Big pharma

Listened to a conversation today about the high costs of medications and the impact they are having on health services all over the world as well as individuals. The argument, as always, was that big pharma was charging way too much for life saving medications and the counter to that was “well, yes, but they do have high R&D costs that they need to cover”, hence the justification that the inventor of a new drug should get a monopoly for a number of years and during that period they should be allowed to charge what they please so that the costs are covered and a healthy profit to boot.
Well, yes, but there are some fundamental flaws with this argument. The first one I can come up with is that there is a built in incentive with the present system for big pharma not to try and discover cures but rather medications that will alleviate the effects of conditions/diseases. This would mean that they would be able to charge a lot more over the lifetime of the patient who would need to come back and buy more of the product. Cure the patient and you never see him again.
The second problem is that the present system incentivizes big pharma to concern themselves with R&D on diseases of the wealthy. Imagine their investing millions on a new malaria treatment where the client base can hardly afford their next meal. Given a choice of spending R&D resources on malaria treatments or boldness then you can imagine that the search for the boldness treatment would win in most cases.
One interesting proposal I heard of recently (one that sadly I do not think has a hope in hell of happening) is changing the system so that new products would come in one of two classifications. One would be of cures for diseases, where the medication would be offered at a very low price, the cost of production with no R&D element taken into consideration, but the incentive for the pharma company would be that they reach as many people as possible as their final reward would depend on the final number of people benefiting. This reward would then be quite substantial and would be paid out by a number of governments under some UN scheme.
The next classification would be for non disease medications where the pharma company would be able to, much the same as in today’s environment, reap the monopoly benefits of a patent for a number of years.
I am pretty sure that loopholes would be found and exploited in such a system, but at least it would be better than the present system we have going that sees big pharma getting richer and richer at the expense of untold third world lives.