For anyone who has been to a pharmacy lately, especially those without health insurance, it is no surprise that prescription drugs are extremely expensive. In fact, Americans spend over twice as much on prescription drugs than residents of other industrialized nations (Kesselheim, 858). In the recent news media, there has been much outrage over these continuing price hikes. Much to their dismay, severe allergy sufferers have seen Epi-Pens, which have been around for decades, rise 400% in price over the past ten years (Woodyard). Those suffering from blood-borne parasites or immunosuppressant diseases such as leukemia and HIV have seen Daraprim marked up by 5,000% (Allen, 459). Most recently, it’s been brought to attention that a drug regimen for hookworm that costs a measly 4 cents in Tanzania costs $400 in the U.S. (NPR). So why is it that, in the land of the free, it costs more for people with serious medical conditions to survive? This is a complex issue with many avenues to cross before a solution comes along. The rising cost of prescription drugs in the United States is an issue that needs to be addressed and remedied, and this cannot happen without the intervention of all three branches of the government. Unfortunately, by addressing this issue, the concept of free markets will come into question. What kind of line can be drawn that does not interfere with the rest of the commerce in such a capitalistic country? Especially under the current administration. When exploring the many questions of ethics that arise when examining any situation, it is very useful to see if there have been any decisions in the Supreme Court related to them. Where exactly do we draw the line with pharmaceutical companies? One such example is in the case of AndroGel, a topical testosterone supplement. In the original case, Solvay Pharmaceuticals, Inc. sued Watson Pharmaceuticals, Inc. and Paddock Laboratories, Inc. (generic pharmaceutical manufacturers) for patent infringement in selling a generic version of AndroGel. Watson argued that the patent was invalid, and before a judge, this case resulted in a settlement. In order for Watson to delay the introduction of the generic testosterone gel into the market, Solvay paid Watson and Paddock a large sum of money. This alerted the Federal Trade Commission, and they filed a lawsuit against all parties involved, citing violations of antitrust, settlement, and patent law. This case was taken up by the Eleventh Circuit Court of Appeals, and in this case, Big Pharma won. The Supreme Court stood by the settlement, stating that everything was lawful (Schmidt). This sets a scary precedent for the American People. In the eyes of our Judicial Branch, it is ethical for Big Pharma corporations to pay generic manufacturers in order to keep a monopoly, even if temporary, on the market. In America, brand-name prescription drugs account for 10% of all dispensed prescriptions, but a whopping 72% of prescription drug spending (Kesselheim, 860). When exactly does a monopoly become unethical? Even with insurance, out-of-pocket costs for civilians are higher for brand-name prescription drugs, and Big Pharma still gets paid. Given the nature of these companies, it is also important to examine the cash flow within their businesses. One would think that pharmaceutical companies spend most of their money on research and development of new drugs and treatments. It is a fair assumption to make, given the nature of their businesses. They develop, test, and manufacture life-saving drugs that are prescribed by doctors and distributed by pharmacists. Scientists are the backbone of these companies. Unfortunately, those who make this assumption are dead wrong. According to analysis by research company Global Data, nine out of 10 big pharmaceutical companies spend more money on marketing than they do on research (Bose). Furthermore, they only spend about 10-20% of their revenue on research and development efforts (Arbiser, 2431). This is extremely unfortunate for consumers as well, because pharmaceutical companies often cite the expenses incurred for research and development as justification for their high price tag (Kesselheim, 863). There is definitely a lack of transparency here. So where does the real interest of these companies lie? Are they in the health of the people whom their products are intended for, or in the pocketbooks of the executives and large shareholders? Unfortunately for the People, it is the latter. Pharmaceutical companies are allowed to change their prices on a whim, and often do so in interest of their shareholders (Arbiser, 2431), or for general profitability of the company. After all, if most of their money is being poured into marketing, they’re looking for one main thing: for consumers to buy their product. It is the free market system in the United States that allows for this to happen. Free markets are a double-edged sword in this instance. On one hand, they allow relatively free commerce in the United States, as long as taxes are paid. This is great for small businesses and independent owners. On the other hand, they allow prescription drug manufacturers to set their own price for their products with no limitations. Drug manufacturers are also allowed privileges by the Federal Department of Agriculture, and granted patents by the U.S. Patent and Trademark Office, that all but guarantee exclusivity to Big Pharmaceutical companies for a period of five to seven years once they make a small modification to a therapy (Kesselheim, 862). During this period, generic products cannot be manufactured and sold. Consumers must pay for the brand-name drugs. In other industrialized nations, such as Australia, England, and France, prescription drug pricing is heavily regulated. Governing bodies exist in these nations (the Pharmaceutical Benefits Advisory Committee, the National Institute for Health and Clinical Excellence, and the National Authority for Health, respectively) to assess the value of pharmaceuticals and set limits on their pricing (Kanavos, 758).