Not everyone is put off by cost.  Some homes are expensive, some...

Not everyone is put off by cost.  Some homes are expensive, some cars are expensive, some clothes are.............  People spend what they can when it comes to staying alive.  I'm quite certain more than few will also do that when it comes to non-lethal diseases too. 

Off label use is between the client and the healthcare provider. See the FDA guidance, Understanding Unapproved Use of Approved Drugs "Off Label"

On a different tangent.

The label extension possibilities are also enormous, investigation into that has already begun before there are labels to extend.

Other organisations/businesses are putting them through the necessary trials. The NIH LVAD trial is an example of another organisation, the trial at Boston Childrens Hospital is funded by one or more private foundations.   Clearly there is no label yet to be extended but you get the idea?  The NIH funded LVAD trial presentation on the 11th is to vascular surgeons, maybe one day that will lead to uses outside the heart needing vascular repair, but that is pure speculation on my part.

Mesoblast plans to extend the label on the pediatric use of remestemcel-L when granted to adult chronic GVHD use in the US. 

I suspect the lists of label extensions will go on, and on, for the products as they come to market.