Rules and Regulations are in place so mishaps don't happen. What if the rules are twisted and things go down the lane as people watched or worse took part in?

In 2021, around 107,000 people in the United States lost their lives to opioid overdoses. The Pulitzer prize for investigative reporting winning duo of the Washington Post's investigation unit, Scott Higham and Sari Horwitz in their new book, the American Cartel bring to light the drug cartel-like operations of the pharmaceutical industry.

The cartel functioned with the manufacturers at the top, wholesalers in the middle, and pharmacies at the level of street dealers. The author duo have been investigating the case for about five years involving money-minded doctors who prescribed these drugs even when they weren't necessary, multiple DEA agents, and people at different levels of the pharmaceutical industry.

The big pharma had made sure that they weren't accountable for the mishaps that they initiated. They went through a number of confidential documents of the pharma industry and those related to the lawsuits that were happening against them. They call it the pill database. These documents of the DEA track the path of every single pill that is manufactured, distributed and dispatched in America.

Higham in an interview with Terry Gross for Fresh Air says that these companies collaborated - and with the lawyers and lobbyists - to create legislation that protected their industry, even as they competed for market share. He also adds that people might think it's the political parties that run the show or it's the White House that runs the show, but it really is the companies that run the show.

When people were dying in thousands, these companies were influencing members of Congress to pass laws and secondarily the Department of Justice to slacken the efforts of the Drug Enforcement Administration. The book further discusses the modes of the investigation by DEA, how the distributors worked in synchronization to make laws that favoured them, changing prescription patterns and selling counterfeit drugs, the flaws of the legislation- Ensuring Patient Access and Effective Law Enforcement Act limiting the DEA's abilities and the lawsuit against the big pharma by a group of lawyers and investigators. Inspite of paying a huge penalty, the lawsuit did not affect the big pharma or the distributors.

Contrarily, it just raised the company's shares in the global market. Higham concludes that people who were a part of this entire chaos often say that this didn't require to happen as there were adequate laws in place to prevent this immense fatality. The avaricious pharmaceutical companies were tricky enough to make favourable laws in order to sell their products which resulted in costing the lives of innocent people.

Such exposé often makes us question a lot of things that happen around us. These might make the general public question the credibility of Healthcare and abstain from taking medical attention even for life-threatening situations. If a well-developed country like the US is facing such a problem, we can only imagine the plight of the rest of the world. Do cases like these call for multidisciplinary teams at both state and judicial levels to ensure the enforcement and maintenance of the right laws? Will Pharmaceutical companies always have the upper hand in influencing the operating conditions of the Healthcare industry?

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