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If you look at the chart in the link, about 45% of the difference between “list price” and “net price” is discounts or rebates to insurers.

It’s particularly gross and brazen, even by pharmaceutical rent-seeking standards, to justify cocaine-like profit margins because large buyers can negotiate.

Insulin prices are driven by anticompetitive behavior. If you look at metformin, a generic drug treating the same disease, profit margins are tight, driven by competitive economics. A 90-day supply is < $10 retail.



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