With prescription drug spending breaking new records almost every year now, people like to blame Big Pharma and use it as the industry punching bag. But the truth is, Big Pharma has little to do with it. Buy-and-raise schemes are also universally reviled because they sound so bad, especially among politicians looking to stay relevant and loud. Buy-and-raise, as distasteful as it is, does not really have much to do with it either.