Revlimid, a bestselling cancer drug with over $100 billion in lifetime sales, is priced at roughly $1,000 per pill despite costing 25 cents to manufacture—a 4,000x markup driven by patent protections and limited generic competition. This pricing structure means patients without insurance coverage face crushing costs while manufacturers capture enormous profits; the gap between manufacturing cost and list price illustrates how pharma pricing power operates largely unchecked in the US market. ProPublica's investigation, part of their 'Paper Trail' podcast series, explores how pricing this divorced from production cost became standard practice in oncology drugs.