I would suggest anyone who is interested in reducing drug prices listen to this econtalk episode with Robin Feldman[0]. They discuss her book "Drug Wars how big pharma raises prices and keeps generics off the market"[1]

In the episode they discuss all sorts of shenanigans that pharmaceutical companies pull. If you want real reform you need to look at weak patents, eliminating "reverse payments" to generic companies, and obstruction to bioequivalence testing. Drug companies routinely manipulate the current laws, specifically Hatch-Waxman in order to stifle competition from generics.

[0] http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...

[1] https://www.amazon.com/Drug-Wars-Pharma-Raises-Generics/dp/1...

For a fantastic discussion about the Byzantine process for generic drug approval, I recommend a recent episode of EconTalk[0]. The guest wrote a book called "Drug Wars: How Big Pharma Raises Prices and Keeps Generics off the Market"[1]. When up to half a billion dollars of revenue is at stake, the drug companies have incredible incentives to delay or prevent generics coming to market. Believe or not, they often simply refuse to give a sample of the old drug to the generic company. No sample to compare, no FDA approval. It is illegal to dispense a drug without a prescription, and the sample is not for a patient, so it can take some maneuvers to get a legal sample. Or the drug company can change a tiny feature of the drug, re-patent the new drug, and then destroy/withhold all the old drug. No old drug sample, no FDA approval of an "identical" generic. The drug companies will contract with a generic company that never, actually gets to production (wink, wink). Those contracts are finally being understood by judges, so now they are going to a second level of contract obfuscation that is even harder to notice, but still keeps the generic off the market.

[0]http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...

[1]https://www.amazon.com/Drug-Wars-Pharma-Raises-Generics/dp/1...

Some of this insanity is covered nicely in the econlog podcast[1] on the book Drug Wars[2]. The NY Times always wants to throw all of the blame at insurers, but they are trying to save money. The generic system is a Kafakaesque set of regulations and processes.

[1] http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...

[2] https://www.amazon.com/Drug-Wars-Pharma-Raises-Generics-eboo...