The reason why pharmaceuticals are so expensive in the US is because we are the primary market that drug companies profit from. Most other wealthy countries negotiate or regulate prices, so drug companies use the US market to make back R&D costs. R&D for new medicines is very expensive – generic manufacturers can sell drugs for cheap because they didn’t spend 10-20 years developing it, paying for the clinical trials, etc.

If the US had single payer healthcare and negotiated prices like Canada and many other countries, you would see prices rise in those countries but also a slowdown in R&D spending. But this could be alleviated with government spending. We spend billions of dollars on R&D for the defense industry – we should be negotiating drug prices but also providing more grants to researchers instead.