I don't know why you omitted the most crucial group who doesn't care: The patient with cadillac health insurance fully paid by their employer. "I don't care what it costs, I have insurance." This once-upon-a-time standard scenario is about to become extinct, precisely because patients didn't care about the costs.
If you are in pain and dying and the drug company says you need this pill twice a day for the rest of your life at $ 25 bucks a pill
In a truly free market, there would be viable competition to produce alternative pharmaceuticals, and drive down the cost of monopoly drugs. What we have instead is an FDA government regulation monstrosity, trial attorneys salivating for drug and medical supply side effects, and drug patents extended for decades by simply changing the shape of a pill.
The FDA/Pharma cycle is an incestuous loop.