> Its not ridiculous. How can you "negotiate" when you have 0 leverage? There is no "negotiation", ever. Why zero leverage? Government contracts contemplate vo

> Its not ridiculous. How can you "negotiate" when you have 0 leverage? There is no "negotiation", ever. Why zero leverage? Government contracts contemplate volume purchasing agreements for suppliers. Many medications include alternative suppliers which can be used as leverage. As noted by others, extremely expensive treatments for rare conditions are often not offered in socialized systems. When they are, it's often the result of a court order forcing the government to make it happen. Better pricing could allow a treatment being provided as an option to the population (by default, without necessitating a court order), which can be interesting to the pharma company due to increased sales volume.