In 2019, the record for the most expensive drug was broken at US$2.1 million per patient. The high costs of new drugs are justified by the pharmaceutical industry as the expense required for maintaining research and development (R&D) pipelines. However, this does not take into account that globally the public pays for between one to two-thirds of upfront R&D costs through taxpayers or charitable donations. Governments are effectively paying twice for medicines; first through R&D, and then paying the high prices upon approval. High drug prices distort research priorities, emphasising financial gains and not health gains. In this manuscript, issues surrounding the current patent-based drug development model, public funding of research and pharmaceutical lobbying will be addressed. Finally, innovations in drug development to improve public health needs and guaranteeing medication access to patients will be explored.

2019 年，最昂贵药物的记录被打破，达到每位患者 210 万美元。制药行业认为新药的高成本是维持研发（R&D）管道所需的费用。然而，这并没有考虑到全球公众通过纳税人或慈善捐款支付了一到三分之二的前期研发成本。政府实际上为药品支付了两次费用；首先通过研发，然后在获得批准后支付高价。高昂的药品价格扭曲了研究重点，强调了经济收益而不是健康收益。在这份手稿中，将解决围绕当前基于专利的药物开发模式、研究的公共资助和药物游说的问题。最后，