They're very expensive to develop. Randomized clinical trials aren't really viable in many of these extremely rare diseases with high mortality. At the same time, we have an essential medicine that we know works: insulin. It was given, basically, to the world by its creator a century ago, and yet we have not seen any decrease in the price of this medication in decades. If anything, some forms of it have actually gone up.
You were mentioning your price review. Is there a mechanism through your agency that can help in terms of influence? You say that you call companies to task if they're charging excessive prices. Would you say that insulin is being charged excessively right now?