when I worled as a manager at a EMS company i was invloved in ordering/billing. the government controls the cost to some extent. the formula is (the exact cut off i do not remeber) is X price times 333% = billing price to consumer.
so we bought a 10 mg vial of morphine at .50 cents we charged aprox 38.00. then the ins company disallowed 72 % and we got what was left. the unisured/self pay had to pay full price. I know the mark up formula is for all medicar/medicaid. the whole chain used it.
so the consumer can not really be sure of the cost to make and the 'real' price of the medication