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If it’s true that imposing drug price controls - while a politically popular move with 2020 looming - will reduce drug innovation, it’s hard to see pharmaceutical companies agreeing to this unless Trump makes it worth their while. Has to be a win-win here though for both sides.
2. If Trump could get EU, Canada, India etc to pay more for US drugs, that could offset any profit losses drug companies may face from a US price control regime - that in my mind is the better win-win: have more countries contribute to R&D they ultimately benefit from.
3. At present, part of the reason prescription drug prices are higher in the US than in Europe is because Europe dictates the lower prices they’re willing to pay (the threat is they can vitiate US drug patents and make copycats).
4. In a way Europe does pay more for drugs—in the form of reduced access. Of 74 cancer drugs launched between 2011 and 2018, 70 (95%) are available in US. Compare that with 74% in the U.K., 49% in Japan, and 8% in Greece. They’re willing to deny treatments if it saves money.
5. In the US, 95% of cancer drugs can be available within 0-3 months of being released vs as much as 26 months delay in Belgium (which receives just 53% of new cancer drugs available), 25-month delay in Czech Republic (which receives just 40% of new cancer drugs available)
6. While countries have lengthy fights about how much the health system will pay, in US drugs are available almost immediately after approval. Better (and more expensive) quality care is partly why US outpaces 10 European countries on cancer survival rates…
7. Very expensive cancer treatments such as the new immunotherapies for cancer are more widely available in US than in countries with national healthcare where there are restrictions based on cost/benefit and budget caps.

Why global royalty often travels to US for treatments.
8. Larger question is whether a society can afford to spend what US spends to get low single digit improvement in cure rates and and to prolong survival by a few months especially at the end of life…
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