Assuming the compounding process is inherently more at risk of contamination. It also gets complicated when the extreme prices are involved: what risk of infection balances out with the risk that the patient will not be treated due to cost or will suffer whatever negative consequences due to bearing the cost? One in two? Probably not. One in a billion? Probably.

Considering that the doctor was able to test the batches and verify contamination, it seems like this is an important step that was skipped by the pharmacy.

Given the litigious nature of medical patients these days, I think most doctors would justifiably avoid the additional responsibility of pharmaceutical QA.

How does that justify a 30 fold increase?

If an individual Dr can get a batch checked while saving the patient money, it obviously isn't justified.

In my opinion this is an unfair risk to the doctor's career in assuming responsibility for the quality of the compounded drug.

In the absence of any other evidence, I assume the 30-fold increase is the cost to the manufacturer of preparing the drug for eye injection "according to Hoyle."

So why isn't the batch checker taking on that responsibility?

Doctors aren't responsible for anything and everything that happens. If they've had a drug tested to check it's safe, after informing the patient, what else is there for them to do? You're creating a hypothetical to enforce the status quo. That's why we end up with this bs to start with.