Negotiation is only effective if you can walk away from the deal. The drug companies can't afford to lose their biggest customer. But since the customer can't

Negotiation is only effective if you can walk away from the deal. The drug companies can't afford to lose their biggest customer. But since the customer can't go anywhere else, it's not like they would. It's a detente where neither side can really make a move because the other just says "Nope." I think transparency - as in publicly available pricing - would be the only thing to change the balance here. Even then, it's not a fix..