I'm not convinced that's true. If the market really is free and fair, and the price is currently 8 times more than elsewhere, why are foreign pharmaceutical companies not flooding the US market?

Why are there not dozens of silicon valley startups springing up to 'disrupt' this market - clearly there are large margins to be made given the price is so much higher at the moment.

It sounds more like some regulatory capture has happened which is keeping prices artificially high, than that all other countries are artificially low.