Big Pharma’s price gouging, unchallenged by the government, is often aggravated by TV ads

[dropcap]A[/dropcap]s outrageous as the cost of health care can be in the United States, it's nothing compared to the markup on some prescription medicines.

While companies certainly have to recoup their research and development costs and earn a profit for investors — and the exclusive window before a generic version of a drug goes on sale is the optimal time to do so — those prices can sometimes get out of hand.

In 2015, you might recall, the price of Daraprim, which is used by AIDS and transplant patients, famously soared from $13.50 per pill to $750, which sparked an outrage. (As of last August, the price was down to $375 per pill, which hasn't done much to dissuade critics.) Last August the cost of a two-pack of EpiPens jumped to $600 (versus $90 a decade prior). That hike has resulted in a class-action lawsuit.

President Donald Trump has vowed to unveil a system that would dramatically reduce the price Americans pay for prescription drugs. So far, that has failed to materialize. Citi analyst Andrew Baum, though, wrote the administration's failure to get enough votes to pass the GOP's first pass at a health proposal "increases the legislative risk to pharma pricing."

Should some method to combat high drug prices materialize, regardless of origin, it would still likely not go into effect for some time, given expected resistance from pharmaceutical companies and the general slow pace of government.

For now, patients are stuck fighting their insurance companies to cover bills that can be jaw-droppingly expensive. GoodRx, which monitors the price of prescription drugs, has compiled a list of the most expensive ones on the market.

Prices listed are for a 30-day supply and do not factor in insurance or discount coupons. Both of those factors can make a big impact on the out-of-pocket price consumers pay, but vary wildly from person to person.

It's also important to note that what's reflected here are not the wholesale prices of these drugs, but rather prices taken from data gathered by GoodRx that is based on 'usual and customary' prices (aka retail prices) where pharmacies submitted four or more claims over a three-month period. (Extreme outlying claims were eliminated and not included, says Doug Hirsch, co-CEO of GoodRx.)

"To be clear, the prices we posted are from actual claims that were submitted by a pharmacy," says Hirsch. "This price is not necessarily reflective of the actual price paid but is the best indicator we have of a 'list' price. ... Drug manufacturers ... quote an average wholesale price, but they do not control the retail price that is submitted by the pharmacy."

Consumers, Hirsch acknowledges, could pay much less than the submitted retail price.

With that in mind, here's a look at the Top 10 from January 2017.

Correction: After this story went to press, GoodRx's revised its list of the most expensive prescriptions in the United States. Previously, GoodRx included Mytesi in error, when in fact this drug, distributed by Napo Pharmaceuticals, ranges in price from $617 to $638 per month. Mytesi is a diarrhea treatment that has been studied specifically for HIV patients. Napo provides people living with HIV/AIDS broad, affordable access to the drug.