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Your starting premise relies on the idea that the costs associated with making drugs are justified. In essence, this implies that the insane rewards are justified because risks associated with not producing a drug are so high.
Most of our science is funded via taxes and controlled by the government, given to researchers through grants that are awarded based on merit as determined by their peers. We've developed an adjacent system where drug discovery is funded by capital and investments from non-scientists based on the idea that "striking gold" in the medical world could make them rich.
Why not just remove the cost-barrier to entry? Require all drug discovery to be funded through grants like other research? Pay people working on drugs whether they discovered a new drug or not, as long as they provided proof of their efforts? Researchers would not need to please those with money (banks, investors) to give them funds for a drug, and so would be free to work on drugs that have a low likelihood of being profitable (such as for forgotten illnesses, or using cheap and widely available medicines in novel ways). And when an amazing drug was discovered, our society would be free to use it efficiently and at-cost, since there wouldn't be stakeholders hungry for their massive payout.
The grant system is a mess, also. And in an ideal world those whose ideas and research led to amazing discoveries would be rewarded extensically somehow, both with appreciation and a reasonable amount of money (the staff of an entire research organization could be set financially for life for a tiny, tiny fraction of the amount of money we shovel over to pharmaceutical company stakeholders). And all of this is also tied up in the clinical medical industrial complex, with all its own neuroses.
So there are barriers to implementing something like this... But holy shit do I hear this idea a lot, that high risk justifies the insane rewards. I think it's bogus!