Presumably, R&D costs should be shared across all countries rather than individual countries footing the bills. Alternatively a cost benefit from such R&D spending such that US R&D subsidies resulted in free drugs for the US market would be acceptable.
Instead, the US both has the largest R&D subsides and the largest drug prices.
This requires some IP protection. Even if it's weaker than in America, at least some. Many nations adopt the stance that if it wasn't invented in their nation, screw the other guy, they're taking the IP. Many first-world nations, including Europe and Canada, do this and use the threat thereof to force down prices because their socialized medicine does not provide sufficient funds.
IP protection isn't a big deal for countries sort out to give equal ownership for split funding. We even have every major country from the US,Canada,Europe,India,China, and Russia all working the first full-scale cold fusion reactor via the multi-billion dollar ITER project built in France.
Instead, the US both has the largest R&D subsides and the largest drug prices.