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
Dec 13, 2025 10:42 AM

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
Wealth and Political Rhetoric in Ancient Christian Perspective
Last Thursday, NPR ran an interesting piece by Alan Greenblat that featured the perspective of several of the nation’s rich (read: annual household e over $250,000) in relation to President Obama’s determination that the Bush era tax increases end for the nation’s rich as part of any deal related to the looming “fiscal cliff.” The article features a variety of perspectives, but I would like to reflect upon one particular section of that article here. Greenblat writes, [Mark] Anderson recognizes...
‘Markets Don’t Make Capitalism’
Earlier this week Dylan Pahman reflected on the question, “Which capitalism?” He helpfully explores the nature of capitalism and the importance of definitions. This conversation reminded me of a point made by Michael Novak during his conversation with Rev. Sirico earlier this year at Acton University. In the Q&A session, he argues that it is essential to understand the nature of what distinguishes capitalism from other economic systems: Novak says that “markets don’t make capitalism,” but rather that “enterprise, invention,...
The Poverty Trap in France
In France, more than half ofthe population benefits directly or indirectly from welfare payments. Not surprisingly, the result has been that that the poverty rate for the past twenty years has remained unchanged. “Despite its good intentions,” saysSylvain Charat, “welfareship has created a ‘poverty trap.’” Let’s take an unemployed mother living alone with two children between six and 10 years old. In 2010, there were 284,445 French families in this situation that were on welfare. This mother will be given...
Today’s AU Online Lecture with Victor Claar Postponed
If you haven’t joined us for this lecture series yet, there’s still time! The final live session for the Globalization, Poverty, and Development AU Online series, Fair Trade vs. Free Trade, has been postponed. This means that you now have a few extra days to catch up on the lectures that we’ve already held before joining us next week for Victor Claar’s lecture on Tuesday, December 18, 2012. Also, if you’re interested in learning more about topics related to development,...
Right to Work and the Free Rider Myth
One of the strongest arguments against Right to Work legislation is that such laws exasperates the “free rider” problem. In the context of unions, a free rider is an employee who pays no union dues or agency shop fees, but nonetheless receives the same benefits of union representation as dues-payers. While this concern should not override an employee’s right of free association, it was a concern that, I had always thought was worth taking seriously. But yesterday I discovered that...
‘Goodbye, Taiwan’: No Babies Means No Economic Base
It’s no secret that certain parts of the world have been losing population for some time. The tightly-controlled Chinese birthrate is the first thing es to most minds regarding this topic. However, large parts of Asia, Europe and now even the United States are beginning to see clear danger signs when es to economies and low birth rates. Taiwan’s birthrate is “dropping like a stone…” says an editorial in the Taipei Times. The majority of people realize there is a...
Right to Work: The UAW and Planned Parenthood Make Common Cause
Video: UAW President Bob King thanks Planned Parenthood, environmentalists, clergy, et al., at anti Right-To-Work Protest looks at the — at first blush as least — strange alliance between the United Auto Workers union and Planned Parenthood on the Michigan Right to Work issue. Elise Hilton of the Acton Institute, interviewed by LifeSiteNews reporter Kirsten Andersen, says that the UAW, Planned Parenthood and other like minded groups are afraid that right-to-work laws will help defund the progressive agenda. “I don’t...
Two Christian Views on Right to Work
MLive asked Rev. Robert Sirico and Peter Vander Meulen, a coordinator of the Christian Reformed Church in North America’s Office of Social Justice, ment on Michigan’s new Right to Work law. Meulen says that the change won’t have much impact on the state’s economy but will adversely affect relations between Republicans and Democrats on “just budget priorities” such as Medicaid and energy: In one fell swoop, with a policy that doesn’t have much effect, we have just trashed an entire...
Ikaria and the Inseparability of Individual and Communal Flourishing
The New York Times has a fascinating profile on Ikaria, a Greek island located about 30 miles off the western coast of Turkey. With roughly 8,000 inhabitants, the island is known for its slow and relaxed lifestyle, munities, and healthy citizenry. As Ikarian physician Dr. Ilias Leriadis says in the article: “Have you noticed that no one wears a watch here? …We simply don’t care about the clock here.” Brendan Case offers a good summary of the article at Call...
Two Catholic Views on Right to Work
On Friday I linked to MLive’s presentation of two Christian views on right to work. In that article, Rev. Sirico argued in favor of the legislation since it advances the freedom of workers. On the opposing side was Peter Vander Meulen of the Christian Reformed Church. Meulen didn’t argue against the morality of the law, but plained that it led to further political polarization and harmed the potential for bipartisan support on issues that “make life better for the large...
Related Classification
Copyright 2023-2025 - www.mreligion.com All Rights Reserved