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 7, 2026 3:53 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
Verse of the Day
  Isaiah 61:1-3 In-Context   1 The Spirit of the Sovereign Lord is on me, because the Lord has anointed me to proclaim good news to the poor. He has sent me to bind up the brokenhearted, to proclaim freedom for the captives and release from darkness for the prisoners,Hebrew; Septuagint the blind   2 to proclaim the year of the Lord's favor...
Verse of the Day
  Commentary on Today's Verse   Commentary on 1 John 5:18-21   (Read 1 John 5:18-21)   All mankind are divided into two parties or dominions; that which belongs to God, and that which belongs to the wicked one. True believers belong to God: they are of God, and from him, and to him, and for him; while the rest, by far the greater...
Verse of the Day
  Commentary on Today's Verse   Commentary on Psalm 119:9-16   (Read Psalm 119:9-16)   To original corruption all have added actual sin. The ruin of the young is either living by no rule at all, or choosing false rules: let them walk by Scripture rules. To doubt of our own wisdom and strength, and to depend upon God, proves the purpose of holiness...
Verse of the Day
  Matthew 24:42-44 In-Context   40 Two men will be in the field; one will be taken and the other left.   41 Two women will be grinding with a hand mill; one will be taken and the other left.   42 Therefore keep watch, because you do not know on what day your Lord will come.   43 But understand this: If the owner...
Verse of the Day
  Commentary on Today's Verse   Commentary on Psalm 33:12-22   (Read Psalm 33:12-22)   All the motions and operations of the souls of men, which no mortals know but themselves, God knows better than they do. Their hearts, as well as their times, are all in his hand; he formed the spirit of each man within him. All the powers of the creature...
Verse of the Day
  1 Corinthians 15:58 In-Context   56 The sting of death is sin, and the power of sin is the law.   57 But thanks be to God! He gives us the victory through our Lord Jesus Christ.   58 Therefore, my dear brothers and sisters, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you...
Verse of the Day
  Commentary on Today's Verse   Commentary on Proverbs 18:12   (Read Proverbs 18:12)   After the heart has been lifted up with pride, a fall comes. But honour shall be the reward of humility.   Proverbs 18:12 In-Context   10 The name of the Lord is a fortified tower; the righteous run to it and are safe.   11 The wealth of the rich is their...
Verse of the Day
  Commentary on Today's Verse   Commentary on Matthew 22:34-40   (Read Matthew 22:34-40)   An interpreter of the law asked our Lord a question, to try, not so much his knowledge, as his judgment. The love of God is the first and great commandment, and the sum of all the commands of the first table. Our love of God must be sincere, not...
Verse of the Day
  Commentary on Today's Verse   Commentary on Proverbs 21:2   (Read Proverbs 21:2)   We are partial in judging ourselves and our actions.   Proverbs 21:2 In-Context   1 In the Lord's hand the king's heart is a stream of water that he channels toward all who please him.   2 A person may think their own ways are right, but the Lord weighs the heart....
Verse of the Day
  Isaiah 41:10 In-Context   8 But you, Israel, my servant, Jacob, whom I have chosen, you descendants of Abraham my friend,   9 I took you from the ends of the earth, from its farthest corners I called you. I said, 'You are my servant'; I have chosen you and have not rejected you.   10 So do not fear, for I am...
Related Classification
Copyright 2023-2026 - www.mreligion.com All Rights Reserved