Yeah, there would be huge profit in curing -say- cancer.

My dermatologist was dx'd with a similar lymphoma/same year as my wife. She went into clinical trials, hoping for the brass ring.

He went into a bone marrow transplant program, also hoping for cure.

Both are doing well 20+ years later. Both therapies developed with cooperation of the NIH.

That the orange stable genius has shitcanned the NIH is unfathomable. Lots of people will die because of his sheer, arrogant, ignorant stupidity.

Tangential to this, however, are orphan drugs. It's not profitable to make the drugs because so few people have condition X

That's true. It would be cost prohibitive to make monoclonal bodies for every idiotype of every cancer.
The earliest form of Biogen's blockbuster drug, Rituxan, was a personalized monoclonal antibody custom made from a patients specific tumor sample. The cost was ginormous. So, Stanford's Dr. Levy created the modified MAB that targets all b-cells (malignant and healthy). The downside; it wreak havoc with one's marrow (immune system). The upside, it's relatively affordable, easy to tolerate, and can result in long long remissions. (lymphoma killed JackieO in 5 years. Onc says my wife's in good health ;-) except for the cancer in complete remission.

I've wondered if one could persuade a guy like Dr. Levy to make a personalized MAB on request (for those who don't have to ask what it costs)