American Medicine: I survived the death knell thanks to the devil.

"80% of prescription drugs in the United States go through PBM (Pharmacy Benefit Management) companies."

"You prescribe a cheap generic drug that costs twenty dollars to a patient. When the patient goes to pick up the drug, the medical insurance system will indicate 'not in the catalog' or require cumbersome prior authorization."

She leaned down and got a little closer.

"Because you can't squeeze any profit out of a 20-dollar drug. If PBM can't get any benefits, it will kick the cheaper drugs out of the market."

Lynn looked at the arrows indicating the flow of funds on the chart.

"So you set the price of this new drug at 1,680?"

"Bingo".

Serena snapped her fingers. "The price is 1,680, but we'll give PBM an 800 dollar rebate privately."

"Once they receive this huge sum of money, PBM will put our drugs into the 'priority drug list' of health insurance."

"Insurance companies take a cut of the profits to embellish their financial statements. PBM then pressures pharmacies to lower prices, pocketing the difference and making a fortune. Meanwhile, Pfizer sells excellent products."

Lynn chimed in, "Everyone's happy except for the patients."

"They still have medical insurance, don't they?"

Serena smiled like a beautiful snake. "Dr. Lin, everyone's making money, what's wrong with that?"

Her finger slid along the flowchart to the starting point representing "doctor".

"In this perfect closed loop, there is only one variable: the right to prescribe medication."

"You are now the acting chief resident. You have the scheduling and clinical teaching of seventeen residents in your hands."

"As long as you include our medication in your clinical pathway for postoperative pain management in orthopedics, it will be considered the first-line treatment."

"Those seventeen resident physicians will be like a photocopying machine, writing prescriptions for 1,680 yuan each."

"Not to mention you're in the VIP group. Those top-tier commercial medical insurance policies for the wealthy would approve this money even with their eyes closed."

She leaned forward, the deep V-neckline casting a shadow that pressed directly into Lynn's gaze.

"You're a smart person; you understand immediately. Some doctors don't understand these rules of the capitalist game and just beg for a few hundred dollars for meals like a beggar."

"You are not only smart, but also young and clean. In less than a year, you have achieved a position that others would take six or seven years to reach."

"We prefer to invest in high-quality initial public offerings like yours."

Familiar words appeared before Lynn's eyes.

The Demon Worldline Convergence System has been activated.

[Demon detected...]

[Race: Empsa]

(Serena Sterling: "This Asian kid is putting on airs. If I just pulled my collar down an inch and shoved this six-thousand-dollar contract into his hand, he definitely wouldn't be able to resist. Men who have climbed up from the bottom crave recognition for power and money the most.")

[You can choose from the following world lines]

Option A: Promote the high-priced drug extensively in exchange for top-tier resources and a large sum of money from Pfizer. (Reward: $5 USD, skill "Complex Pelvic Fracture Reconstruction - Advanced")

Option B: Exploit compliance loopholes to require Pfizer to use "medical consumables" instead of cash payments, thus establishing a high-value consumables supply chain for unlicensed clinics. (Reward: Consumables Supply Chain, Skill "Minimally Invasive Spinal Fusion Surgery - Advanced")

Option C: Utilize the PBM rule in reverse. Superficially agree, but secretly collude with Arjun to intercept the huge rebates from prescription drugs, profiting from both ends. (Reward: Long-term profits, skill "Emergency Cricothyrotomy - Advanced")

[Option D: Shout "I am a follower of Hippocrates!", tear up the check, shove her to the ground, and call security for a citizen arrest. (Reward: One psychiatric bed at Metropolitan Hospital)]

Lynn glanced at the panel.

Options A, B, and C are all very tempting.

Choosing option A will allow you to immediately obtain a large amount of funds.

Choosing option C allows you to establish a long-term, highly profitable channel.

But no matter which option you choose, you need to accept the other party's kindness, whether genuinely or feigning it.

Seeing Lynn's silence, Serena assumed he was interested.

She placed an envelope next to the five boxes of chocolates.

"A continuing medical education lecture contract. Three lectures, $2,000 each. It's accounted for as a consulting fee, completely compliant, and the IRS can't find anything wrong with it."

"You decide the content of the lecture. Just mention our clinical data briefly in the PPT."

"Moreover, our medicine is indeed the most effective, with a score that is a full 3 percentage points higher than that of generic drugs."

Serena stood up.

She went around to Lynn's side and placed her hands on the armrests of the chair on either side of Lynn's thighs.

This is a posture that is both extremely oppressive and incredibly ambiguous.

She leaned down, her blonde hair brushing against Lynn's cheek.

Her neckline was completely open, and her two snow-white mounds were almost touching the tip of Lynn's nose.

"You can take your time to think about it."

She leaned close to Lynn's ear, her breath sweet as orchids.

A hand slid inside Lynn's white coat collar, and through the thin shirt, the fingertips gently traced circles.

"I'm not in a hurry..."

"Click".

The doorknob suddenly turned.

Without knocking, the office door was pushed open.

Victoria, dressed in a black trench coat, stood coldly in the doorway.

A black turtleneck cashmere sweater, with a Hermès scarf tied tightly around the neckline.

Her gaze met Serena's hand, which was inside Lynn's clothes, and their faces, which were almost touching.

"Serena".

"Victoria".

Serena straightened up, withdrew her hand, and calmly smoothed her hair.

Victoria walked in, her gaze sweeping over the chocolates and envelopes on the table.

"La Maison du".

She picked up a box and flipped through it. "The last one they gave me was Godiva. Are chief resident physicians more expensive than attending physicians now?"

"It's the new product promotion period, so the budget is sufficient." Serena stuck out her tongue and gave an apologetic smile.

"So plentiful that it's precisely divided into packages based on an average of 13.7 US cents per person?"

Victoria threw the chocolate back on the table and tapped her fingernail on the lid of the box.

"Your Ostelara was rejected by the Pharmacy and Therapeutics Committee and lacks statistical advantage."

"It will be resubmitted next quarter with new data to support it."

"That article in The Lancet's subsidiary journal? The p-value is 0.048, it's clearly barely passable."

Victoria tilted her head. "And it was Pfizer's own money that was invested."

"Clinical significance and statistical significance are different, Dr. Vanderbilt."

"So this should be discussed in the committee, not in my subordinate resident's office."

The word "mine" was emphasized a bit.

Victoria herself didn't realize it, but Serena did.

Serena's eyelashes drooped slightly as she pulled a contract from her briefcase.

"For the lecture contract next quarter, the travel expenses have been upgraded to first class, in accordance with compliance standards."

Victoria didn't answer.

Send it to my academic email address.

Serena put away her briefcase, leaving the chocolate on the table.

"Looking forward to cooperation."

She turned and shook hands with Lynn goodbye.

The moment their palms crossed, Serena hooked her middle finger into his palm.

A folded piece of paper slid in silently.

It was fast and at a tricky angle, perfectly positioned in Victoria's blind spot.

The sound of red-soled heels faded into the distance.