“And it is clear that the problem with most drugs that are deemed not cost effective is not that they are not effective, but they are too expensive. “
Actually a lot of new drugs offer minimal if any benefit over existing drugs. (That is particularly true for cancer.) But in any case the US is one of the few developed countries that does not regulate in any way the price of prescription drugs. What in fact happens is that in the US, for-profit health insurers are the ones making most of the decisions for what to cover.