Only a fool would think that Lilly’s / Novo’s margins are not robust to the point of absurd. But only a fool also thinks that the right way to calculate costs of a dose are akin to what’s listed in that study. The indirect people costs alone of bringing that product to market every day is very high. Forget direct selling. The Regulatory, Compliance, Quality, Pharmacovigilance and patient support programs would be in the tens (perhaps as high as 100M) of millions annually. It’s not as simple as adding ingredient cost to formulation to packaging and saying “tada! here it is!” unless one is writing a sensationalist piece.