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An insider explains how U.S. prescription drug prices are set



THE U.S. SPENDS more than any other high income country on health care, and prescription drugs account for about 17 percent of all health care spending. President Donald Trump has vowed to lower drug prices but has not yet proposed any concrete approach for doing so. There was no mention of the issue in the American Health Care Act proposed by House Republicans in March.

More than $370 billion per year is spent on prescription drugs in the United States, exceeding all other countries. Pharmaceutical companies often justify the cost of drugs as necessary to support the research and development—the R&D—of innovative treatments. If we want cures for devastating diseases, they say, we have to pay for them. But that explanation is disputed.

Research by the Tufts Center for the Study of Drug Development put the cost of developing a new drug at $2.6 billion. That research was supported by the pharmaceutical industry, however, and the estimate has been questioned.

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WHEN BILLIONAIRES ATTACK MR. Monopoly, that mustachioed fat cat, was about as close as most Americans got to a New York City billionaire until candidate Donald Trump started flying his jet to their villages last year. Now they are practically an everyday sight, because President Trump has coaxed a pack of them out of their penthouses and private jets to either join his Cabinet or sit on his councils and advisory boards. Trump voters know they’ve had a government for billionaires, that’s one reason they’re so mad, but to have one by billionaires means the Mighty Oz is now setting the nation’s agenda, and there is no curtain.