Most of the researches are from ethical drug companies. They do have a 20 % profit margin, but they also put 20% of their income into research, so it balances.

Even if a company get the medicine all the way to the finish line, it then has to show that it is an improvement, significantly so, over what is already on the market, or it cannot be brought to market. That does happen.

President Biden decided that those on Medicare should not pay more than 2,000 per year for medicine, starting this year.

The median family of four makes 50,000. That is 4 % of its income. We could say that starting at $50,000 every American pays at least 4% of its income on medicines. It goes up at every 10,000, so that someone making 55,000 would not notice an increase in cost, with no cap. So someone making 1,000,000 would have to cover the first $400,000 in medicines. and so on. Everyone would pay the same rate, and the richer would pay more. This is just my thought, but if spread around, and not just for Medicare, it could perhaps help many more.