Conservative
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Ok...I wasn't sure that the point about the cost to manufacture drugs was what you actually meant to say.
Pharmaceutical companies make massive profits. What that means is that after all of the money they spend on all of the things you're referring to they still make massive profit. I'm not suggesting that they shouldn't make profit but that that profit should not be unlimited. The American healthcare system if grotesque. It is unique in the highly developed world in that grotesqueness. They wouldn't sell Epipens in Canada for 20% of what they sell them for in the US if they weren't making a profit on them. And, to be clear, Epipens contain epinephrine the wholesale cost of which is $5/mg and an Epipen delivers 0.3 mg which means that the drug in the Epipen costs around $1.50 wholesale. Is the little plastic pen with the spring in it worth $600? I don't think so. I don't even think that it's worth the $150 you pay in Canada. You can have a pharmacist load a syringe for you for $15.
Profit margins for pharmaceutical companies are typically between 10 and 20 percent in the US, 2020 & 2021 are exceptions as the covid shot boosted numbers considerably. Those are normal profit margins for industry.
And...
Their profits are not grotesque
20% of $1.2 trillion is $240 billion dollars. That is a grotesque amount of profit to make by holding people's health hostage.
What would you consider a reasonable profit?