What an amazing system! Poof! just like magic you can pretend that sophisticated medicines, that are years in development, should cost nothing just because! And then you can act all smug about it!
Not at all. The majority of the cost is subsidised by the Government who acts as a central purchaser to minimise profiteering and keep prices down.
Everyone pays a little bit towards it all via general taxation but if you prefer a system where individuals have to front the vast majority of their own costs, much of which is just being extracted as profit, then you are welcome to that. I prefer the option that leans a lot more towards socialism than rapacious capitalism.
The NHS prices in the Issue #2 analysis are not subsidies. They are the generic reimbursement rates from the UK Drug Tariff after patent expiry on each molecule. Apixaban (Eliquis) costs £1.16 per 30-day supply on the Drug Tariff. That is what the open market charges for the active compound once patent protection expires. The NHS does not manufacture it or subsidize the price: that is the market rate for the molecule itself.
The $862 Medicare gross cost for the same molecule is not explained by active R&D recovery, either. The IRA's first ten negotiated prices (effective January 2026) cut Medicare gross costs 40-70% per drug, which does not happen if those gross costs were development-cost-justified.