It's as you say - crony capitalism and corporatism. The politicians/government are corrupted and bought by pharma corps to create a situation where competition

It's as you say - crony capitalism and corporatism. The politicians/government are corrupted and bought by pharma corps to create a situation where competition and the free market is stifled, which leads to high prices as the inevitable consequence. It's a principal-agent problem in the context of having a large state/government with extensive powers to interfere in private business. You see this playing out everywhere; e.g. agriculture subsidies in rich countries, which just serves as protectionism for domestic farmers at the expense of poor-country farmers. The fundamental causal factor here is the large and powerful state - private, autonomous actors will always try to corrupt and co-opt the state's powers for their own benefit (whether that's farmers, pharma corps, oil companies, hedge funds, tech firms, or whoever), so laying the causal blame at their feet is misguided since their attempts to do so are inevitable. It's a government problem.