I had a buddy who worked in compound research. He did get paid pennies for his work, but he also told me about all of the costs. Each monkey for a trial is like $10k, and you often need dozens of them.

They pharma companies are take a lot more than they should for sure, the staff are way underpaid, and now they're basically getting away with skipping all real research and safety trials .. but even if the system wasn't corrupt as it is now .. the costs are not trivial.

Countries without the same medical patent laws just manufacture the same drugs without paying into the research either.