The patent monopolies are partly there to offset the very high costs of getting FDA approval, which are there in order to ensure safety and efficacy, to prevent

The patent monopolies are partly there to offset the very high costs of getting FDA approval, which are there in order to ensure safety and efficacy, to prevent people from dying from unsafe pharmaceuticals. And this causes people to be unable to afford drugs that could have kept them from dying, because the prices need to be high to pay for the testing. I'm not sure what the right balance is between caution and cost in FDA drug trials, but I think that the procedure should probably be made less rigorous (and long, and expensive) than it is today.