In the UK, the newer insulins cost the NHS £30-£37 for a box of 5 x 3ml disposable pens. Diabetics don't pay any charges for the prescription.
However, doesn't some of that mafia fee go toward R&D? (Developing new drugs)? Why isn't the price to the NHS slightly higher, also in part to fund research? It's hard to imagine $10,000 just gets pocketed by Don Carleone, without any of it going back to the laboratory.
Is the analogy really sound?
The NHS (via NICE) sets a standard amount that it is prepared to pay for any treatment based on the QALYs (Quality Adjusted Life Years) it results in. So really a non-generic manufacturer can charge whatever they like, so long as the end result is worth it. In a sense we don't eliminate the mafia, just set the terms of engagement under which they have to justify their pricing. Whether they take that money and spend it on R&D or dividends is the vendor's decision.