@hc4361
//Some drugs do use very, very expensive ingredients. //
I would have thought the most expensive part would be the safety trials, animal then human, followed by the double-blind efficacy testing.
That last bit would be tricky if it is the kind of condition where the occurrence rate is so low that we have to pool patients with other countries to get a group big enough to obtain meaningful efficacy results. International cooperation doesn't come cheap.
Drugs for rare medical conditions will always suffer similar economics to that of luxury cars:- similar design, tooling and launch cost as less exotic designs but fewer units will be sold so the unit cost has to be higher… and, possibly, not come down as time passes because the development cost would have been in the millions (both for cars and medicines).
Brutal as it sounds, the question is whether the NHS remit extends as far as bespoke"one-off" treatments or whether it should stick to common complaints, treatable at a cost commensurate with average worker's contributions?
(Or am I drifting into bean-counter territory myself, now?)