The “insane US margins” don’t go to the pharma companies, they go to the PBM middlemen who take home the majority of the list price, and therefore have interest

The “insane US margins” don’t go to the pharma companies, they go to the PBM middlemen who take home the majority of the list price, and therefore have interest in higher list prices, which also increases copay. That’s why it’s consistent across the USA market, and why they drop products that lower prices.