the US and EU could do a mutual acceptance of each others drug marketing authorizations. but it's messy, so there's no political will. USA first anyway. (and the pharma industry probably likes it this way.)

and even then ... the industry is complex, costs are high, funding is always finite, keeping product quality consistently high is a lot of effort, which is definitely not cheap, etc.

many generics "don't break even" as far as I understand

there's a lot of potential for having some kind of centralized mass-manufacturing setup of these low-profit drugs. but the cautionary tale is the baby formula brouhaha. it shouldn't be a single point of failure. but then it's not that low cost, right? so it should be some kind of industry-wide system. (ie. every big manufacturer should have some capacity that is pooled for these. but it must not hinder the market, it must not be a barrier to entry, and it must not lead to manufacturers exiting the market. so many considerations and challenges.)