R&D are surely contributing to the high price. But as can be seen in the yearly financial statements of these companies, they are not that high, as they want us to believe.

Take Europe for example. As far, as I know in Germany the producers can pretty much dictate the price (ok, the have to discuss with the insurance companies, but they just can raise their fees so they have no real interest in saving money). After the German price is decided neighboring countries (Belgium for example) take these, cut of about half of that and dictate this as the maximum price for the drug.

Looking at the financial statements, the regarding companies still make a lot of money in Belgium of these drugs. But way more in Germany.

So I really do not believe the story being told, that the R&D costs and the risk are the reasons for these astronomically high prices.

And - when your life is at stake, your are more then willing to pay every price necessary - so your bargaining position is not quite great and your market power is drastically lowered.