That's a function of perverse incentives, rather than some sort of immutable truth. If there were stronger penalties for (e.g.) cartel-like pricing (e.g. TKIs), and more price transparency for the true costs of care (ibid), we might see less of this. Or if, say, the primary market for such drugs adopted a single-payer system where the payer negotiated on behalf of the patients, rather than on behalf of its shareholders.

Gleevec and Sprycel are the canonical examples of "competition makes the price go up" but if a single payer dominated the market and used this as leverage, it would be simple enough to just say "not at that price" and force manufacturers to play ball. The real problem is regulatory and legislative capture which prevents this from happening.

Agreed. Patent and insurance reform are crucial.