You could concentrate on patent expired drugs that cost the most on an annual usage basis. Yeah, that leaves out the newest meds, but you'd still make a dent, and every year, you get cooler stuff to make that's already been market tested.
No, because patients deserve the best or most effective drug, not the cheapest.
Unless you'd like to put a price on human life that is.
Also, meds don't hit the market before they are tested...
Testing meds is part of the resource allocation problems because cheap & effective off-label use won't be researched & tested because there is not enough money to be made...
The best or most effective isn't always in consideration. At least outside of the US, you get what has been approved for care and only if it's not too cost prohibitive.
If governments were making their own generic drugs and sold them at cost then it would help avoid situations like Martin Shkreli. The drug wasn't protected by a patent, it's just that nobody else produced that drug. In my opinion this seems like a reasonable thing for governments to do.
Also, the best treatments aren't always available in this first place. Eg (at least a few years ago, don't know today) Adderall was illegal as a treatment here. Some EU countries, until recently, even treated methylphenidate like that.
> Unless you'd like to put a price on human life that is.
It's been put at about $10 million, for the purposes of EPA regulations. Insurance companies have their own formula, from a couple hundred thousand into the millions, and healthcare users QUALYs - quality-adjusted life years, and those are priced at $50,000-$150,000.
