The reason for skyrocketing drug costs and price gouging is simple. It’s greed. But figuring out what to do about it is tougher. Consider these examples:

More Americans die of hepatitis C than from all other infectious diseases. The good news: there’s a cure. The bad news: a drug company charges more than $1,000 per pill for the treatment.

The average annual cost of widely used specialty drugs is $53,000 -- more than the nation’s medium household income and beyond the reach of many people.

The poster boy for drug price gouging is young wunderkind Martin Shkreli, whose company, Turing Pharmaceuticals AG, bought the malaria and HIV medicine Darapim and overnight jacked up its price from $13.50 to $750 a pill. After smirking his way last year through a congressional hearing on the increase, he later told a financial conference that if he had it to do all over, “I probably would have raised the price higher. My investors expect me to maximize profits.”

EpiPens are an emergency treatment for allergic reactions. They are so beneficial that federal and state laws now allow many public schools to include them in emergency supplies to respond to a student’s potentially fatal allergic reaction. In 2007, a two-pack of the EpiPen device sold for $56.64 wholesale. Today, a two-pack sells for about $600.

These are just a few examples of the escalating cost of medications. But efforts to rein in costs, or even require manufacturers to justify increases have been blocked by the cabal known as Big Pharma. Their willing accomplices are politicians who are more interested in Big Pharma’s campaign contributions than in representing the people who have sent them to Sacramento or Washington.

Consider this summer’s legislative betrayal. Senate Bill 1010 was a simple, modest proposal to do two things: require health plans to identify for state regulators their most used and most costly medicines; and require drug makers to give prior notice to insurance companies, pharmacy managers and state agencies when they plan to raises prices.

Big Pharma threw the kitchen sink of lobbying against this bill, and as a result it was gutted and rendered useless. The author had no choice but to withdraw the bill from consideration.

It appears Californians may have to take matters into their own hands. They cannot look to their elected politicians to fight Big Pharma.

Proposition 61 on the November ballot proposes to control Big Pharma’s ham-fisted grip on our wallets. But, regrettably, the measure falls short and should be defeated.

Prop. 61 would prohibit state agencies from buying any prescription drug from a manufacturer at any price over the lowest price paid for the same drug by the U.S. Department of Veterans Affairs. These would be medicines bought for such programs as Medi-Cal, prisons, healthcare programs, etc. You name it, if state taxpayers pay for the drugs, they’d better be purchased at the VA’s lowest rate.

The problem is that drug makers enter into all sorts of deals with private and public entities. Manufacturers require some of their “discounted deals” to be kept secret. So the VA’s published price may not actually be its secret lowest price.

And the prohibition only applies to the state agency buying the drug. It does not compel the manufacturer to sell the drug to the state at the lowest price.

The state Legislative Analyst noted that manufacturers could respond in two ways. They could raise the price charged for drugs sold to the VA; or they could decline to sell critically needed drugs to state agencies.

Either way, Californians could and likely would suffer if Prop. 61 passes.

The only real way to fight Big Pharma is for Californians to elect politicians who have the guts and willingness to stand up to those greedy drug manufacturers.