But prices are going up. Look at the statements your insurance company provides about the reimbursed "cost" of covered generics:

Some experts report that PBMs overcharge for generics; The Wall Street Journal estimated that Cigna and CVS Health, both of which own PBM services, are able to charge prices for specialty generic drugs that are 24 times higher than what manufacturers charge.

https://www.americanprogress.org/article/5-things-to-know-ab...

So this must be worldwide. It seems like the patents held by big pharma are the root of the corruption. What is the guarantee here? That the chemicals are pure, or just that the companies are getting their cut?

Huge caveats. The drug manufacturer gets over a decade of market exclusivity which bars the selling of generic versions of the medication, which they can then extend again if they find another distinct use case for the medication (3 more years). This is why the Vyvanse generic took so long.

That's what he said. Brazil is in (South) America.