Companies are given monopolies on drugs because in order to make a profit they need the exclusive right to sell what they spent millions discovering. (Just as authors own their books and singers their recordings). They aren't charities, they are companies that test a few thousand chemicals, find one with that has some effect and then do the legally mandated 10+ years of clinical trials. Add the cost of being sued when it all goes wrong and the salaries you pay people with medical skills, and of course it isn't cheap. The rarer the disease the more expensive it is -- as there are fewer custormers to offset the research costs.

Pharmmeceutical companies need to be regulated, but not driven out of business... then there will be no moral dilemma because there will be no new cures.