If that buyer decides your price is too high, you sell around 0 units.

You can often receive these treatments if you wish to pay privately. Only the very wealthy do this, a small market.

Drug companies in the US prefer to sell units at the prices that the buyers in those nations are allowing them VS not selling them at all. That's why they do it. Then turn around and say they can't do the same in the US as it would bankrupt them.

The difference is in the US, Medicaid is quite happy to pay prices that are multiples of what other nations are paying. They sort of pretend this is all some sort of accident or due to some complexity that you wouldn't understand but it's just theft.