[dghlsakjg]

What a take.

I have no idea what Americans overpaying for healthcare has to do with a Danish drug company participating in the Canadian Healthcare market.

I’d rather thank the Canadian government for having a drug pricing review process.

If these companies don’t want to sell their drugs here, no one is making them. They are still here, so I think it’s safe to assume that they are still making money.

[twoodfin]

I don’t think it should be controversial to say that if the US imposed a Canadian-style price control regime on more than the handful of drugs currently regulated by Medicare, the future number of drugs developed and commercialized would drop significantly.

It’s just basic addressable market vs. development cost math.

[dghlsakjg]

The drug companies in Canada are part of the drug pricing process. Their development costs are considered. In exchange, they get additional monopoly priveleges on patented medicine.

Canada doesn’t even have particularly low drug pricing compared to the rest of the world, the opposite in fact. Canada just had low drug prices compared to the most expensive market on the planet.

It’s possible that lower drug prices in one country would disincentivize a global industry that touches almost every human on earth. Or it could not.

[phatfish]

Would the number of drugs developed drop, or would a few luxury yacht companies go bankrupt?

[twoodfin]

The number of drugs developed would drop. In particular, the really expensive to develop drugs that target rare conditions, exploit novel pathways, or require difficult synthesis.

The kinds of drugs that routinely experience years of delayed availability in markets like Canada and the UK until the learning curve has kicked in via the US and other less constrained markets.

[loeg]

It's unambiguously the case that the US subsidizes drug development for the rest of the world, including non-US pharma companies like Novo.

[dghlsakjg]

Just because they extract massive profits from the US market does not mean that they would stop operating if they only extracted healthy profits.

[loeg]

They would continue operating but fund less speculative drug development.

[dghlsakjg]

Maybe.

Personally, I think that they would cut other cost centers before they cut the only department that ensures their long term success

The industry could save tens or of billions per year by not advertising (this is a US thing, drug ads are nonexistent in many places), and eliminating pricing games, cost rebate programs, coupons, drug reps, etc. These are all significant costs and friction that don’t exist in most other countries.

My personal feeling is that claiming that the worlds least cost efficient healthcare system with many layers of added complexity is the driver behind pharmaceutical budgets is marginal.

And of course you have to consider that a significant portion of drug research costs are paid by government and other institutional grants