In Chinese Mainland, there is no middleman and drugs are bought directly online, which can be said to be one of the most efficient medical systems in the world. For example, in mainland China, if you want to buy Tilpotide, you can go to a public hospital and register a number for a doctor to determine if it can be used. Then, you can place an order on JD.com and it will be delivered within an hour for only 400 yuan and 10mg. If you are in Hong Kong, you cannot buy prescription drugs by yourself, and you have to pay a few hundred to 1000 yuan outpatient fee to the doctor first, which is twice as expensive. I'm not very familiar with other countries, but GPT says that in the United States, a month's worth of tiltrotide may cost $1000. Various intermediaries are crazily profiting from price differences.