As a GP I hand out synthetic drugs on the NHS on a daily basis. In my 30 years as a doctor, hundreds of new drugs have come onto the market. A few of them have been very useful - for instance, we no longer have to chop half the stomach away for people with ulcers, as we can now give them PPI drugs (ones ending in -azole) to suppress acid production. This still begs the question of why so many people are producing too much acid, but we must not divert from the point.
With every genuine advance comes a flurry of "me-too" drugs, variants on the theme.
Most pharmaceuticals are directed at chronic disease like arthritis, because the patients have to take them for years. Which is good for sales.
Now all these drugs are synthetic, and under patent for 20 years, so that the developing company can recoup their investment. After 20 years, generic companies can move in and produce the drug - cheaper, but sometimes the quality is not so good.
Now, here's the point: arguably the best advance that I have seen in arthritis is not a synthetic drug, but a nutrient called Glucosamine. This is the building block of the joint bearing surface. It is dirt cheap, (£10 for a year's supply, if you can find the right place) almost free of side effects, and not only does it ease pain and stiffness, but also it slows the rate at which the bearing surfaces wear away. (There is some anxiety that the NSAIDs that we give may accelerate this wearing).
So good is Glucosamine that we can even prescribe it on FP10 (ie on the NHS). Amazing. Although it had been around for a decade before it got that status. Why? Because it is natural, nobody was motivated to do the necessary safety and efficacy research to get it onto FP10.
So the Patent route is skewing drug research to expensive synthetic drugs, and excluding potentially beneficail natural nutrients, methods and herbal medicines.