Should the government be allowed to negotiate drug prices for Medicare patients, as Bernie Sanders' bill and Democrats say, or have to pay full price, as Republicans say?
This is a trade off. The US market props up the entire worldwide pharma industry. Most of the revenue generated from pharma comes from one country- the USA.
Without this market, pharma would be much less profitable, and the innovation we have seen in the industry over the last couple decades would absolutely suffer. Risk taking is inherent in drug development, and when you have less reward, you simply don’t take risks.
You really, really, REALLY want innovation in pharma. It’s literally keeping many of us alive. Look at the mRNA vaccines for a recent example, and look at statins as an old one.
Thirty years after the first statin was out, we now basically have millions of people on this incredibly cheap drug that noticeably has reduced cardiovascular death and complications all over the world. None of that would have happened without the huge investment into clinical trials over the last few decades to expand their use and understand their impact. The dollars for those risky studies came from US spending on the drug and the knowledge that the US would spend even more if we showed the drug works in specific areas of disease.
The pricing in the US is the result of a simply insane system. Insurance companies, PBMs, government run programs all combine to make high prices to the consumer a thing, because no one actually pays full price for any drug out there, except for some unfortunate patients.
The weird ‘coupon’ system that exists, and odd generic pricing and restriction on your pharmacist being able to tell you cash price is lower than an insurance copay are all symptoms of the mess.
Removing patent protection would be a potential disaster, Allowing Medicare negotiation would reduce revenue to the companies. That’s fine, but realize the consequences. The cost of that is innovation. And if we’ve seen anything over the last 20 years, it’s that the current system is ridiculously innovative.