Most western countries are subsidized by US pharmaceutical innovation.
I am also aware that almost every drug advertised on TV (and available as a treatment) is now narrowly targeted to specific conditions of specific diseases rather than broadly. Yet, even when we were seeing Tylenol and Ibuprofen developed, the arguments for the "expenses of innovation" were the same.
I suspect it's hand waving away corruption. The number of large pharma companies going out of business is very small, meaning they aren't assuming risk that would justify the "expense of innovation" reasoning, in the US.
"Manufacturers say decent returns are needed to reward high-risk research and prices reflect the economic value provided by medicines. They also point to higher U.S. survival rates for diseases such as cancer and the availability of industry-backed access schemes for poorer citizens."
https://www.scientificamerican.com/article/how-the-u-s-pays-...
http://rooseveltinstitute.org/wp-content/uploads/2019/02/RI_...
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Contrary to the industry’s claims, unaffordable prescription drugs are not the price we must pay for the industry to find cures and innovate affordable medicines; rather, it is the price tag we pay for an industry that values profits over patients and public health.
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Despite ample revenue and profits, however, R&D spending has been relatively stagnant. While industry revenue increased by 45 percent, or $241 billion from 2008 to 2014, industry spending on R&D increased just 8.5 percent in that same period, from $82 billion to $89 billion (GAO 2017). By some measures, R&D expenditures are actually falling, as more firms are outsourcing R&D to third parties. In that seven-year period, purchased R&D increased from $20.5 billion to $31.2 billion while in-house R&D fell from $61.7 to $58.2 billion (GAO 2017). Finally, the industry can only claim partial credit for recent medical breakthroughs. The federal funding provided by taxpayers contributes around 25 to 30 percent of all R&D spending per year, and a Bentley College study found that all 210 drugs approved between 2010 and 2016 were rooted, in whole or in part, on National Institute of Health (NIH)-funded research (Cleary et al. 2017).
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>The United States, which leaves pricing to market competition, has higher drug prices than other countries where governments directly or indirectly control medicine costs.
Leads me to believe that it's so expensive because it can be.