Just to tack onto this… it’s possible that we will see different branded drugs, and perhaps even slightly modified drugs to contain effectively a placebo to go through clinical trials concurrently with the primary drug. From there they just release one drug in the US and the other drug exclusively everywhere else.

That’s just one creative way to keep prices exorbitantly high. They can also target medical devices aka the delivery mechanism (think pre-packaged syringes) to try and keep profits high. Just release a US only delivery mechanism and suddenly it’s different than the rest of the world. I’ve worked at companies that slightly altered the injector of their drugs to keep their monopoly going, as doctors preferred the improved injector that had no generic due to being in copyright, even after the drug patent expired.

The pharma lobby is so wealthy and powerful though I sincerely doubt even dumpy can fight them. There’s a reason why biden started with just a handful of drugs, it built a foundation to slowly drain their profits while their current patents run out and they adapt to the new dynamic.

There’s also all those health insurance companies that legally can only profit a % of overall revenue that will face severe profit cuts if treatment costs actually dive, drugs are a key component to building a sizable margin today.___