To many, the spiraling cost of prescription drugs is a scandal. To Jerry Pappert, Pennsylvania's attorney general, the pricing schemes of major pharmaceutical companies are one reason for the escalating drug prices - and they are a crime.

Paralleling similar actions by attorney' general in other states, Pappert filed a lawsuit in Commonwealth Court this spring against 13 major pharmaceutical companies over drug-pricing practices. Pappert's lawsuit charges the drugmakers with artificially inflating the average wholesale price (AWP) in an effort to enhance the financial incentives to doctors to prescribe their drugs over equally effective, but less-expensive, medications from competitors.

While the drug manufacturers set a high AWP, they generally charge much lower prices to doctors, or even give drugs to some providers for free. Yet health insurance reimbursement, including state insurance and Medicare, is generally based on a percentage of the AWP.

The spread between the low-price - or free - drug provided to the doctors and the higher official AWP creates artificial profit to the prescribing doctor and results in patients, insurance companies, Medicare and other taxpayer-funded programs paying more than is warranted.

Pappert's lawsuit contends that the pricing schemes, which are alleged to have been going on for more than 10 years, have "cost consumers and the commonwealth hundreds of millions of dollars in overcharges for prescription drugs."

The increased profit created by the artificial spread between the inflated AWP and the actual cost of the drug, Pappert noted, turns the normal forces of competition upside down - by rewarding the companies that charge the highest (AWP) prices and punishing the companies that hold down their prices.

Pappert's efforts are being echoed across the United States. In Ohio, the attorney general filed charges in March nearly identical to Pappert's against five large pharmaceutical companies. The Ohio suit alleges that the drugmakers issued false wholesale prices to inflate Medicaid reimbursements. The lawsuit charges the companies with unjust enrichment and violations of the state's anti-kickback laws.

In early June, Wisconsin filed suit against 20 major drugmakers over false and inflated average wholesale prices. That lawsuit alleges that the unlawful scheme of distorting drug prices dates back to 1992.

In early 2002, Montana's attorney general filed a nearly identical suit against 18 companies alleging that false AWPs defrauded the state, consumers and others of millions of dollars. That suit noted that federal law requires drugmakers to report the lowest or best price for a drug, yet the AWP reported by drug companies were often vastly higher than prices paid by physicians and suppliers.

The same price spread referred to in Pappert's lawsuit produces a windfall for some doctors or hospitals and results in overpayments by Medicare and Medicaid.

The momentum developing with multiple states' lawsuits against the nation's largest pharmaceutical companies is similar to the lawsuits that targeted the tobacco industry. As more and more states join the effort, pressure will mount for the drug industry to change the way it markets and prices drugs - and, as a result, save consumers, insurance programs and taxpayers hundreds of millions - or billions - of dollars.

As the multiple lawsuits suggest, there is mounting evidence of price manipulation creating artificial profits and costing consumers, insurance companies and taxpayers hundreds of millions of dollars. The pharmaceutical industry appears to be abusing its power and gouging consumers over life-sustaining medications while at the same time providing certain doctors with inflated profits in order to gain market share.

Pappert and the other attorneys general should be supported in their efforts to bring an end to this unethical practice and force changes that will be good for consumers and taxpayers.