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It's a complex mix of factors: Patent Protection: Pharmaceutical companies hold exclusive patents for years, allowing them to be the sole manufacturers and set the price without direct competition
doi: 10.1111/jtxs.12142 39 DeFazioRADvoryanchikovGMaruyamaYKimJWPereiraERoperSDet al

They require proper nutrition and medical monitoring

Diabetes Care 36 Suppl 2: S245-252, 2013
The heat typically dissipates within several hours
