We have heard a lot about health care in the last year as everyone has chosen one side or the other in the national debate. A regular claim by politicians is that a common goal is to eliminate "waste, fraud and abuse." That is a convenient phrase because it rings true but is absent any hint that it could reduce the income of any special interest group.

In March of this year there was an event that provides an opportunity to jump on fraud in health care big time. A burglary occurred at a warehouse full of pharmaceuticals in Enfield, Conn. This facility was stocked with the very expensive products Prozac, Cymbalta, Zyprexa and other pricey items marketed by Eli Lilly. The value of missing merchandise was set at $75 million. This was not just a matter of punching through a metal building wall, loading up a tractor trailer truck and roaring off into the night. A sophisticated security system had to be defeated and plans needed to be in place to not just move but sell the merchandise.

A similar theft occurred in Richmond, Va., in 2009 when the drug stolen was Advair, an inhaler used to treat asthma with a market value of about $5 million.

There is a limited market for millions of dollars in stolen pharmaceuticals. Property like this needs to move fast and at a significant discount to account for the risk involved. Even 50 percent off the regular price, for example, is a good profit for a long night's work when acquisition cost is zero plus the tractor trailer rental.

And this is where the devil arises in the details. If the new purchaser, knowing this is half-price merchandise, bills the drug at the normal rate on claims for Medicaid patients or health in plans, it would be Medicaid or insurance fraud. If the new purchaser bills the same claims at the actual, or half, price it is a "de facto" admission of dealing in stolen merchandise and a violation of state or federal law.

Some potential buyers can be ruled out. These burglars would attract a lot of attention at the typical flea market, not to mention the difficulty in maneuvering an 18-wheeled vehicle into a rental space. Besides, they want to avoid many smaller transactions and the potential for discovery in favor of one big sale to get their money and vanish.

"Mom and Pop" independent drug stores can be eliminated as not having enough capital to swing such a deal. Public hospitals would be an unlikely purchaser because transactions tend to be transparent and go through too many hands to remain free of scrutiny.

Legitimate pharmaceutical wholesalers are large businesses and know the reward is relatively small and the risk is huge. It would put them out of business if discovered. It is also safe, I believe, to exclude foreign purchasers because United States customers now pay the highest prices in the world for pharmaceuticals. The thieves would then be taking a discount on a discount, which is not a preferred way of doing business, not to mention the distance and the foreign customs issues.

There is a significant "Gray Market" in pharmaceuticals that includes items from stolen goods to counterfeit products that contain no active ingredients in some cases. We do not know the extent of this activity but FDA opened 300 criminal cases on counterfeit drugs from 2001 through 2008. The lesson to be learned here is that where you get your drugs can make a difference.

Big brand name pharmaceutical companies, many represented by the Pharmaceutical Research and Manufacturers Association, (PhRMA) pay very close attention to their products because there is a lot of money at stake. They seek out data on the number of prescriptions written for their product, quantities dispensed, quantities purchased by pharmacies and other information whenever possible.

Eli Lilly may not know the burglars in Enfield but I believe they know where their sales have suddenly sunk for Prozac, Cymbalta and Zyprexa after the middle of March. It is up to the FBI to find those culprits and help the U.S. Attorney bring them to justice for the first substantial case of health care fraud and abuse in a long time.