As noted by others, the cost of Evzio is up from $690 to $4500. So, yes, there always is some reason. The pharma company needs to cover the costs to their whol

As noted by others, the cost of Evzio is up from $690 to $4500. So, yes, there always is some reason. The pharma company needs to cover the costs to their whole business with the revenues from their whole business, and they'll play whatever games help them do that. The price for a drug does not correspond to the cost to produce (or develop or get approval for) that particular drug, the price corresponds to maximum revenue for that drug. With all the max revenue from all drugs, they need to cover research for a bunch of drugs that won't work out, marketing, board of directors, and other expensive hires to power the rotating door between regulation and industry, etc. It would obviously be better if prices paid for long-existing well-known drugs did not mostly go to cover inept big-business shenanigans. "Real competition" would fix this, but the health care industry is fucked up in 10 different ways and we can't agree which direction to go to fix it. (In this case I'd say the problem is that the end-user is not paying for it, so bureaucracy and politics decide how much of which brand to buy, and the result is so bad the end-user would never pay for it, so we're stuck - it's unfixable.)