This is a pretty tremendous issue for people with AIDS in the Third World. The generic version of the drug costs $170 per month, while Novartis' branded version costs about $2500 per month. Indian generic manufacturers are the primary source of the drugs for many poor countries.
“About 80 per cent of anti-AIDS drugs and 92 per cent of drugs to treat children with AIDS across the developing world comes from the Indian generic manufacturers,” says Leena Menghaney of Medecins Sans Frontieres (translated from French as Doctors Without Borders). “India is literally the lifeline of patients in the developing world, especially in the poorest parts of Africa…If Sec. 3(d) is overturned, it means any meaningful effort to make these vital medicines available will be put in jeopardy.”
As far as I can tell, there's no need for-profit pharmaceutical companies. A lot of what they do starts from publicly available basic research done by academics and government scientists. They then carry the ball across the goal line and get patents that allow them to make tremendous money. Instead, we could turn research and development over to academic researchers funded by government grants, and set up a Fed-like body of scientists that would pick the best projects and farm clinical trials out to contract labs. The creative work can be done by smart people seeking glory and tenure, and the grunt work can be contracted out. The resulting knowledge would be open to all, and generic manufacturers could crank out cheap pills for everyone in the world.