If a drug is under a patent, the generic form still pays royalties to the patent holder, so of course it's still expensive.

not entirely true. semaglutide is a great example. the FDA allows compounding pharmacies to make semaglutide because wegovy/ozempic are sold out and therefore have limited availability. compounding pharmacies are allowed to sell their own royalty-free in this situation! wellsrx does just this (probably with chinese sourced semaglutide)