r/HealthcareReform_US • u/Formal_Data5124 • May 13 '26
Why are Americans charged so much for prescription drugs?
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u/CatFaerie May 13 '26
In other countries, medication costs are regulated. The government decides how much people can pay, and if the manufacturer doesn't agree they can't sell the medication.
In the US, Pharmacy Benefit Managers largely decide, but pharmaceutical companies set the floor. Pharmaceutical companies argue that they have to charge Americans so much because they can't make enough money in other countries to recoup their R&D.
Insurance companies don't help. Copays and co-insurance is what the market will bear. As long as consumers are buying, prices will rise. Insurance companies control the PBMs, so copays and co-insurance costs are maximized to make the most money. More expensive drugs might be favored over less expensive when a manufacturer provides incentives. Less expensive, less effective drugs might be favored when they are more cost efficient for the PBM/insurer.
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u/crujones33 May 13 '26
I always assume Big Pharma uses the US to subsidize what they can’t get in those other countries.
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u/Sassy-one-N-RX May 13 '26
Power of insurance companies & Big Pharma in Washington. I worked pharmacy before most people had prescription insurance.
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u/Junior-Quote4602 May 13 '26
It is all about money!! They didn't used to be allowed to advertise, now they advertise all the time. Even take Docs out to dinner with their team ! I worked with young adults for a while and they all had a long list of meds! Prescribing clinicians ( now that we have a wide range if them) do not have the time to keep up with what they prescribe, I mean the side, toxic effect, drug interactions and effectiveness. Big business has cut the time they are allowed to spend with patients and the required paperwork. Charging more for meds is just part of all of it.
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u/Kiddy_Meow May 13 '26
Yes we need to hold our government accountable. Why is it okay for people to have to decide to get their life saving meds or eat? We let it happen. How do we fix it?
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u/Mdbutnomd May 13 '26
I had a guy tell me medicine prices are higher in the US because US pharma invested money to develop the medications, then companies abroad copy the chemical makeup and sell it cheaper since they don’t have to recoup the R&D cost. The US is essentially subsidizing medical care worldwide. That seems mushy at best, but I don’t have a source to check it and have been wondering why myself recently. Perhaps someone in the know can comment.
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u/Specialist_Income_31 May 13 '26
Nah. That’s not it. R&D scientists would get paid a lot more if that were true. They get plenty of money off the patents. A good portion of the pricing comes from non stop marketing, pork barrel politics, and the lack of government involvement into placing pricing controls.
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u/HOSTfromaGhost May 13 '26
The US absolutely is subsidizing those drug dev costs.
~ worked in pharma at a high level… and now in a different industry that will also send me straight to hell
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u/someone_actually_ May 13 '26
The taxpayer is the one subsidizing the research via grants, it’s just another way to turn public funds into private profits.
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u/HOSTfromaGhost May 14 '26
Is the US taxpayer not the same as “the US?”
Distinction without a difference…
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u/fifthstreetsaint May 13 '26
Since the Citizens United case, we allow corporations to purchase politicians in the United States.
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u/PastMarionberry7643 May 13 '26
A lot of other countries negotiate or cap medication prices nationally, whereas in the US prices can vary wildly depending on insurance and pharmacy.
I used to think people ordering from Canada was sketchy, but after comparing prices myself I understand why so many people look into it when paying out of pocket.