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Thanks to meddling in legislation by lobbyists and industry groups (e.g., AMA, ADA, etc) many treatments proven over centuries have been made unnacceptable to practioners and mostly unavailable to patients since the insurance will not pay for them. Health costs are immeasurably higher and health outcomes vastly inferior because of this effort to eliminate those non-patentable competitive treatments.
There needs to be some middle ground that allows these products back in the mainstream.
That said, R&D has to be recouped somehow - and for every drug that makes certification there are numerous that didn't make it. When governments legislate that you can only make x% over actual cost of making a specific drug in profit, that doesn't take into account all the costs that will never be recouped due to drug research that didn't pan out.
Drug companies are, of course, granted FDA-enforced monopolies on the treatment of anything considered a "disease." As such, drugs are pushed into the marketplace at monopoly prices. Because if you're the CEO of Gilead Sciences, Inc., makers of the Sovaldi drug to be sold at $1,000 a pill, your job is to maximize revenues by any means necessary. When you're handed a monopoly by the FDA, the strategy for achieving that is simple: Raise the price to whatever you can get away with, then bill the insurance companies, Medicare and Medicaid for $100, $500 or even $1,000 a pill.
This isn't a situation of monopoly - it is basic business. If your price is regulated, and you can still cover the costs of production, it is a good business decision. BUT that assumes that you can cover your costs of development somehow. The fact that these countries are regulating their prices are what drives the costs in the US so high.
Don't rail against the drug companies, complain about the unfair pricing laws across the world - starting with Canada. I have a hard time with the local purchasing companies that buy drugs from Canada (where prices are regulated) and then import them to the US. They do not pay the costs of development, leaving the rest of us to do so.