The problem of affordability and accessibility of life saving medicines and the decline in breakthrough drug innovation has been a global public healthcare crisis for decades. Several policy and regulatory reforms have been targeted towards solving this problem. The World Trade Organisation’s (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) enacted in 1995 had a significant impact on healthcare reforming the approaches that countries had in place prior to TRIPS. It requires that all WTO members provide patent protection for medicines. This is aimed at facilitating pharmaceutical innovation through patent protection allowing companies to recoup their R&D investments and incentivise further innovation. Paradoxically, the patent eligibility of both breakthrough and incremental pharmaceutical inventions has led to strategic patenting practices that enable pharmaceutical companies to prolong their market monopoly causing extended period of inflated drug prices. This paper argues that the existing patent system does not support the creation of affordable and much-needed pharmaceutical innovation. We find that it encourages incremental rather than breakthrough innovation, resulting in, what we call, the ‘Dorian Gray Paradox’. We urge all the stakeholders to work together in experimenting with new arrangements and models with higher degree of openness aimed at maximising the balance between private and public interests in medicines for the future.