Perhaps a Different Perspective
What is costs to "make the stuff," is actually a very small fraction of the real cost of a pharmaceutical.
Full disclosure; I was a state government affairs director for a very large pharma company for lots of years. I am not a lawyer but some of us with tech backgrounds reported to the general law department of this large pharmaceutical company (I mostly represented their crop protection products division).
Attending the general law dept. meetings was highly informative with regard to the challenges pharma has in areas of R&D, patent protection, litigation, liability, costs and conduct of clinical trials, regulatory hurdles which can be virtually insurmountable, technology transfer to physicians, and marketing. The "D" in R&D for "development" was always the most impressive phase it seemed to me. It's not uncommon for a new drug to cost well over $650M to get to final clinical trials and only one in 500 get that far but still incur costs along the way to failure. The Food & Drug Administration is no pushover and discovery chemists don't grow on trees.
The law dept. seemed mostly concerned with patent protection and liability issues. There were 100 attorneys on the payroll and they were all busy.
Some observations: the more widely prescribed the drug the cheaper it was over time, block-busters commanded premiums, patent life was seldom long enough (20 years from application date - which was long before anything was sold) to recoup the investment on anything but block-busters or very widely prescribed medicines.
Generics, available after patent protection expires, are generally cheaper only because the generic manufacturer can petition and access the development history, clinical trials results, and the manufacturing process of the original inventor company - essentially the FDA registration package as a whole. That saves millions upon millions of dollars that the inventor had to bear, and the federally arbitrated price for access to this necessary information seldom adds much to the inventor's bottom line.
It was never openly discussed but it seemed drug prices were generally higher in the US because we could bear it due to more widespread insurance and affluence compared to third-world countries or those with active pharma price controls.
Remember they are publicly traded/owned companies that must return on their owner's investment. Capitalism? You bet. Most of us really wouldn't want them to go away would we?
