When I pick a bottle of wine in the store, I pay for décor and the attention of a salesperson, perhaps to the detriment of quality. The goal of businesses is to maximize profit, even by catering to my other preferences if I am unable to judge quality. This is not immoral because I end up drinking a product approved for sale; no harm done.
My patients are the “wine drinkers” of health care. They are not supposed to know about medicine more than I know about wine when we are acting as average citizens. However, selling lesser quality medicine is immoral because it has the potential for harm.