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This reads like straight up corruption and extortion. There could be no other reason to do this than to milk as much money as possible out of people who have no alternative.

You should absolutely be testifying before Congress, not before HN.

This is exactly what happens when a monopoly produces extremely price inelastic goods. If it's not illegal, the monopoly will attempt to charge each customer as much as they can afford.

Why does the distributor know the identity of the patient?

That needs to be made illegal tomorrow.

Heck, sounds like there could be a Civil Rights Act case, if prices impact people differently based on race or sex or other protected class.

That doesn't change the question though. It just changes who it's posed to.