Sounds like it's a lot of things, but one thing mentioned in the article is pricing pressure from plan administrators. Large plans have outsized influence on pr

Sounds like it's a lot of things, but one thing mentioned in the article is pricing pressure from plan administrators. Large plans have outsized influence on pricing. Mix that with unscrupulous manufactures that cut corners to lower costs and you have a mess. Those bad manufactures can agree to go lower than legit manufactures and they then let the plan administrators force pricing lower for everyone. At some point the legit manufacturers are priced out, leaving only the bad ones. Then when a bad one implodes, the market isn't there anymore. By this point plan administrators have anchored pricing too low and are likely going to be slow to adjust (if they adjust at all). NB: I'm not involved in the medical field or in economics, so take my statements as what they are, conjecture.