Perhaps the FDA should bankroll clinical trials, subject to a pre-agreed price and a reasonable case that the trial will work out. Monopoly sellers and monopoly buyers is fairer than a monopoly seller.
(1) the FDA regulating access, pricing, and financing to the pharmaceutical industry, effectively nationalizing it, and,
(2) the US effectively bankrolling pharma for the rest of the world (it does this to a large extent already, but this would throw the scales all the way).
It would also have little effect on what innovator (or generic, for that matter) drug companies could charge outside the US.
So instead of private companies employing the top researchers who are jockeying for success in an open market that decides the winners and losers through doctors' and consumers' choices, you end up with winners and losers being picked by politicians, bureaucrats, and lobbyists.
Then when the whole system is ineffective, corrupt, counter-productive, and an enormous wastes our tax dollars (see the current FDA, PTO, DOE, etc.), what will happen? Well, at best, nothing. At worst, the Statists will use the lack of success as an excuse to take over even more of the system. Maybe the FDA would then want to hire the researchers to design and test the drugs in the first place. They would need a bigger budget for that.
In this situation who decides what drugs go into clinical trials? The drug companies are in a much better position to know which drugs are worthwhile, but if they don't pay the price they have to reason not to throw everything at the wall to see what sticks.
