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My understanding also is that pharma is a case where you can often show you spend $X on a medicine and it gives $10X or more in savings.

For instance inhaled steroids for asthma can cost an eye-popping $300 a month but some people with asthma get hospitalized once a year at a cost upwards of $8000 so the inhaler is really a bargain.

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That's like saying smoke detectors should cost thousands of dollars bc they can save a 500K+ building. That's a poor way to look at value in these situations. It's cheap and easy to make, so it should be cheap to the consumer if there weren't all sorts of red-tape and opaque pricing schemes used as an excuse to prop of extortion.

Why is that a poor way of looking at the situation? The reason smoke detectors don't cost thousands of dollars is that there are lots of different smoke detectors competing the price down.

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