The price increase for Retrophin from 12.50 to 750 was NOT for no apparent reason. The previous owners of the rights sold the rights cheaply because they were unable to make money selling Retrophin, and in fact had large losses for years, despite multiple large price hikes. Businesses that continually lose money shut down. Most of the costs are large fixed regulatory costs for each drug manufactured that a business owner cannot cut, so the only realistic alternative is to raise the price dramatically.

A USD 750 list price for a drug does NOT result in most people paying the list price. Most people get it via insurance, insurance companies pay a negotiated rate and you pay the copay (frequently higher than what the insurance company actually pays). Retrophin isn't a widely used drug so the effect on overall premiums was also tiny. His company literally offered the drug for free to anyone who for whom insurance didn't pay for it and who couldn't afford it. He also had a publicly stated business plan whereby he would use profits from Retrophin to invest in research into similar drugs which pharmaceutical companies have not been doing since Retrophin had been losing money.

Given the byzantine manner in which payments are actually made in the US, there simply isn't any other way to price an orphan drug, i.e. a drug that very few people actually need. The only way to make a business that produces life-and-death drugs needed by very few people sustainable is to price the drug very high due to very high fixed regulatory costs per drug manufactured. If you want to change this, it needs legislation and FDA reform. Demonizing businesses that raise prices to ensure they make a reasonable profit, will only result in drugs that are life-and-death for a small number of people either getting taken off the market or not coming to the market in the first place.

What's FAR more concerning is things like the recent increases in pricing for things like the Epi-Pen. Prices were raised 10x but also the expiration date on Epi-Pens is artificially short, so hospitals, schools etc are forced to throw away perfectly usable Epi-Pens for no good reason. Nobody talks about that because that price hike was by order of a senator's daughter. Shrekili just happens to be a bit of a PR nincompoop.

What we really need is a populace that thinks carefully and independently and a press that actually spends money on investigative reporting instead of relying on what politicians tell them to report, which helps their bottom line since it's much cheaper.