Dr. Oday Alsheikh Calls for Transparency in the Pharma Industry Before It's Too Late

Reuters

03-06-2025

SAN ANTONIO, TX, June 3, 2025 (EZ Newswire) -- Dr. Oday Alsheikh, opens new tab, a practicing physician and vocal advocate for healthcare reform, works to bring transparency and accountability to the systems that shape patient care in America.
When one walks into a pharmacy to fill a prescription, they probably don't consider what's happening behind the counter, beyond the price tag. They don't see the squeezed margins, the impossible choices, or the quiet desperation behind every filled (or unfilled) order. And according to the ophthalmologist and medical director of TLC San Antonio, opens new tab, Dr. Oday Alsheikh, that lack of public awareness is part of the problem.
'Margins have become so tight that some medications cost pharmacies more to dispense than they're reimbursed for,' says Dr. Alsheikh. 'We're reaching a point where filling certain prescriptions actually puts pharmacies in the red.' It's not just an operational dilemma; it's an ethical one. When delivering care becomes financially unsustainable, everyone suffers.
But why and how did the system become complicated?
A core issue, says Dr. Alsheikh, is the unpredictability and secrecy around drug pricing. One patient might pay $50 for a medication, while another, on the same insurance plan, might be charged $500, even $1,000. 'There's no transparency,' he explains. 'And that variability can delay or derail treatment altogether.'
Even doctors, tasked with prescribing the most effective therapies, are left in the dark. 'We don't know what something costs until after it's given to the patient at the pharmacy,' he says. 'There are no upfront numbers, no consistency. That leaves us powerless to help patients make informed decisions.'
And when patients discover the high price, they don't question the system. They blame the doctor.
Pharmacists are among the most educated healthcare professionals, often completing up to eight years of training and accruing hundreds of thousands in debt. But as pharmaceutical benefit managers (PBMs) and insurers increase their grip on drug pricing, pharmacists are being muscled into unsustainable positions. To stay open, some are forced to operate at high volumes, sacrificing time, attention, and ultimately, safety.
'This is about more than money,' Dr. Alsheikh emphasizes. 'When margins shrink, mistakes increase. The risk of dispensing errors rises, especially without pharmacists having the time or resources to double-check every detail. That puts patient lives in danger.'
What's worse, some pharmacies, bound by confidentiality clauses in their contracts, aren't allowed to disclose pricing structures or even why a medication may be unaffordable. In these cases, patients are often told prices verbally, never in writing, making it nearly impossible to verify or challenge.
Dr. Alsheikh explains that PBMs were originally designed to negotiate lower drug prices for insurers and patients. But over the years, they've grown into behemoths, consolidated, acquired by insurance companies, and now control up to 80%, opens new tab of the prescription drug distribution in the United States.
'They're the ultimate middlemen,' Dr. Alsheikh says. 'They negotiate with pharmaceutical companies, pharmacies, and insurers, but not for the benefit of patients. The negotiations are designed to maximize their own margins.'
Today, only three major PBMs dominate the industry. And with so much power consolidated in so few hands, the incentive to drive prices up, and with vague reasons as to why, has never been greater.
Even Big Pharma, often criticized for high prices, is now struggling to navigate this ecosystem. New drugs cost hundreds of millions, sometimes billions, to develop and get through FDA approval. But once approved, pharmaceutical companies must still negotiate with PBMs to get those drugs covered by insurance. If they fail, even life-changing treatments remain out of reach. 'There's brilliant science being developed,' Dr. Alsheikh remarks. 'But patients don't see it because of how tightly controlled access is by PBMs. The system that should make care better is making it worse.'
So what's the solution? 'It starts with transparency,' Dr. Alsheikh argues. 'Right now, everything is designed to confuse. If the public understood how this worked, it would be impossible to maintain the status quo.'
But transparency is precisely what the current system resists. Confidential contracts, non-disclosure agreements, and legal threats keep pharmacists and physicians from speaking openly. Even the true cost of medications is often a mystery, hidden behind layers of deductibles, markups, and rebates. Dr. Alsheikh further states, 'We're talking about real people, real families, real lives impacted every day by a system they don't understand and can't navigate.'
Until the veil is lifted and transparency becomes the norm, patients will continue to fall through the cracks of a system built for profit, not care. 'Fixing healthcare isn't someone else's job,' he concludes. 'It's all of ours. Because one day, it won't just be your pharmacist or your neighbor or your doctor affected. It will be you.'
About TLC San Antonio – Dr. Oday Alsheikh
Dr. Oday Alsheikh is a board-certified eye surgeon. With his advanced expertise in LASIK, standard and complex cataract surgery, glaucoma treatment, and corneal crosslinking and transplants, Dr. Alsheikh leads the way in clinical excellence. He is also a thought leader in the health space who gives voice to the sector's overall improvement. For more information, visit www.tlcsanantonio.com.
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SOURCE: TLC San Antonio – Dr. Oday Alsheikh
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