I read the comment as proposing only that the NSF (or someone) run the trials for old drugs that are already widely used, in lieu of the current odd system of re-monopolizing drugs that had previously been widely available as generics.
For new drugs hoping to win approval, which are inventions and are already granted monopolies via patents, things could still work the current way.
For new drugs hoping to win approval, which are inventions and are already granted monopolies via patents, things could still work the current way.