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Big Pharma.... is, imho, a bit complicated....

we guarantee a monopoly for X years to a pharma company that comes up with a (hopefully useful) new medicine

this is to encourage them to invest the (sometimes hundreds of millions of dollars required) to develop, test, and then manufacture and market the new meds

now then, SOME but not nearly all of these costs are also imposed by us (FDA), in the testing and approval process

and of course our tax regs (partially written by the industry, natch) is horribly complex, as it is for us all and then some, and this both constitutes an additional cost for the firms AND provides them with some tax benefits.subsidies too

so... there are at least 3 key areas where our public policy directly impact, help determine pharma firms’ drug prices

now then,
IMHO...... we probably do not want to lighten up TOO MUCH the testing and permitting regs, except to make it easier for untested drugs to be obtained by patients whose lives, etc may be at risk (like, maybe they won’t last long enough for the testing to get done!)

IMHO.... the first area we might look at is the length of time we grant the drug patent (monopoly market) for....
maybe its too long? in that it might be shortened and still provide sufficient incentive for the development of new medicines?

but that’s a very very very difficult balance, line to draw.
Clearly, the shorter the patent period, the less incentive is afforded for the development of new medicines

(also, often drug firms get their patents before the testing process begins, to protect their product from being copied by competitive firms during the testing process....
and since the testing can take maybe 5 or 6 years and sometimes even longer, the effective market proection we’re giving these new meds is reduced to maybe 13 or 15 years, not 20)

the moment anyone proposes to reduce the patent period, the drug companies and economists rise up and object...that we won’t be seeing as many new medicines and thus the proposal will cost patient lives, perhaps our own

the moment anyone proposes to reduce the testing requirements, (other than some sort of special early-you=can-have it rule) for patients who won’t last long enough as above, the drug companies, and many doctors too... start objecting that we’re risking lives with ‘untested or inadquately tested drugs”

and of course we could lower the firms’ cost of business by reducing their tax burdens, but the minute that’s proposed a whole bunch of “consumer advocates” and leftists object that we’re “rewarding piggy Big Pharma”

so... its very complicated, imho anyway. I do not see an easy solution