freedom from pain is a fundamental human right.'"

"We want to see an elderly woman in a wheelchair crying in front of CNN cameras, saying that the insurance company cut off her life-saving medication to save money. We want veterans to throw their medals in the faces of insurance company executives."

"This is called 'Astroturfing'," Victor said, exhaling a smoke ring with a cold look in his eyes. "On the surface, it's a lush, green grassroots movement, but in reality, every single blade of grass is something we paid for to lay down."

The board members were shocked by this insane plan. They were used to negotiating with numbers and contracts at the table and had never imagined that they could turn patients, who were originally victims, into weapons to attack their opponents.

"Is this...is this legal?" someone asked in a trembling voice.

“Completely legal.” Saul adjusted his glasses. “The First Amendment protects freedom of speech and the right to assembly. We’re simply ‘funding’ a voice for the disadvantaged. As for what they say… that’s their freedom.”

Victor stubbed out his cigarette; the embers flickered briefly in the ashtray before going out.

"Gentlemen, in this country, no one dares to offend the victims. Especially when these victims are pitiful, angry, and well-organized."

He straightened his tie and regained his elegant posture.

"PBM thinks they control the rules. But I will show them that when you ignite the anger of the masses, the rules will be burned to ashes."

"Now that I've finished speaking, who agrees and who disagrees?"