As a result, the medical industry is less competitive than other industries. Also, it’s seen as ethically dubious to compete on saving lives. Instead, there’s a lot if in-licensing deals (see above re patents) as opposed to trade secrets.
Plus the clinical trial process is extensive. It would be much harder in the present regulatory regime to have a new BS prescription drug than a new BS testing startup, like this one or Theranos. (Old drugs are a little different - some were grandfathered into the current testing regime and evidence for their effectiveness is in some cases limited.)
Certainly there are trade secrets in medicine, but not everywhere.
This is one reason why we have the patent structure, so people can publicly disclose data for validation purposes and still make a substantial profit.
