[Zhang Fei]

Sure but distribution in the pharma industry is exceptionally concentrated - 90% of all drugs are supplied by either AmerisourceBergen, Cardinal Health, and McKesson.

And that’s just the top tier of distribution.

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Their margins aren’t wonderful. MCK’s profits were 2.5% of sales for FYE 3/31/2017, and that was in a good year:

https://finance.yahoo.com/quote/MCK/financials?p=MCK

The big margins are with the successful drug manufacturers, but without those margins, they’d have no money to conduct new drug research. Pfizer makes over 15% of sales in profits, but that’s how it has money to spend on research without selling new shares every few years:

https://finance.yahoo.com/quote/PFE/financials?p=PFE

[JohnnyP]

We just discovered my wife has stage 4 cancer. One of the drugs they are telling us about is over $11k for a month’s supply of 21 capsules. Our HMO plan doesn’t cover it.

Pfizer, palbociclib.

“The racket behind Pfizer’s new $9,850 breast cancer drug”

http://www.citypages.com/news/the-racket-behind-pfizers-new-9850-breast-cancer-drug-7891854