Home
/
RELIGION & LIBERTY ONLINE
/
Why cheap drugs from Canada won’t reduce U.S. Drug prices
Why cheap drugs from Canada won’t reduce U.S. Drug prices
Jan 1, 2026 8:40 PM

If you suffer from acid reflux, your doctor may prescribe Nexium. But at $9 a pill, the price is enough to give you a worse case of heartburn.

That’s the lowest price in the U.S. If you live in Canada, though, you can get the drug for less than a $1 a pill.

This price disparity leads many politicians to think the solution is obvious: Americans should just buy drugs from Canada or other countries where they are cheaper.

Its plan supported by economic liberals like President Trump and Bernie Sanders. Several years ago Sen. Amy Klobuchar (D-Minn.) and John McCain (R-Az.) twice introduced legislation to allow Americans to order up to a 90-day supply of medicines from a licensed Canadian pharmacy. The Democratic Party even made it a part of their party platform in 2016.

If this seems too easy, it’s because it’s an economically ignorant idea. Writing in the Harvard Business Review a few years ago, Rafi Mohammed explained why this strategy won’t work:

The reason why pharmaceutical prices are relatively high in the U.S. is panies employ mon strategy called differential pricing. This strategy targets specific segments with different prices. So instead of having the same price for everyone, the goal is to tailor the “right” price to various segments. Movie theaters, for instance, use differential pricing by offering lower prices to students and seniors. The assumption is students and seniors are sensitive to price, sooffering targeted discounts to them is profitable. As a result, moviegoers seated next to each other often have paid different prices.

For differential pricing to be profitable, targeted segments have to be easily identifiable, and,most importantly, arbitrage cannot occur. By arbitrage, I mean those who receive discounts don’t resell to customers who are currently paying more. This strategy works well at cinemas: it’s easy to identify seniors/students, and since tickets are sold individually at the door, enterprising seniors/students typically aren’t reselling discounted tickets for a profit.

Why are drug prices so much higher in the U.S.? The answer is straightforward: most countries regulate prices or have a single-payer health care system, in which the government pays for citizens’ health care costs. In a single-payer system, the government buys all a country’s pharmaceuticals, and it has leverage in “take it or leave it” negotiations with panies.

Mohammed’s explanation is helpful, but it’s also plete. What he doesn’t mention is the reason whythe price differential for drugs can work: because expensive medicines in the U.S. subsidize the creation of drugs for the entire world.

According to the pharmaceutical giant Eli Lilly, the average cost to discover and develop a new drug is between $800 million to $1.2 billion, and the average length of time from discovery to patient is 10 to 15 years.

If a product costs $1 billion to produce and bring to market, that is the initial fixed cost. Think of it this way: the initial cost to produce the very first Nexium pill is roughly $1 billion. But once that first pill is created, the cost to produce the second, third, fourth, . . . hundred thousandth pill is very low. But if the initial fixed cost cannot be recovered, then pany will lay out the money and spend a decade or more creating the product. New medications will simply not exist.

This point should be obvious—and yet it is widely overlooked and ignored. People see a drug, like Nexium, and forget that it only exists because a pany believed it could recoup the cost of research and development and make a profit by selling the medicine. But how is pany able to earn back the initial billion dollar fixed costs? By charging some buyer—whether a government, HMO, pany or individual—a price that will cover the initial fixed costs.

Once that fixed costs of creating the drug is covered, though, the price can be reduced since the remaining variable costs (e.g., the cost to produce each individual pill) tend to be relatively low. And this brings us to why you, as an American, pay a higher price for a drug that Canadians and Europeans get much cheaper.

To make it easier to understand, let’s imagine that a medicine is created to cure a single disease in three patients living in America, Canada, and France. Now let’s say that the patient in America pays all of the fixed cost ($1 billion), plus the variable cost for one pill (50 cents), plus 50 cents in profit for pany. In total, the American ends up paying $1,000,000,001 for a single pill.

The pany is happy because they recouped their costs and made a profit (50 cents). Canada and France say that they too want to buy the drug, but they will pay only $1. The pany agrees to sell the pill for $1 to both Canada and France because an additional $1 profit is better than $0 in additional profit. Everyone is happy.

Well, maybe not everyone. The American may say that it wasn’t fair for them to pay all the fixed costs —and they’d be right. In our example, Canada and France are free riders that are able to take advantage of the lower costs only because the Americans have already paid the exorbitant fixed costs. The American subsidized the cost of the drug for the patients in the other countries.

This is exactly what happens with most drugs. Very few new medicines are produced in countries that have government restrictions on drug prices. And almost no new drugs would be produced if all countries had government restrictions on drug prices. Without the willingness of the United States to pay the higher prices, the drugs would never e into existence. Countries like Canada and France are like roommates who let you pay full price for a pizza but expect you to give them a slice in exchange for a few pennies they found in the couch.

Which brings us back to the “reimport the drugs” strategy. The reason this approach won’t work is because once Americans stop subsidizing the drugs for the rest of the world, panies will not be able to recoup their costs for R&D. paniessimply won’t be able to afford to create innovative new medicines. That makes everyone worse off than before.

Ultimately, socialized medicine—in the form of government-imposed drug pricing—doesn’t work for the same reason Margaret Thatcher said socialist governments don’t work: “They always run out of other people’s money.”

Comments
Welcome to mreligion comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
RELIGION & LIBERTY ONLINE
United Airlines and the economist who solved the overbooking problem
This weekend a video went viral that shows a passenger on a United Airlines flight from Chicago to Louisville being forcibly removed from the plane before takeoff at O’Hare International Airport. According to an eyewitness of the incident: Passengers were told at the gate that the flight was overbooked and United, offering $400 and a hotel stay, was looking for one volunteer to take another flight to Louisville at 3 p.m. Monday. Passengers were allowed to board the flight, Bridges...
Why the rule of law matters for human flourishing
In our efforts to reduce poverty, spur economic growth, and cultivate the conditions for human flourishing, the conversation can quickly be consumed with debates over material wealth and the allocation of physical resources. Yet economists are increasingly recognizing the role “intangible assets” — unseen forces that propel humans toward increased innovation and collaboration. These include a range of underlying features, from basic honesty and virtue to the cultural appetite for risk and experimentation. But one of the most prominent has...
Why government regulation of airline fares created ‘quality waste’
Note: This is post #28 in a weekly video series on basic microeconomics. If you flew on an airplane prior to 1978, when the government regulated air fares, you probably noticed the high quality of air travel—wide seats, good food, friendly service. But as economist Alex Tabarrok explains, that was actually a bad thing for customers since the government imposed prices floors created “quality waste.” (If you find the pace of the videos too slow, I’d mend watching them at...
Booker T. Washington on the beauty and dignity of work
“My plan was to have [my students]…taught to see not only utility in labour, but beauty and dignity.” –Booker T. Washington We live in a time of unbounding prosperity. Opportunities are wider, work is easier, and innovation continues to accelerate at a break-neck pace. Yet standing amid such blessings, it can be easy to forget or neglect the basic freedoms and philosophy of life that got us here in the first place. Alas, in a culture propelled by pleasure, materialism,...
The responsibility of entrepreneurs for a flourishing, just society
Embed from Getty Images During a recent trip to Chile, Acton’s Samuel Gregg spoke to Diario Financiero about the rights and responsibilities of entrepreneurs. Business’ contributions to the well-being of society are enormous, but explaining the good they do can be a challenge. “Businesses have a great story to tell,” Gregg laments, “but they’re not very good at telling it.” Also contributing to general distrust is that corporate scandals tend to put all the focus of on a few bad...
Lord Acton Meets Lord Krishna: Yoga as the Reign of Conscience
In North America ‘Yoga’ is synonymous with exercise consisting of a series of postures as well as form-fitting and fortable pants. But there’s much more: it’s a philosophy deeply grounded in conscience as the source of virtue. Yoga is one of the six orthodox schools of Indian philosophy which accept and rely on the Vedas, the most ancient scriptures of Hinduism. Yogic ideas of conscience are strikingly similar to the those of Lord Acton in particular and the Christian tradition...
Video: John Stonestreet on the gospel in a culture of identity crisis
The changes in western culture over the past decadesreflect a major shift in how we think of the nature of reality and, in particular, the human person. In light of these changes, how is theChurch to address the deep issues of the day without ing captive to political ideologies? How can it recover and advance a Biblical vision on humanity? On March 30, John Stonestreet – President of the Colson Center for Christian Worldview – delivered an address as part...
Kirk on Acton on Revolution
Russell Kirk was a luminary of American Conservatism, philosopher, historian, and novelist of horror and suspense. In addition to being a true renaissance man he was, with his wife Annette, an early friend and supporter of the Acton Institute. It was at Acton that Kirk gave his last public lecture on the topic of ‘Lord Acton on Revolution’ on January 10, 1994. He would be called home to the Lord later that year. Kirk pulls no punches in his lecture...
How global trade enriched your Palm Sunday
This weekendmarked Palm Sunday, the beginning of Holy Week, when memorate Christ’s entrance into Jerusalem en route to His voluntary death, burial, and resurrection. On that day, Christians of all backgrounds bless and wave palm branches in imitation of the crowds who cried “Hosanna” as He rode a donkey into the city. But not all Christians use palm branches. Palms cannot grow in the harsh climate of northern Slavic nations such as Russia, Ukraine, and Poland. Instead, Catholics and Orthodox...
What Christians can learn from Utah’s economic success
How do we move closer to ending poverty and expanding opportunity in America? Does a single solution or road map even exist? In a widely cited study, the Brookings Institute’s Isabel Sawhill and Ron Haskins famously argued that at least one predictable path is evident. “The poverty rate among families with children could be lowered by 71 percent if the pleted high school, worked full-time, married, and had no more than two children,” they argue. Skeptics and critics abound, but...
Related Classification
Copyright 2023-2026 - www.mreligion.com All Rights Reserved