The US doesn't have to. Rybelsus already costs less than a thousand dollars per month, some of which is offset by reduced spending on groceries/restaurants/coffee/alcohol.

This is the even more effective pill that is about to hit the market:

https://www.lilly.com/news/stories/what-to-know-about-orforg...

>11. How much will orforglipron cost?

>LLilly recently announced an agreement with the U.S. government to expand access to its obesity medicines and reduce patient costs. Upon FDA approval, self-pay patients living with obesity will be able to access orforglipron through LillyDirect's self-pay pharmacy channel with the lowest dose starting at $149 with additional doses up to $399.