As far as solvadi goes... It's a great drug but no payer will pay for it because its upfront cost is so damn high. Great innovative drug sure but no one has easy access to it. Also there's a very big distinction between medicaid and medicare. Medicaid, which is run by the state can negotiate prices, whereas Medicare, which is the one that private insurances try to model, does not have the same power.

It proves your point but I wanted to add india already made a generic that costs $900 for full treatment (vs $94,500 for solvadi/harmoni) that Americans have no access to. My point bringing this up is that the cost to manufacture the drug is far less than what its being sold for; yes u have to consider r&d costs and costs lost due to other drugs that have failed clinical trials but most industry analysts think the drug should be is the $200 (iirc) rather than in the $900 range per pill. Btw gilead actually just bought out the company that originally was developing the drug. So yeah, profitability drives innovation but also kills patients (look into the craziness going on with the epipen for example)