I see the insurance companies as the evil overlords here, not Big Pharma. I've written about many of the other misbehaviors of BIg Pharma, but at least they are researching and producing some medications that are lifesaving and powerfully helpful. The insurance companies are who control to access at all levels of our US medical system, have no incentive to lower costs (since they're just skimming a percentage off the top), and who base their decision making primarily on profits, not preserving health.