Yes and the factors are the costs of accepting the government granted monopoly pricing (free markets don't have government saying you can't sell this thing beca

Yes and the factors are the costs of accepting the government granted monopoly pricing (free markets don't have government saying you can't sell this thing because some other people have gotten the government to say only they can sell it) and the costs of saying we don't accept the current patent system. The costs of fighting the existing copyright/patent cartel led by the USA is very high. Countries want to avoid this and if the cost is diverting a few percent of their GDP to the USA's drug companies they likely will do so. If however that diversion because too great they will have huge incentive to decide the cost is too high and we have to fight the USA's governments policies put in place at the behest of their drug companies. The costs will be enormous to the countries that fight, especially at first. The USA is enormously rich and can accept losses internally and use economic power to punish those defying it's dictates. If several rich countries decide to align with India (which seems to be by far the leading advocate for fighting the copyright/patent cartel) costs to the USA will also get step. At some point step enough that others force the government to stop using the rest of the USA's economic clout to benefit the drug companies. But I think it is very unlikely the other countries could sustain the losses long enough for the USA to cave. It is a big if, but if China grows well economically for the next 20 years it is much more likely India and China together could work together on this to bring together a large coalition. I don't think China and India would work together as strong allies but they could come together in this area if the USA continues to demand large percentage of countries GDP be diverted to the USA drug companies. All these types of things get complicated. It isn't as if the Drug companies don't understand this same path. They will obviously seek to use corruption in other countries as successfully as they have in the USA to get those governments to act in their interest for cash payments that are peanuts compared to the costs those governments will place on their citizens to benefit the drug companies. The payments to corrupt political parties doesn't only work in the USA, it works most everywhere. So don't count out the insane movement of wealth into drug companies coffers changing anytime soon. If you want to be practical buying stock in these companies will likely reward you well. That is what I have done. I can understand if you think it is repugnant to profit from corruption in the political system on such a massive scale (very little corruption ever impacts multiple percentage points of GDP but, as this does). That is likely a higher ethical decision, weighing my options I accept that "hit" to my karma. If I were given the authority to decide the policy I would make a decision that would harm my stocks but I am not given that option. And based on my estimates of likely future outcomes betting on the USA political parties staying very corrupt in relation to providing benefits to drug companies seems a very likely bet.