Personally, I think that they would cut other cost centers before they cut the only department that ensures their long term success
The industry could save tens or of billions per year by not advertising (this is a US thing, drug ads are nonexistent in many places), and eliminating pricing games, cost rebate programs, coupons, drug reps, etc. These are all significant costs and friction that don’t exist in most other countries.
My personal feeling is that claiming that the worlds least cost efficient healthcare system with many layers of added complexity is the driver behind pharmaceutical budgets is marginal.
And of course you have to consider that a significant portion of drug research costs are paid by government and other institutional grants
