"A CPAP machines costs about 10x as much as it should, and a part of that is insurance companies wanting to make sure they are not paying for a device you are n

"A CPAP machines costs about 10x as much as it should, and a part of that is insurance companies wanting to make sure they are not paying for a device you are not using." If you look just at BOM, I am sure my insulin pump must seem the same way (about $3500); but the technical support from Medtronic is top notch and the devices are not mass market; probably only about 100,000 of them each year (just based on a 4 year warranty period, which is when your insurance covers them, and a quick google showing about 350,000 on them). I do think there is a bit of a razor blade model here though, given that the consumables will cost nearly as much as the pump over the course of a year.