The pharma business used to have spectacular margins, 20 years ago. The ROI of new chemical entities has been falling since the 1990s. Pharma companies have been shedding personnel and facilities and merging for a long time to keep stock prices up. They're having a hell of a time coming up with new patented products that are broadly useful and better than generics, so direct-to-consumer advertising is one of the few avenues left to boost revenue. It's funny how corporate arrogance and desperation can look so similar.
This is a great example of what my comment is saying. There is no obvious silver bullet because everything in the US costs more than in other countries.
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Also, per-capita government expenditures on health care in the US are actually higher than in Germany[1]
1: https://data.oecd.org/healthres/health-spending.htm#indicato...
"Ask your doctor to prescribe you this"? what the hell.