Around the country, a pervasive question being asked: How can I afford my prescription drugs? The high cost of those medications, particularly very expensive drugs to treat serious diseases like multiple sclerosis and cystic fibrosis, have fueled a nationwide business in which insurance programs are using companies called “alternative funding programs” or AFPs that promise to get these medications at little or no cost to the patient. “RiskyRX,” a CNBC investigation, found AFPs are becoming more pervasive around the country as drug costs skyrocket.

CNBC submitted nearly 100 public records requests and sorted through more than 10,000 pages of contracts, emails, invoices and complaints that show these companies have penetrated the country’s health-care system through private employers, cities, counties, school districts and unions. In some cases, employers require their staff to use an AFP. CNBC traced the trail of medications from abroad to the U.S. via a supply chain that’s not authorized by the pharmaceutical companies that manufacture the medications. The investigation features an exclusive interview with a Department Of Homeland Security official who says these programs should be shut down because they’re illegal and post a serious safety risk to patients. A former high-ranking FDA official, speaking out for the first time, says these programs typically don’t disclose the risks to patients. The AFPs strongly defend their business practices as both legal and safe and say their businesses are an antidote to high prescription drug prices. Those prices, across all drugs, in the U.S. are nearly three times as much, on average, as those in other high-income countries, according to a 2024 report by Rand, a nonprofit, nonpartisan research organization.

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