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Comment by chongli | Hacker News Reader

Why can’t they make carveouts on a country by country basis? So they lose in the EU and Japan, but they could still maintain their profits in the US.

Look at the world of pharmaceuticals. Drugs are way more expensive in the US than most other countries. Big pharma companies make nearly all of their profits in the US.

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> Drugs are way more expensive in the US than most other countries. Big pharma companies make nearly all of their profits in the US.

I wonder how sustainable this is. If the US imposed the same regulations on drug makers that the EU does, would there be a material effect on quantity or quality of drugs available across the entire globe? To what extent is the US subsidizing the low cost other countries like to brag about?

> To what extent is the US subsidizing the low cost other countries like to brag about?

None whatsoever. It's preposterous to even consider it in a serious manner.

Most of the work of drug discovery is not done by the pharma companies, it's done by publicly-funded research labs. What big pharma pays for is the elaborate (and very large) clinical trials which are required by the FDA before a drug can be sold.

One simple change the US could make is to direct the FDA to fast-track approval for drugs that have been approved in other countries the US considers to have high enough standards of rigour, such as the EU or Canada.

I think people are generally more wary of importing drugs than electronics, and it is really easy to import bits from other countries.

Tech companies can definitely put up lots of hurdles here and might even manage to defeat their customers. But at least there will be some possibility to work around it…

I’m not sure how you could work around it. If you wanted to, say, import an iPhone from Europe then Apple could gate access to the App Store based on your IMSI. Then you’d need a European SIM with your imported phone, so you’d be roaming all the time. And presumably Apple could detect that you’re roaming and just redirect you to the US store anyway, disabling any 3rd party app stores anyway.

> Why can’t they make carveouts on a country by country basis? So they lose in the EU and Japan, but they could still maintain their profits in the US.

I wouldn’t be surprised if they do so just to spite.

That would still matter quite a lot. Imagine a world where every country on earth would pay drugs as much as the US does.

So you run a Japanese VPN, install all the apps you want from App Store alternative, and turn off the VPN.

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