"Big Pharma" is a cartel with more steps (via semi-emergent regulatory capture). Nothing to do with healthcare in the United States is anywhere close to a free market.

One of the counterpoints is that it's not the same insulin, it's constantly new and improved insulin that functions better than the insulin we had 10 years ago, but of course each improvement comes with a price increase.

Yes, but this is considered by many to be scandalous and I doubt it will continue to be so high-priced long-term.