Replying to myself since apparently people don't like financial facts. If you read Pfizer's 10-K for 2019 (chosen for pre-pandemic numbers), the US accounted f

Replying to myself since apparently people don't like financial facts. If you read Pfizer's 10-K for 2019 (chosen for pre-pandemic numbers), the US accounted for 45% of their gross revenue compared to Western Europe's ~15%. If you discounted the US down to a similar per-person revenue level as Europe, the company would fluctuate between profitability and non-profitability quarter to quarter. I genuinely don't know what people want here - drugs aren't magically summoned into existence for free. If you want new drugs, someone has to cover the cost and the prices that the non-US world pays aren't nearly high enough to do that. You could lower the prices for Americans, but only if you simultaneously increase the prices for everyone else, too.