The prescription drug delivery systemâhow a drug gets from the manufacturer to the patientâis complicated. More than 4.4 billion prescriptions are written for drugs each year for Americans who then pick up these prescriptions at 60,000 drugstores or receive them from doctors or hospitals or online pharmacies. Chapter 1 is about how Americans pay for prescription drugs and where that money goes. Chapter 2 is about the process, beginning with the manufacturers development of a drug, the different steps through which the drug travels before arriving in a patients hands, how this is paid for, and what the costs are at each step along the way.