Chicken and the egg question: If this regulation in the US did not exist, would these drug companies and the medicines they've developed even exist? Which cam

Chicken and the egg question: If this regulation in the US did not exist, would these drug companies and the medicines they've developed even exist? Which came first the patent protections or the companies that depend on them? In the case of orphan drugs, it's indisputable that it was the legal framework enabling profits that made orphan drug development possible.