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It was the day before Christmas in 2015 and a senior director of national accounts at Novo Nordisk, one of the biggest makers of diabetes medicines, was excited about what Santa might bring.

Eli Lilly had just raised the wholesale price for a diabetes drug, and the employee was hopeful that yet another rival would do the same. “Maybe Sanofi will wait until tomorrow morning to announce their price increase…that’s all I want for Christmas,” the senior director wrote to a colleague.


A price hike by both companies would have been a fine gift for a drug maker that practiced shadow pricing – or simultaneous price hikes. Such moves allow drug companies pricing parity when negotiating for favorable slots on formularies, the list of medicines covered by pharmacy benefit managers and health insurers. Pharmaceutical industry critics argue such moves suggest collusion.

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