Drug costs are skyrocketing, but why? This is an essential question to ask since we must understand the cause of high drug costs in order to properly address the problem. As someone who has worked in healthcare and life sciences technology for more than twenty-five years, I’ve seen drug costs grow and dominate pharmacy budgets across the United States. Despite substantial technological improvements during this period, drug prices remain unaffordable for many Americans. After extensive contemplation, I’ve concluded that the root causes of high drug costs fall into five categories.