Price gouging of essential items, and the global debate on pricing of vaccines and treatments during the COVID-19 crisis, provide an optimal proxy to revisit the law and economics discourse on excessive pricing as an abuse of dominant position. Beyond a normative soul-searching of the efficiency v fairness debate, this chapter analyses excessive pricing cases during the COVID-19 pandemic in the EU, US, and South Africa. The assertion is made that neoclassical, marginalist, and welfarist law and economics schools will forever be in direct conflict with the black letter law of European Competition Law, which prohibits unfair, excessive pricing, and thus, other law and economics schools such as Keynesian, Behavioural, and Neuro-economics offer far better congruence with the legislative intent and history of Article 102a TFEU.