Glucocorticoids are very old drugs. If there were a new patent at this stage in the US, it would be a combination drug or delayed release oral form ([source](https://www.patentdocs.org/2018/09/patenting-repurposed-drug...). There's also a dozen alternative generic analogues. There's already a [markup](https://www.washingtonpost.com/news/wonk/wp/2018/06/19/the-g...) for very common drugs in IV form, which is bad, but unfortunately it's a very small part of the ICU bill to begin with in the US.