The true cost of bringing a drug to market - inclusive of the extensive research and development required, the failed candidates, the FDA testing and approval processes, etc. - is around $2,800,000,000.

And so, as the saying goes, the first pill costs $2.8B, the second pill costs $0.01. "People" only consider the $0.01 cost to produce the pills that they desire to take, and seem to easily ignore that initial $2.8B investment. This is why patent protection is so critical to the success of many industries, especially medical devices and pharmaceuticals.

This also explains why drug companies refuse to develop life-saving drugs if the potential market for the drug is too small. In many cases, they would have to charge $1,000,000+ per treatment to break even. There are several medications on the market which, for the full course of treatment, cost around $300,000. This seems to be the upper limit in drug development, and insurance is willing to pay the price because one successful treatment will likely save them 10x that amount in the elimination of future care.

This is a recent (3/2/2017) article [1] on one such $300,000/year enzyme-based treatment for a rare disease which affects an estimated 5,000 to 10,000 people worldwide! Development of drugs for rare diseases has been a major problem for quite a while, with legislation on the matter dating back to 1983. However, it's apparent that it's still a problem.

And here is another article on yet another $300,000 treatment (see, there's that number again) to treat cystic fibrosis.

[1]: http://www.cnbc.com/2017/03/02/pompe-drug-lauded-by-trump-co...

[2]: https://www.statnews.com/pharmalot/2016/09/19/sarepta-duchen...