In September, cancer patient Gary Gratzer’s physician prescribed a medication known as lomustine. This drug, developed over four decades ago, is normally administered after a patient has undergone surgery or radiation therapy for a brain tumor. However, when the Gratzer family was told that their out-of-pocket cost was going to be over $2800 per month, they realized the price was out of reach. They were forced to settle for the less-expensive second-line treatment, temozolomide.

The Gratzers can thank NextSource Biotechnology LLC for that. Since cutting a deal with CordenPharma, which grabbed the rights to the drug in 2013, it has raised the price for lomustine from $50 per capsule for the maximum dose to almost $770. Two of those price increases took place just this year, within the space of four months.

This is a continuation of the same larcenous price gouging that has been going on for several years with products such as the EpiPen, Daraprim, and  Calcium EDTA. The pharmaceutical industry admits that its primary goal is not treating the sick – it is to maximize profits at all costs. If people have to go bankrupt or simply die, well, that’s just part of the cost of doing business (which gets shouldered onto the public).

NextSource CEO Robert DiCrisci offers the same, tired old excuses: development costs (for a 40-year-old drug? Really?), “burdensome” regulations, and patient benefits. He adds that his company “generously” offers “discounts” to uninsured and low-income patients – but those “discounts” aren’t going to help Gary Gratzer.

The real reason the pharmaceutical industry is engaging in this reprehensible behavior is because it can. The time and expense involved in getting FDA approval and retooling manufacturing facilities forces generic drug makers to be selective about which medications they decide to offer.

It should be noted that many drugs that have been subjected to such egregious price hikes, such as lomustine (which NextSource rebranded as Gleostine), are not widely prescribed. This is why many generic drug manufacturers do not consider getting into the market to be a worthwhile investment. As a result, 40% of all generic medications are made by a single company.

Currently, there are over 300 medications with expired patents on the market today that have no competition. The FDA is attempting to remedy by streamlining the application and approval process for generic medications. However, this is unlikely to address the issue of demand for drugs such as lomustine, which are prescribed to few patients – and therefore, do not generate sales.

Meanwhile, Big Pharma is going to milk their cash cows for all they’re worth. According to a recent study in the Journal of Clinical Oncology, the industry is jacking up the price of cancer medications by an average of 18% a year – even when these medications have generic competitors. Not only is this adding financial hardship to patients, it’s literally killing them as patients cut back on their doses and suffer the added stress of wondering how it’s all going to be covered.

Since the Republican-controlled Congress under Trump continues to refuse to allow Medicare to negotiate drug prices or permit the reimportation of cheaper drugs from abroad, this situation will get only get worse. The authors of the study, which was done at Ben-Gurion University in Israel, believe their study will provide better information for legislators and policy makers in shaping better regulations – but with oligarchs in charge of the Executive Branch and most of the GOP Congress firmly in Big Pharma’s back pocket, the situation in the U.S. is unlikely to change anytime soon.

K.J. McElrath is a former history and social studies teacher who has long maintained a keen interest in legal and social issues. In addition to writing for The Ring of Fire, he is the author of two published novels: Tamanous Cooley, a darkly comic environmental twist on Dante's Inferno, and The Missionary's Wife, a story of the conflict between human nature and fundamentalist religious dogma. When not engaged in journalistic or literary pursuits, K.J. works as an entertainer and film composer.