When Michael Rea started working as a pharmacist, he soon found all his customers asked the same question: why had their medicines become so expensive?
The plight of one particular woman on eight different drugs — a 65-year-old diabetic with high blood pressure — prompted him to find answers.
“She asked me which two medications she should skip,” says Mr Rea, who in 2008 was working for Walgreens, the US pharmacy chain, in Kansas City. “She was making a matter-of-fact, life-or-death decision and wanted to know which drugs were the least important.”
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