I believe it is ok for a company to market a product at an outrageous mark-up in a
competitive environment (more in a bit) if consumers are willing to buy it. Of course a company invests in advertising, spokespeople, whatever to hype a new product. Why on earth would they not?
This is a chart of Nike's net margin per year from 2012 thru 2021. Nike is publicly traded so these statistics are available to anyone. It is trading at around $112 dollars a share which is about right for a business with its market cap. Like most profitable business ventures it is trying for 15% net and averaging around 12%. Hardly what I would call robber barons at work.
What would your solution with regard to the price of sneakers be? A price cap? Price control mechanisms are proven a catastrophe whenever tried.
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Businesses have to be competitive are they fail. Off-shoring of work and accounting is indeed a plague on our work force. But your finger needs to be pointed at the drivers of those decisions. If unions make labor so expensive that a competitive product can't be developed and produced in this country, then the business has to find alternative means of production or fail. If taxes become so punitive, that the business can no longer absorb their impact within cost, then the business must offshore or fail. Waving the flag is a great thing - but not if simply waving it into Chapter 11.
I actually believe there needs to be "collusion" between business and government, but that cooperation needs to be in creating a more competitive investment environment here in the US. Trump took a huge step in that regard, sadly all too quickly being reversed by the democrat party, by lowering corporate taxes and by taking a machete to some of the constraining regulatory structure.
I have little personal experience with the pharmaceutical industry. A quick review of net margins across the industry shows nets roughly the same to a little higher than other businesses sectors. The patent rules regarding medications allow for limited periods of high margin to underwrite research costs for both successful and unsuccessful new development.
That said, the specific case you cite, insulin, is indeed one of the most problematic. Unlike sneakers, insulin obviously is not a voluntary use of disposable income. Production is largely restricted to just three companies, and the highest prices per dose are in the US. I should note that Novo Nordisk, an outlier with respect to net margin (30%), is one of those major producers. A class action anti-trust suite has been filed in the State of New York alleging collusion with respect to insulin pricing. Hopefully it will progress. When pricing collusion between a limited number of producers creates non-competitive conditions indistinguishable from a monopoly, those activities are and should be subject to legal penalties.