The problem is Congress (as usual), the law doesn't allow medicare to negotiate drug prices as the suppliers already owned the congress critters.
The problem with the patient is you go to the doctor and he says wear this.
The patient says ok and finds out later the costs, and researches the alternatives.
Unless he's been burned a few times, it probably isn't even in the thought process at the time.
In the doctors office your mind is busy contemplated the impact of what he says about your condition plus trying to think of the other shit you wanted to ask him about that you should have written down but nooo, you'll Shirley remember stuff that important to your life and limb.