The table included in the original post is a completely unfair representation of "markup". While the active ingredients in prescription drugs may be fairly inexpensive, that's hardly the the basis on which the drug companies can set prices. The average new medicine takes between 7 to 10 years and $500 million dollars to produce...and that's before the FDA gets a crack at them. The additional trials to get it through the regulatory system cost a few hundred million more. After approval, they have to pay to manufacture the drug, package it, ship it to the store, advertise it, teach doctors about it, etc. Then the company has about seven years to make enough money to cover the costs of development, the costs of all the research that didn't result in any useful drugs, and to return a profit to the shareholders.