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doi: 10.1186/s13722-024-00481-7, 41 FreetC

Pharmaceutical Economics 101 Brand-Name Drug Costs Include: Research & Development: Clinical trial costs: $2-3 billion per drug Years of research before approval Failed drug candidates FDA approval process Amortized across all units sold Manufacturing & Facilities: Large-scale FDA-approved manufacturing Extensive quality control Regulatory compliance costs Facility maintenance and upgrades Marketing & Sales: Direct-to-consumer advertising (billions annually) Physician detailing and sales force Medical education programs Brand building campaigns Profit Margins: Shareholder returns expected Executive compensation Wall Street expectations Quarterly earnings targets Distribution: Pharmacy benefit managers (PBMs) Wholesalers and distributors Multiple middlemen taking cuts Rebates and discounts (complex system) Eli Lillys tirzepatide list price of $1,069/month reflects all these costs plus significant profit margins

This approach ensures employers and health plans only pay for measurable success

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Instead, patients often experience a complex constellation of neurological, cognitive, and immunological complaints that overlap with many other chronic conditions

The rise in autism and the role of age at diagnosis