[kenhwang]

I briefly worked for GSK. It's not like the inefficiencies are limited to only US companies because they can charge more. Nor have I seen the public sector run any more efficiently or effectively (and it's often worse). The reality is that it takes a very large organization to develop a drug and large orgs tend to be run inefficiently.

[kgwgk]

> It's not like the inefficiencies are limited to only US companies because they can charge more.

US companies cannot really charge more than European companies [+]. They all charge more in the US and less elsewhere.

[+] In general, there are also cases where the same drug is marketed by a US company in the US and a non-US company in the rest of the world.

[kenhwang]

The US companies inherently had a home field advantage. Yet non-US companies were willing to jump through the hoops to follow the US drug funding model. If their original funding and development mechanism were sufficient or better, why go through the trouble? Why did all of them do it?

[kgwgk]

I don’t understand what are you referring to. Big pharma companies are multinationals that will adapt to the regulatory requirements and commercial practices of the different markets where they want to operate. Why would European companies renounce to be present in the principal drug market?