Yes, a sterile lab is expensive, but like normal business expensive. It's very achievable to build, drug cartels manage it just fine.

This bit right here told me that I didn't need to take this too seriously. An actual medical lab is not comparable to cocaine plants in the Congo.

But the pills themselves? The materials and production cost is cents. They themselves cost basically nothing

This is the exact same point from the previous comment. You cannot just look at the material cost of something and say, "see? It only costs cents to make." Go buy a part that goes in a car engine - it's just a few cents worth of metal! But, you can't just take a hunk of metal and magically form it into car parts, there's a manufacturing process and it's expensive. That's part of where the cost comes from. It doesn't matter if you can make the most expensive pill in the world out of 10 cents of flour if you need a $10 million dollar assembly line to process it and turn it in to what is useful. They aren't just taking a premade substance and pressing it into pills, there's numerous chemical reactions and processes taking place.

That's why other countries can afford to sell them for cents - they really are that cheap to make

You start your comment off with saying that R&D is subsidized, and end with saying "other places can sell them for cheap cuz they really are that cheap." In these other countries, the drug company is not selling the medication directly to the public for pennies, it's getting subsidized by the government to make it affordable for citizens. Granted the government is not paying US cash prices, but companies simply are not selling direct to consumers for 10x less than other places.

Look, this is coming from someone who fucking hates the predatory medical industry, especially that of the US. I used to work as a very small cog in it. There are absolutely places where prices are disgustingly manipulated and people are taken complete advantage of. Things exist today the way they are because of corporate greed and the continuance of putting profit over people. We can accept all of this as true, and still recognize that producing drugs at a medical grade, with medical levels of consistency and purity, is a difficult, expensive task that requires resources to accomplish. Medication needs to be cheaper (it's my belief that it should be no direct cost to the user), but momentum is instantly removed from the cause when we use arguments based on a limited grasp of reality.