UK licencing and submission to NICE hardly costs in itself but like FDA or other foreign licencing, there is an R&D cost in clinical trials, because you don't bring things to market until they perform better than either placebo or current alternatives.

The pharmaceutical industry will of course protect patents and there is no profit to claw back your costs in such compounds. A bit of a catch 22 of course but Whilst I am certainly no apologist for a cynical marketing strategy by the whole industry, I do feel comforted by the clinical trials regime. Therapeutic positive treatment needs side effects to be studied too.

After all, if it weren't for such studies, Pfizer might not have put their angina pill on the market as it wasn't too effective, but then, Viagra was found to have a certain side effect that altered their marketing strategy....