I think this is mostly true. Perhaps truer still is that the US willingly had rules that massively reduced their market power in negotiations, which in a game of parallel negotiations leads to the obvious price discrimination. You cannot blame big pharma for giving a client willing to pay any price without negotiations what the client wants: high prices.
One counterpoint is that in my country we’ve successfully reduced prices for medicines a lot by strong negotiations in the last decade. We are last in line among western nations for medicines now. Shortages all around.
And the US isn't paying for the R&D (that sounds like a regurgitated line from somewhere?) so much as paying for the pharma company's profits, due to the US's totally screwed-up healthcare system and situation.
How is it different from the normal market? If I have a product and sell in Germany for 50 USD and Switzerland for 100 USD because that is what people are willing to pay, would you also say that Switzerland pays for R&D while Germany gets it below cost?
That is right, but it is a global market where Novo Nordisk can decide to sell in a country or not, so I do not think they would sell below cost. I agree with the point that the US pays disproportionately much for the R&D portion of the cost, though.
One counterpoint is that in my country we’ve successfully reduced prices for medicines a lot by strong negotiations in the last decade. We are last in line among western nations for medicines now. Shortages all around.