Consider that the cost may be astronomically high because it's possible to make marginally more. It's entirely possible that the same level of drug research can be done for much less money.

For instance, with patents there is an incentive to find a solution first. This probably raises the cost of research because (a) pharmas spend more time researching alternative medicines with different compounds with the same effect as existing drugs simply to get around pre-existing patents and (b) pharmas spend more money to rush research to patent it first.

Also, if clinical trials are the problem, India appears to be willing to help.