Right, so in this case there was a tiny modicum of competition, and the smart company selling the drug priced their product appropriately. However, that does n

Right, so in this case there was a tiny modicum of competition, and the smart company selling the drug priced their product appropriately. However, that does not mean that they (or some other organization) couldn't have developed this drug for less. The question isn't whether it's better that what came before, the question is whether it's efficient. If there were many buyers and sellers, you'd have some faith that is at least approximately efficient. But with just one seller, they could recoup their costs many, many times over. That's terribly inefficient - those resources could be better used elsewhere. And it's quite a bit worse than that - by being so inefficient, you're creating all kinds of perverse incentives. Instead of trying to find and create a worthwhile drug, the aim is to find those drugs with captive audiences. The Martin Shkreli saga illustrates that quite blatantly. The appropriate benchmark is efficiency, not whether the drug at the offered price is better than nothing.