I deal with this stuff on a weekly basis.
My mom is 68 and is on social security. She has insurance and gets extra "help" from medicare for her prescriptions. This insurance costs her around $150 of her $1200 a month social security. Her prescriptions then cost, normally, between $3-$6 each. Recently they decided that she had too much income (apparently $1200 a month is wealthy) so they stopped the extra help and her medicine went up to around $10-$20 per prescription. She takes about 6 different things so it was about $90 per month increase. After many calls and much filling out of forms she is back on the help plan, but same deal, they just stopped it and didn't say anything.
One of the problems is because we are the only industrialized nation in the world without some kind of price protection on medicine so the pharmaceutical companies are free to rape us at their will. I have asthma and one of the medicines I take costs $319 a month. That is at costco and is the cheapest I can find it. Since I have asthma I cannot buy health insurance that will cover anything asthma related so I have to pay for it out of pocket. I can buy the exact same medicine online from a non-us based pharmacy for $90. The second medicine I take costs $39 at costco (again cheapest I can find) and I can buy it online for $6. for a 90 day supply that would mean: US price: $1074. Internet non-US price: $288 (or less than the monthly cost of one medicine) and it is the exact same stuff.
Another problem is that pharmacies can charge cash customers whatever they want. Most insurance companies have a ceiling. This is the max price an insurance company will pay for a medicine. For example lets say the max price for your medicine that the insurance company will pay is $120. If you have a $10 co-pay the pharmacy charges you $10 and the insurance $120 for a total of $130. Now someone comes in and wants to get the medicine and pay cash they can, and often do, charge them more. They may charge them $150, $160 or more. Just call around to pharmacies and ask for the price of a prescription. Many of them will ask you, "The cash price?" it is because they have different prices for cash customers.
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