Pharmaceutical companies often justify pricing life-saving drugs in the thousands or even millions of dollars by arguing they need to recoup the billions they spent on research and development costs.
But ProPublica reporting duo Robin Fields and David Armstrong dismantle that reasoning in a two-part investigation revealing how drugmakers exploit public funding and legal loopholes to turn eye-watering profits at the expense of children and cancer patients.
Fields examined how Zolgensma – a miracle cure for spinal muscular atrophy in babies – ended up costing $2 million per dose. Armstrong unraveled the tactics drugmaker Celgene utilized to maximize profits on Revlimid – a $1,000 per pill cure for multiple myeloma – while taking readers through his own cancer battle.
Their investigations won the Gold Award in the Global/National category of the 2025 Barlett & Steele Awards. Fields and Armstrong gave the Reynolds Center a closer look at their reporting process.
How it started
Fields and Armstrong previously reported on the rate of health insurance denials and patients’ struggles to afford the care they needed. One case stuck out to Fields: An insurance company denied a man’s claim for an expensive cancer drug, and he died after not receiving it.
“In talking to a lot of the doctors that he worked with, oncologists and things like that, they were all extremely worried about access to this sort of growing class of ultra-expensive drugs,” Fields said. “That’s how I sort of got into this in certain ways, through the previous project and understanding the struggles that people were having to get access to cutting-edge medicine.”
For Armstrong, the cost of Revlimid was personal: He needed it to fight his own case of multiple myeloma, a rare blood cancer.
“When I first started taking this drug and I looked at the first claim that my insurance company paid on it, I was just really kind of gobsmacked by the cost of it,” Armstrong said. “I wanted to know why it was so expensive.”
Building trust with sources
Families, devastated about their loved ones’ illnesses yet determined to save their lives, form the emotional center of gravity in Fields and Armstrong’s investigations. That’s why both journalists spent time earning trust and getting to know their sources, overcoming the walls the grieving family members had put up.
Zolgensma would never have made it through FDA approval without the Gaynor family, who desperately wanted to cure their daughter Sophia’s spinal muscular atrophy. They set up a small charity that helped fund the gene therapy’s clinical trials, but were cut out of ownership rights when the drug made it to market.
“They had sued various other parties involved in developing the drug, and it was clear that they had a story to tell, and also that they’d had an unusual window into the development of this drug,” Fields said.
But the family was exhausted from the media attention and the failed lawsuit against the pharmaceutical titans. They “emphatically” declined to work with ProPublica, Fields said. But as she kept reporting on Zolgensma, Fields realized that the story wouldn’t be the same without the Gaynors, so she sat down and wrote them a letter.
“I wrote them an old-fashioned handwritten letter in which I sort of explained who I was and what ProPublica was, and how we go about our work,” Fields said. “I talked about how we spend a lot of time, and we take great care, and we don’t do sort of quick hits or take cheap shots at anybody. We really want to understand things deeply and authoritatively and to take whatever time is needed to do that.”
Vincent Gaynor, Sophia’s father, called Fields within 20 hours of getting the letter, in disbelief that she actually wrote him such a heartfelt appeal, and the family eventually opened up to Fields “bit by bit.”
“It took me a while to speak with them about Sophia and how she was and how her case had progressed,” Fields said. “I understood that we were going to have to get into that, but I wanted them to get to know me a little bit first, and for them to sort of be able to move gradually through this set of experiences.”
Armstrong ran into similar challenges while trying to talk to Beth Wolmer, the “most important person in the story of the development of the drug” to him. He initially thought she would be eager to share her experience, but she actually wanted to put the painful, bittersweet past behind her.
“We exchanged emails a couple of times, and I just proposed, well, look, just meet me. I’ll come to New York. Just have a cup of coffee. Let’s talk,” Armstrong said. “We talked for a long time. I think anytime you can meet with somebody in person, it just makes a difference.”
Unexpected insights
Fields and Armstrong have investigated pharmaceutical companies and the healthcare industry for years. But in reporting about predatory drug pricing for Zolgensma and Revlimid, the veteran investigative journalists discovered new insights.
Armstrong felt a sense of “baseline grieving” after examining thousands of court records showing drugmaker Celgene’s indiscriminate price hiking of Revlimid, a medication he took.
“As somebody who was taking the drug and whose health plan is paying for it, it was really meaningful,” Armstrong said. “That really struck me to kind of see it up close and personal after years of writing about it.”
For Fields, the difficulty of getting inside the process of drug pricing was a new hurdle she hadn’t faced before in covering the insurance industry. She had reported stories where she could eventually find people to give her an inside scoop on insurance company decision-making, but it was harder to crack people at Novartis and AveXis, the companies that pushed for Zolgensma’s $2 million price tag.
“They hadn’t been the subject of any litigation of that nature, and they really were able to sort of stay behind the wall, and everyone sort of stayed in line,” Fields said.
Finding out that those companies paid to have research done designed to justify higher prices for medical breakthroughs like Zolgensma struck her as “extraordinary” for its attempt to quantify the value of saving a baby’s life from spinal muscular atrophy.
“That was one of the most genuinely sort of mind-bending parts of my reporting process, and certainly one that stayed with me as I was writing the story,” Fields said. “Nobody wants to argue against that, that a life is worth less.”
Advice for aspiring investigative reporters
Armstrong and Fields both encourage aspiring reporters to consider covering healthcare. “It is that greatest of things, which is a beat that is really about life and death, and that every single person ultimately becomes a patient,” Fields said. “Everyone has everything at stake in this…it’s an unbelievably rich vein.”
Armstrong echoed the urgency, saying that what pulled him into healthcare reporting was its broad scope.
“This is, obviously, a story about life and death, and you know, people living good lives and living lives with dignity, but it is a huge business and economic story, too,” Armstrong said. “So I think for reporters, it’s got everything, it really does.”
