An analogy: you live in an apartment building in which every other apartment has rent control. Because of this you're going to pay every extra expense for the entire building.
You could decide to become a rent controlled unit as well -- but the building owners would have less money to improve the building, and it would fall into disrepair.
Or, instead, you could try and find a way to get everyone to equitably share the improvements to the building.
And you would know... how?
https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-p...
So what? They clearly believe the marketing helps them make more revenue with the drug; that has nothing to do with covering the cost of R&D.
Your argument would make sense if marketing reduced their ROI, but they clearly believe it does the opposite.
I'm sure developers in San Francisco spend more on housing than on professional/personal development, but that doesn't mean one is precluding the other.
It's only "excess cash" if you assume the ROI on marketing is negative, which is a bold and unsubstantiated claim.
> Also in countries where there’s a public system pharma usually has 0 advertising because people have no choice anyway.
Direct-to-consumer advertising is only one tiny portion of marketing. European pharmaceutical companies spend massive amounts of money on marketing within Europe.
But here's one with unrestricted access [1]: big pharma spends in average 17% of their revenue on R&D, while Apple spends 3%.
[1] https://www.investopedia.com/ask/answers/060115/how-much-dru...
Edit Here's another link that states the average for Big Pharma for 2018 was 20%
[2] https://www.fiercebiotech.com/special-report/top-10-pharma-r...
I think explaining the economic dynamics directly leads to a self evident conclusion: internationally drug prices would increase as US consumers add to demand on foreign markets. Domestic prices would fall for the same reason
Allowing reimportation would do exactly that by increasing (from zero) US demand for drugs from foreign markets.
EDIT: for explaining why.
The reason drugs are cheaper in Canada and Europe is because of the massive negotiating power of a single buyer
OHIP (the government-run insurer in Ontario, to which taxpayers pay the Ontario Health Premium directly) will sometimes pay some or all the cost of some pharmaceuticals in some cases (i.e, antibiotic-corticosteroid ear drops if you are under 25 or over 65, and have been experiencing an ear infection for longer than 30 days) for some classes of people (mostly youth and seniors); but by no means is there a single buyer in Canada, and there isn't one per province either.
I have bought more pharmaceuticals out of pocket in Canada than I have ever been provided during a covered clinic or emergency department visit, and I technically qualify for the youth drug coverage.
The listings for which drugs are covered under what circumstances can be found here: https://www.ontario.ca/page/check-medication-coverage/
Very few countries have single purchasers for pharmaceuticals.
We're not talking about pharmacies; they don't enter the picture here at all.
> If the single payer health plan
Again, almost no country uses a single-payer health plan for pharmaceuticals, so this is isn't relevant.
Why create more laws and complexity? Why not simply repeal the laws that prohibit importation of drugs and possibly also refuse to enforce private contracts prohibiting reimportation? The reason drugs are cheaper in Canada and Europe than in America is because of American laws that prevent importation.