No, it really doesn't. This is yet another magical medical care "retail price" that has little connection to reality. First, you can be sure that medicare, me

No, it really doesn't. This is yet another magical medical care "retail price" that has little connection to reality. First, you can be sure that medicare, medicaid and private insurers have negotiated that price down. Second, Gilead itself offers a coupon to reduce co-pays to $5 per refill for health insurance plans that don't cover the entire cost of the prescription[1], up to 20% of the total cost (so it appears if you have a 20% out of pocket copay for prescription drugs, you pay $30 total instead of $16800). So, who is paying $84k? If it's like most other medical costs, the answer is only people who don't negotiate the price down first. The important aspect is that by charging $1000/pill retail, they probably get tax benefits from offering it for less, and anyone on a healthcare plan (if such plans still exist post-Obamacare) which caps lifetime expenditures who get the prescription get a good chunk ($84k) taken out of their lifetime healthcare coverage, which the insurer would love. To get to the bottom of it, it would be good to know: What are the typical prices (definitely average, median, and perhaps various other percentiles) that Giliad gets from these prescriptions? What does Gilead's internal accounting for the drug (separating R&D, advertising, and marginal costs) look like, and what are the tax consequences of inflating the sticker price? [1] https://www.sovaldi.com/copay-register.aspx https://www.sovaldi.com/copay-register.aspx