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How much do executive payouts, lobbying, and marketing costs take out from those profit margins?
At least some of this information is publicly available and you can go look it up. Or I can. But before that, what do you guess those costs are? Their yearly revenue is about $48bn, to give you a starting point.
My point is that the only way to make sense of this situation is to look at it in another way, and if you do look at it that way, you see that, yes, they are making excessive profits. But not so excessive as the original perspective would say.
In case you're skeptical still, take your estimate and ask: do you think the company spends so much on all of those items that it would make a comparison of the price to the cost of manufacturing an individual pill look reasonable?
Because I don't think there is any realistic number you can come up with that would make this line of argument sensible, which is my point. Do you complain about having to pay $10 to buy a book when printing a single book costs like $2?
$10 no.
If that book enabled sick people to continue living another year, and they started out charging $2000 and gradually increased that to $10000 while the book production cost remained at $2, there would begin to be many ethical questions.
You're right that the per-pill cost is only the start of what it takes to develop / test / manufacture / distribute / market the pill. But the first two are done by the time the pill comes to market and the last is minimal because you have a captive market, people who have the cancer the pill is treatment for.
Increasing the cost year after year, because you have a captive market of people that will die without your product, should raise significant ethical and legal questions. Especially because large parts of the research and testing are publicly subsidized anyway.