The problem is recovering all the development costs

Yeeeaaahhh, but no.

There is also a huge amount of plain greed in there, drug companies aren't exactly known for being very generous to put it mildly. Cost of healthcare in the US is beyond insanely expensive and that isn't just because Americans are rich, the vast majority aren't and for many, getting sick is not only a death sentence, it's also a death sentence to the family as they'll be stuck with the medical bills that will bankrupt them.

The US healthcare system is beyond fucked up with corruption and just plain extortion. Wanna live? Say, that's a nice first born you have there!