[calibas]

Regulatory capture is a big part of it, the current head of the FDA has very close ties to the pharmaceutical industry: https://en.wikipedia.org/wiki/Robert_Califf#Relationships_wi...

[akira2501]

Driven by monopolization. It's one of the side effects that's rarely explored in the FTC and DOJ "analysis" of these mergers over the past few decades. That there are only three domestic suppliers controlling 90% of the market seems like it could be the root of these particular issues and is what allows such seamless regulatory capture in the first place.