Having to prove the new medicine is both better than the old one, with less side effects is indeed a worthwhile endeavor. However, from things I recall, a lot of trials test the new medicine vs non-treatment via placebo, not against the current best treatment.
One other issue is a lot of side effects are seen many years down the road for the newer targeted medicines. Are the side effects caused by the drug or normal human variation due to aging?
The final thing that needs to be investigated is the people who demand 'medicine' for everything. If you just give them the 'right' medicine, they dont' need to do anything else. See also: prescribing antibiotics for viral infections, weight loss pills, etc. If society is going to be paying for health care, can we as a society force others to live healthier? I would be first on the chopping block for not being quite as healthy as I probably should be, but that is the question everybody ignores.