The 4x spend on research per capita seems to be true. I looked into that before and found that the absolute spend is about $59 billion in the US and probably ab

The 4x spend on research per capita seems to be true. I looked into that before and found that the absolute spend is about $59 billion in the US and probably about $30 billion in the EU [0,1]. With the US population at 327 million and the EU population at 514 million the 1:4 factor seems about right. But there is another factor which IMO is important: The domestic spend on pharmaceuticals. The US healthcare system seems to be more pharmaceutical friendly. Yearly US spend on pharmaceuticals alone is about $330 billion [2], while yearly EU spend on "medical goods", which I assume to include pharmaceuticals, seems to be only €120 billion [3]. So pharmaceutical spend per capita is also about 1:4 when compared to the EU, not just R&D. As production usually follows consumption (which is why e.g. every US and EU car producer has domestic factories in China), one could also argue that the high US health care costs are the reason why so many US pharma companies exist. [0] https://www.healthaffairs.org/do/10.1377/hblog20170307.059036/full/#one https://www.healthaffairs.org/do/10.1377/hblog20170307.05903... [1] https://www.vfa.de/download/the-pharmaceutical-industry-in-germany.pdf https://www.vfa.de/download/the-pharmaceutical-industry-in-g... [2] https://www.actuary.org/content/prescription-drug-spending-us-health-care-system https://www.actuary.org/content/prescription-drug-spending-u... [3] https://ec.europa.eu/eurostat/statistics-explained/index.php/Healthcare_expenditure_statistics https://ec.europa.eu/eurostat/statistics-explained/index.php...