Population of the USA is about 340 million, population of Canada is about 42 million. Assuming similar statistics of people needing a given medicine, proper cost sharing to result in the same profits would put it much closer to the USA cost than the Canada cost.

It depends on your moral system. Equalizing costs across markets almost certainly reduces the number of people who can be served by a medication.

I'd be really interested to see these costs averaged (like parent post) but then re-distributed by average income...

Um it also increases the number of Americans who can now access those drugs? So whose healthcare is more important to you?

It decreases the total number of people with access. Like I said: it depends on your moral system.

The people paying the most in healthcare costs should be getting priority to treatments and medicine don’t you think? Isn’t that fair?

If you are getting cheap healthcare because these people are basically subsidizing it for you, and they’re not even getting anything, then you’re the leech.

These people laughing at Americans having to go bankrupt to afford $1000 medicine that they only have to pay $10 for in their country: fuck em. How I wish we could distribute the costs evenly…

Depends on your moral system.

How do you know what their profit margins are in each country?

How much profit is enough?

Since most non-biological medicines don't cost very much to manufacture at all; enough profit is enough to cover that drug's R&D and the R&D of the 9 other drugs that didn't pan out. If the US market can cover all those costs, then whatever you get out of other countries is gravy. If that ceases to be true, then other countries will have to pony up more money or go without.

This is flamebait. Nobody with a cursory understanding of a market economy thinks in these terms.

Yeah man that's what they do. They sell it at a loss in Canada and then profit in the US to make up the loss. That's definitely how it works.

Let's hope they never discover that they could just not sell it in Canada at all and make even more money.

I'm not certain if there's a specific example you have in mind but as a Canadian familiar with the pharma market you can rest assured that Canada (sometimes through the hidden mechanism of government subsidies) pays well above cost for every medication and medical device I'm familiar with.

Sure, companies are gouging the US worse - but they still make a tidy profit in the Canadian market.

I was being sarcastic

Oh my apologies - the internet and my habit to take things literally got the best of me.

No worries, I should have added /s to make it clearer.

This theory that American prices subsidise the rest of the world has really caught on in the US but I have never seen any evidence for it.

Most common drugs are out of patent anyway, so there should be no barrier to low cost production anywhere.

Moreover the EU and China give huge funding to basic and specific research, which forms the basis of many drugs. For instance the RNA research that gave us COVID vaccines was completely European from start to finish, only production then involved American companies due to scale benefits and market access.

On the contrary where the evidence is obvious is that the US pharma companies have amazing profits (such as the few Europeans that sell at scale in the US).

My personal, unscientific, take is that the entire narrative that the US prices fund global low prices is completely unfounded and just an attempt by big pharma to get the US government on their side to break fair pricing mechanisms in other countries.

The COVID vaccine is such a great example too, because the US government negotiated it's price as part of getting it regulated and distributed, just like other countries do for all sorts of medicine.

The US admin negotiated them down to $20 a dose IIRC. Billions of dollars to just do scale manufacturing of a drug someone else slaved over, invented, stood behind for a decade while nobody else cared, and quickly utilized to deal with a novel virus that seemed to evade normal vaccine strategies.

$20 ain't nothing, but in our terrible system, it's almost a bargain.

And the shareholders of the Pharma company involved were fucking incensed that they didn't get more money.

They are ghouls.

But no, lets keep insisting that the US government couldn't negotiate prices for drugs to save Americans a significant chunk of change despite the fact we have a recent and obvious example of them doing a good job of it. Let's keep insisting that Democrats are in bed with Pharma and profit off our costs even though it was republicans who banned import of cheap drugs from Canada and republicans who refuse to allow Medicaid to negotiate meaningfully.

Pharma companies are public. You can see how much they spend on R&D. The claim is false.