Not mentioned: the US research complex and healthcare spending subsidizing development of state-of-the-art therapies for other countries.
They don't bear the cost so expecting the US to do better at same or lower cost is structually impossible.
They don't bear the cost so expecting the US to do better at same or lower cost is structually impossible.
Is the cost of funding the "research complex" included in the expenditure on health care?
At least some of this cost is born by the Federal government, foundations etc, is this counted as general health care expenditure (I doubt it)
Some of the research is funded by companies - since they sell globally this funding cannot be counted as purely of US origin.
Other countries also have significant health research - e.g. UK, France, Germany - your point would also apply to them.
Overall your point is dubious, and vague - you'd need to present some solid numbers to back it up.
Specific claims:
- The US pays more for new drugs than the rest of the world
- The US contribution is disproportionate, and is major driver of the drug development industry.
-If the US paid less for new drugs, the entire industry would slow, and we would have fewer more effective treatments.
...
Routine medical procedures being crazy expensive is unrelated and pathological.
Given how pharma companies operate, I kinda doubt it.
To compare costs: For an extremely rare cancer, total cost of treatment was 100k EUR in Germany, whereas US patients report case costs of >2m USD.
Part of these savings stem from the public healthcare system not providing adequate treatment, while strictly necessary for a reasonable chance of survival in this case. What happens in Germany then is the amazing doctors do stuff anyway (if you can convince them), bill whatever they can, and write off the remainder. Profits from privately insured patients make up for this shortfall here.
Public healthcare being adequate is somewhat of a myth, for Germany at least.
this 2017 article[2] claims that the US pharma $ premium is more than R&D spending for 13 of 15 top pharma cos. (Note: this isn't even talking about profit, it's talking about the excess profit from higher US prices). Maybe you can make an argument that R&D is lockstep to margins, and would shrink if margins went down?
1. https://www.hhs.gov/ohrp/sachrp-committee/recommendations/no...
2. https://www.healthaffairs.org/do/10.1377/forefront.20170307....
I would suggest The Great American Drug Deal, by Peter Kolchinsky.
Also - https://www.rand.org/pubs/research_briefs/RB9412.html
>For example Cuban healthcare/treatment/outcome is excellent based on its own research
Cuba does not contribute substantially to global pharmaceutical research.
>Roche(Swiss) nor Merck ( German, not related to US Merck) don't benefit much (if at all) from US subsidies.
Roche makes 55% of its revenue from US drug sales (https://assets.cwp.roche.com/f/126832/x/db9d31e8a7/fb20e.pdf p22)
EMD Serono (formerly Merck KgAA) is similar.
These revenues are the topline driver of the drug development industry.