Well there are market realities also ...re pricing
Take the case of the PSCK9's ...for CAD patients . Originally launched at around $14,000 a yr . Insurers erected numerous hurdles enabling them to deny coverage ...drug manufacturers backed down a year or so later ...negotiated easier access in exchange for lower prices .
PSCK9's ( Repatha etc ) dropped down to about $5,400 a yr cost to health care providers and a lot more patients ( my self included ) obtained coverage.
Not all drugs are outrageously priced .
Amarins drug Vascepa ( CAD patients ) is a bargain at around $1,400 a yr to health providers since the average yearly cost in healthcare services for its key patient population ...diabetics on optimal statin therapy with a previous CV event is around $5,000 a yr. ....ICER report .
In fact Amarin could double the price it charges for this key population and health providers / insurers would still save $
JMO
Kiwi