The company not existing at all might be worse though? I think it’s too easy to make blanket judgments like that from the outside, and it would be the job of regulation to counteract adverse incentives in the field.

Agree that most companies prioritize profits over lives in an unconscionable manner, but there's a point of diminishing returns where eventually you can save a few more lives, but at an astronomical cost. Auto manufacturers have the same dilemma: spend a few hundred million dollars adding safety features, or nix the features and hope to lose less than that in lawsuits?

Eventually the question will be, how far do we really need to go, i.e. how much profit do we allow ourselves before it's morally untenable and we should plow it back into R&D? Unfortunately, as long as health care is for-profit, and absent effective regulation, companies will always err on the side of profit.