[sanderjd]

You can't realistically discuss "how to do drug pricing in general" without taking into account the dynamic where companies recoup their research costs on a tiny number of hit drugs. It doesn't work if those hit drugs only make a small margin.

[WWWMMMWWW]

You're over thinking it.

Americans are just fatter.

[sanderjd]

That's true, but I'm honestly not sure what you think that has to do with this.

Is your theory that demand is higher in the US and that's why the prices are higher?

I don't see any reason to think that would be the case for a product that is very easy to transport globally. That is, absent other effects, like regulation and the differences between how insurance works in different places, I think this would be a global market with prices driven by global demand.