You've hit upon an issue that people have been talking about for a long time: that the drug companies will not open up their books to reveal their R and D costs for new medications. There's a figure of $2.6 billion that's bandied around as being the cost of getting a new drug to market. That kind of figure is based on confidential data that won't be released. If drug companies want to prove that they need to charge these significant amounts of money that they do for new drugs, then they should prove to Canadians and to insurers that those prices are actually justified. However, so far, they haven't.
When you look at some of the other countries.... For instance, you were pointing out that Canada is just behind the U.S. and Switzerland. In Denmark, where there aren't any bodies lying around on the streets due to lack of drugs, they spend $240 per person per year on medications versus over $700 per person per year in Canada.