The problem is that it is not actually a free market. The government grants monopolies to prescribers, restricting access that way, and to drug manufacturers, through the FDA, directly or indirectly (it's crazy to me that the government grants these monopolies and then complains when businesses take advantage of them financially). Then you have the insurers, who are not actually the beneficiaries of the product and who are therefore not in a position to fully judge the benefit:cost ratios of the products.

To me, the problem is lack of competition. The government should remove or sharply curtail licensing laws, or expand them to other professions substantially, and eliminate or loosen drug schedules (the new kratom fiasco is just one example of many spanning decades of how inept the government is at regulating substances). Basically, decriminalize and deregulate drugs completely. Let the FDA focus on purity and rigorous testing and education, but take away its regulatory authority beyond that. Let pharmacies produce more drugs, and get the government in the business of producing drugs. Nothing will drive down drug prices faster than a public entity producing drugs in competition with private corporations. Give tax incentives to businesses for producing or researching drugs in the public interest.

It's madness to think that somehow problems with overregulation and monopolies are going to be solved by increasing regulation and monopolies.