I didn't say they were on the market in other developed countries, since the drug approval bodies in those countries tend to face similar incentives. My point is that the process which requires drugs, even many existing generics, to go through extremely extensive testing for each possible application, is a problem because it means that only very large companies have the financial wherewhithal to get drugs through approval, and there is a strong incentive to focus on drugs which will be big sellers in a large market, rather than drugs for smaller markets.

The trouble is that one does not see what was prevented from existing.