How much of the problem is actually the way (big) pharma conducts research? ( I know that I am over simplifying and dozens of startups are focused on improving the way research is done)
From a manf process standpoint, there are cheaper ways to create these compounds. Generic drug manufacturers have proved that ignoring the cost of research, the drug itself costs next to nothing to make, market and sell.
From an economics standpoint, healthcare costs are a significant part of GDP. In an ideal model if all research is funded directly via government grants and the key research is licensed through a free licensing - It should create a very competitive drug cost model.For a healthcare practice standpoint, legislation can really help. Stripping down some of the malpractice laws are a good starting point.
Additionally, the monopoly on medical education should be broken - Making medical education a national priority is a key step. We also need to make sure, that doctors are not the only healthcare providers. Enabling entrepreneurship among non doctor(nurses, mid wives etc) medical practioners can increase the market supply.
These 2 actions in theory should create more doctors and reduce the cost of practicing medicine.