Hospitals start their own drug company
nytimes.com
nytimes.com
Now, they could possibly pay a contract research organization (CRO) to manufacturer the drug, but the regulatory costs are still enormous. A new generic drug (i.e. a new manufacturer) has to submit an aNDA to the FDA (of which there is a massive backlog). There are CROs who are able to meet all the regulatory requirements, but a huge amount of work still fall on the manufacturer.