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The thing is, the USA has subsidized everyone elses health care systems. All major health care innovations were invented here. So when your drug prices are chea

The thing is, the USA has subsidized everyone elses health care systems. All major health care innovations were invented here. So when your drug prices are cheap, its because your country has access to free USA drug innovation. What created modern health care (free market privatized drug companies and equipment manufacturers), also causes health care to be a broken system. Theres two sides to this coin

9HZZRfNlpR 7y ago
What is the source of this all meds are created in the USA? Plenty of strong European companies out there, now of course all companies are global. I'm trying to get some strong arguments since i hear this all the time. Also, by that thinking, all the suckers and losers in the market subsidize others.
fooker 7y ago
> All major health care innovations were invented here. Citation needed.
- malandrew 7y ago
  https://en.wikipedia.org/wiki/WHO_Model_List_of_Essential_Medicines https://en.wikipedia.org/wiki/WHO_Model_List_of_Essential_Me... I never went through the whole list because it took a super long time, but when I tried sampling where most of these ~300 drugs were developed, it was like 80% developed in the US. I got through like 50-60 of them before I gave up. 50-60 should be good enough to be representative of the 300 or so. Feel free to go through them yourself if you don't believe me.
  - brmgb 7y ago
    > Feel free to go through them yourself if you don't believe me. I didn't so I did. I checked the first thirty listed in the Wikipedia article. Of those, only 8 have been developed in the USA including one developed by the American branch of a Swiss company. That's merely 26%. Not insignificant but quite far from 80%. After a quick sampling of the rest I would be surprised if the exact proportion is above a third.
    - malandrew 7y ago
      I just went through the first 24 and you couldn't possibly have gone through the first 30 since I hit 8 drugs developed in the US in the first 20. So you're clearly lying about fact checking my statement. 11 were developed in the US and one more was introduced to western medicine by an American traveling. And if you only include drugs developed in the last 100 years, of which there are 14, 10 were developed in the United States, so 71%. What has the rest of the World been doing for the last century? Halothane - England (1956) Isoflurane - United States (1979) Nitrous Oxide - England (1772) Oxygen - N/A Ketamine - United States (1966) Propofol - United States (1989) Bupivacaine - Sweden (1957) Lidocaine - Sweden (1885) Ephedrine - China (?, introduced to western medicine by an American traveling to China) Atropine - Germany (1833) Midazolam - United States (1976) Morphine - Germany (1803) Aspirin - France (1853) Ibuprofen England (1953) Paracetamol - United States (1877) Codeine - France (1832) Fentanyl - United States (1960) Methadone - Germany (1937) Amitriptyline - United States (1960) Cyclizine - United States (1947) Dexamethasone - United States (1957) Diazepam - United States (1959) Docusate - ??? Fluoxetine - United States (1972) It's ridiculous how hard it is to figure out where most of these were developed. When I first went through the WHO list, I did so in reverse by year of discovery: https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_discovery https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_disco...
      - brmgb 7y ago
        Except Propofol was discovered by a Scot working for a British pharma in the 70s and Fentanyl was discovered by a Belgian working for a Belgian pharma. I stopped checking again at this point. As a reminder your first claim was 80% of the list. I think your reliability has clearly been established at this point.
        malandrew 7y ago
        ~80% in reverse chronological order by year of discovery. Just went through the list of drugs developed in the 21st century: https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_discovery https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_disco... Except for Alectinib, which was developed in Japan, 13 of the 14 drugs developed in the 21st century for example have been developed in the United States: That's 93%. Again what has the rest of the World been doing? So 9 by the 24th in the list not 30, so your reliability has also been established.
robert_foss 7y ago
I think this is a very commonly told story in the US. I would like to see the data backing it up.
- Ididntdothis 7y ago
  There is no data. Everything in the US medical system is opaque. It’s the same story with hospitals. They say they have to overcharge everybody to compensate for the people who don’t pay. But there are no real numbers to demonstrate that.
paulsutter 7y ago
Enough Americans believe this myth to perpetuate the insane costs and poor service that we endure here
coldtea 7y ago
>The thing is, the USA has subsidized everyone elses health care systems. All major health care innovations were invented here. So when your drug prices are cheap, its because your country has access to free USA drug innovation. Sorry, what? My country doesn't have any "free access" to drug innovation, it pays mucho dinero to buy drugs, and American companies hold and enforce all kinds of patents on them. It's also not some "one way" innovation street. Tons of medical/drug innovation, especially all the major "low hanging fruits" (which make up for most of modern health benefits) up to the mid-20th century came from outside the USA. And that's not counting all the major European etc drug companies GlaxoSmithKline (British), La Roche (Swiss), Novartis (Swiss), Sanofi-Aventis (French), Bayer (German), Boehringer Ingelheim (German), etc. Of the top 5 grossing drug companies, only 1 is American (#1 Pfizer). And the revenues of #1 are close to the revenues of #2 and #3, (45 vs 40 and 38 billion) so it's not like some great disparity where Pfizer takes all. Not to mention that a lot of "USA innovations" were created by immigrants, whose country of origin paid for their raising, education, etc, even up to their undergraduate degree, and then they went to the USA and innovated as researchers... Slow down with the chauvinism...
- malandrew 7y ago
  Once the patents expire, your country gets the free access. If you didn't develop a drug or pay for its development, but get access to it one day at only the cost of manufacture, then you're getting the R&D for free. All of the drug companies you mentioned, while not founded in America, do most of their R&D in America. You're right about many immigrants developing those drugs, but they came to America to do so. You should ask yourself "why?" For the record, I'm an immigrant to the US.
  - coldtea 7y ago
    >Once the patents expire, your country gets the free access. Everybody gets the free access (including other American companies). Like you get free access to European drugs, once the patents expire. But all this is played into the cost of the drug while the patent holds. Nobody sells drugs at a cost, so there's that... >All of the drug companies you mentioned, while not founded in America, do most of their R&D in America. That's just wrong. >You're right about many immigrants developing those drugs, but they came to America to do so. You should ask yourself "why?" More cushioned life, compared to a place like China (at least of yore), and opportunities to make it big in business.
peteretep 7y ago
Right, I mean, aside from Roche, Novartis, Bayer, GlaxoSmithKline, Sanofi, AstraZeneca, Teva, Takeda, Merck, NovoNordisk, the synthesis of antibiotics and vaccines and modern surgery, what have the non-Americans ever contributed?!?!?!?!!!!!! > All major health care innovations were invented here To quote Rage Against the Machine: whoever told you that is your enemy
chipotle_coyote 7y ago
Since people were asking for citations, here's a couple, but they seem to contradict your assertion: "US Pharmaceutical Innovation in an International Context," the American Journal of Public Health. "We explored whether the United States is responsible for the development of a disproportionate share of the New Molecular Entities (NMEs) produced worldwide. [...] The United States was responsible for the development of 43.7% of the NMEs. The United Kingdom, Switzerland, and a few other countries innovated proportionally more than their contribution to GDP or prescription drug spending, whereas Japan, South Korea, and a few other countries innovated less. Conclusion: Higher prescription drug spending in the United States does not disproportionately privilege domestic innovation, and many countries with drug price regulation were significant contributors to pharmaceutical innovation." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/ "Global Drug Discovery: Europe is Ahead," Health Affairs Vol. 28 Supplement 1. "It is widely believed that the United States has eclipsed Europe in pharmaceutical research productivity. Some leading analysts claim that although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important. Yet a comprehensive data set of all new chemical entities approved between 1982 and 2003 shows that the United States never overtook Europe in research productivity, and that Europe in fact is pulling ahead of U.S. productivity. Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs." https://www.healthaffairs.org/doi/full/10.1377/hlthaff.28.5.w969 https://www.healthaffairs.org/doi/full/10.1377/hlthaff.28.5.... The argument that the US "subsidizes" the rest of the world's health care is something that US pharmaceutical companies would very much like us to believe, but the evidence for it appears to be pretty shaky.
- malandrew 7y ago
  > We collected data on NMEs approved between 1992 and 2004 and assigned each NME to an inventor country. I'm curious why they chose that time period. It was published in 2010. This omits 6 years between publication date of the article and the end of the range they chose and omitted all data prior to 1992. How would the data differ if you didn't choose this 12 year period? > although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important. > Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs. These two statements contradict one another and the second one sounds awfully like moving the goal posts because the data doesn't support the conclusions.
JauntTrooper 7y ago
Roche and Novartis are Swiss. GlaxoSmithKline is British. AstraZeneca is British/Swedish. Sanofi is French. Novo Nordisk is Danish. Bayer is German. Takeda and Daiichi Sanyko are Japanese. Teva is Israeli.
tracker1 7y ago
It's less subsidizing as what a controlled market allows. Dual sourcing requirements and limiting extension patents would go a long way. Combined with a fiduciary responsibility for insurance (and more so medicare) negotiations on behalf of clients.

9HZZRfNlpR 7y ago

What is the source of this all meds are created in the USA? Plenty of strong European companies out there, now of course all companies are global. I'm trying to get some strong arguments since i hear this all the time. Also, by that thinking, all the suckers and losers in the market subsidize others.

fooker 7y ago

> All major health care innovations were invented here. Citation needed.

malandrew 7y ago
https://en.wikipedia.org/wiki/WHO_Model_List_of_Essential_Medicines https://en.wikipedia.org/wiki/WHO_Model_List_of_Essential_Me... I never went through the whole list because it took a super long time, but when I tried sampling where most of these ~300 drugs were developed, it was like 80% developed in the US. I got through like 50-60 of them before I gave up. 50-60 should be good enough to be representative of the 300 or so. Feel free to go through them yourself if you don't believe me.
- brmgb 7y ago
  > Feel free to go through them yourself if you don't believe me. I didn't so I did. I checked the first thirty listed in the Wikipedia article. Of those, only 8 have been developed in the USA including one developed by the American branch of a Swiss company. That's merely 26%. Not insignificant but quite far from 80%. After a quick sampling of the rest I would be surprised if the exact proportion is above a third.
  - malandrew 7y ago
    I just went through the first 24 and you couldn't possibly have gone through the first 30 since I hit 8 drugs developed in the US in the first 20. So you're clearly lying about fact checking my statement. 11 were developed in the US and one more was introduced to western medicine by an American traveling. And if you only include drugs developed in the last 100 years, of which there are 14, 10 were developed in the United States, so 71%. What has the rest of the World been doing for the last century? Halothane - England (1956) Isoflurane - United States (1979) Nitrous Oxide - England (1772) Oxygen - N/A Ketamine - United States (1966) Propofol - United States (1989) Bupivacaine - Sweden (1957) Lidocaine - Sweden (1885) Ephedrine - China (?, introduced to western medicine by an American traveling to China) Atropine - Germany (1833) Midazolam - United States (1976) Morphine - Germany (1803) Aspirin - France (1853) Ibuprofen England (1953) Paracetamol - United States (1877) Codeine - France (1832) Fentanyl - United States (1960) Methadone - Germany (1937) Amitriptyline - United States (1960) Cyclizine - United States (1947) Dexamethasone - United States (1957) Diazepam - United States (1959) Docusate - ??? Fluoxetine - United States (1972) It's ridiculous how hard it is to figure out where most of these were developed. When I first went through the WHO list, I did so in reverse by year of discovery: https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_discovery https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_disco...
    - brmgb 7y ago
      Except Propofol was discovered by a Scot working for a British pharma in the 70s and Fentanyl was discovered by a Belgian working for a Belgian pharma. I stopped checking again at this point. As a reminder your first claim was 80% of the list. I think your reliability has clearly been established at this point.
      - malandrew 7y ago
        ~80% in reverse chronological order by year of discovery. Just went through the list of drugs developed in the 21st century: https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_discovery https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_disco... Except for Alectinib, which was developed in Japan, 13 of the 14 drugs developed in the 21st century for example have been developed in the United States: That's 93%. Again what has the rest of the World been doing? So 9 by the 24th in the list not 30, so your reliability has also been established.

robert_foss 7y ago

I think this is a very commonly told story in the US. I would like to see the data backing it up.

Ididntdothis 7y ago
There is no data. Everything in the US medical system is opaque. It’s the same story with hospitals. They say they have to overcharge everybody to compensate for the people who don’t pay. But there are no real numbers to demonstrate that.

paulsutter 7y ago

Enough Americans believe this myth to perpetuate the insane costs and poor service that we endure here

coldtea 7y ago

>The thing is, the USA has subsidized everyone elses health care systems. All major health care innovations were invented here. So when your drug prices are cheap, its because your country has access to free USA drug innovation. Sorry, what? My country doesn't have any "free access" to drug innovation, it pays mucho dinero to buy drugs, and American companies hold and enforce all kinds of patents on them. It's also not some "one way" innovation street. Tons of medical/drug innovation, especially all the major "low hanging fruits" (which make up for most of modern health benefits) up to the mid-20th century came from outside the USA. And that's not counting all the major European etc drug companies GlaxoSmithKline (British), La Roche (Swiss), Novartis (Swiss), Sanofi-Aventis (French), Bayer (German), Boehringer Ingelheim (German), etc. Of the top 5 grossing drug companies, only 1 is American (#1 Pfizer). And the revenues of #1 are close to the revenues of #2 and #3, (45 vs 40 and 38 billion) so it's not like some great disparity where Pfizer takes all. Not to mention that a lot of "USA innovations" were created by immigrants, whose country of origin paid for their raising, education, etc, even up to their undergraduate degree, and then they went to the USA and innovated as researchers... Slow down with the chauvinism...

malandrew 7y ago
Once the patents expire, your country gets the free access. If you didn't develop a drug or pay for its development, but get access to it one day at only the cost of manufacture, then you're getting the R&D for free. All of the drug companies you mentioned, while not founded in America, do most of their R&D in America. You're right about many immigrants developing those drugs, but they came to America to do so. You should ask yourself "why?" For the record, I'm an immigrant to the US.
- coldtea 7y ago
  >Once the patents expire, your country gets the free access. Everybody gets the free access (including other American companies). Like you get free access to European drugs, once the patents expire. But all this is played into the cost of the drug while the patent holds. Nobody sells drugs at a cost, so there's that... >All of the drug companies you mentioned, while not founded in America, do most of their R&D in America. That's just wrong. >You're right about many immigrants developing those drugs, but they came to America to do so. You should ask yourself "why?" More cushioned life, compared to a place like China (at least of yore), and opportunities to make it big in business.

peteretep 7y ago

Right, I mean, aside from Roche, Novartis, Bayer, GlaxoSmithKline, Sanofi, AstraZeneca, Teva, Takeda, Merck, NovoNordisk, the synthesis of antibiotics and vaccines and modern surgery, what have the non-Americans ever contributed?!?!?!?!!!!!! > All major health care innovations were invented here To quote Rage Against the Machine: whoever told you that is your enemy

chipotle_coyote 7y ago

Since people were asking for citations, here's a couple, but they seem to contradict your assertion: "US Pharmaceutical Innovation in an International Context," the American Journal of Public Health. "We explored whether the United States is responsible for the development of a disproportionate share of the New Molecular Entities (NMEs) produced worldwide. [...] The United States was responsible for the development of 43.7% of the NMEs. The United Kingdom, Switzerland, and a few other countries innovated proportionally more than their contribution to GDP or prescription drug spending, whereas Japan, South Korea, and a few other countries innovated less. Conclusion: Higher prescription drug spending in the United States does not disproportionately privilege domestic innovation, and many countries with drug price regulation were significant contributors to pharmaceutical innovation." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/ "Global Drug Discovery: Europe is Ahead," Health Affairs Vol. 28 Supplement 1. "It is widely believed that the United States has eclipsed Europe in pharmaceutical research productivity. Some leading analysts claim that although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important. Yet a comprehensive data set of all new chemical entities approved between 1982 and 2003 shows that the United States never overtook Europe in research productivity, and that Europe in fact is pulling ahead of U.S. productivity. Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs." https://www.healthaffairs.org/doi/full/10.1377/hlthaff.28.5.w969 https://www.healthaffairs.org/doi/full/10.1377/hlthaff.28.5.... The argument that the US "subsidizes" the rest of the world's health care is something that US pharmaceutical companies would very much like us to believe, but the evidence for it appears to be pretty shaky.

malandrew 7y ago
> We collected data on NMEs approved between 1992 and 2004 and assigned each NME to an inventor country. I'm curious why they chose that time period. It was published in 2010. This omits 6 years between publication date of the article and the end of the range they chose and omitted all data prior to 1992. How would the data differ if you didn't choose this 12 year period? > although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important. > Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs. These two statements contradict one another and the second one sounds awfully like moving the goal posts because the data doesn't support the conclusions.

JauntTrooper 7y ago

Roche and Novartis are Swiss. GlaxoSmithKline is British. AstraZeneca is British/Swedish. Sanofi is French. Novo Nordisk is Danish. Bayer is German. Takeda and Daiichi Sanyko are Japanese. Teva is Israeli.

tracker1 7y ago

It's less subsidizing as what a controlled market allows. Dual sourcing requirements and limiting extension patents would go a long way. Combined with a fiduciary responsibility for insurance (and more so medicare) negotiations on behalf of clients.