the simple math is these companies spend less than 20% of their revenue on drug development and have operating margins over 40% so prices don't need to be as high as they are
You need to take into account of the fact that patent clock starts ticking as soon as you file it, whether the drug gets approved by the FDA or not. The drug development process itself eats away that exclusivity at about 12 years on average, so that 40% needs to account for the time when you don’t get another drug approved (remember the 90% failure rate).
Drug business is EXTREMELY hard, and investors aren’t running a charity. There needs to be high profit margin to motivate people who fund the discovery and development process for new drugs to come out.
As I keep saying, once we bring down the cost of clinical trial (which is totally artificial, and not under the influence of pharma), you will bring down the risk and cost of drug.
Again, you are pointing the finger at the effect of high medical cost rather than the cause. Ask yourself: why are doctors in US paid 3x the amount compared to UK? Do they raise price because of the drugs? No.
