[nikster]

Kind of shocking but that's not even the biggest problem.

The first problem is the money they spend on buying laws, aka bribes, aka "lobbying" as the USA likes to call it. Corruption in its finest form. That's why they get perpetual patents;

The second problem - and I kind of assume that that falls under "marketing" expenses - is that they can basically bribe healthcare providers and doctors to use their products.

Result: Most expensive health care system in the world, by a large margin.