Today in health care, aside from the overarching debate about keeping people insured, nothing likely dominates the debates, especially the political ones, more than the cost of prescription drugs.

According to RAND Corp. in a 2024 report, drug prices in the United States were about three times higher than in 33 other high-income nations for name-brand drugs still on patent. The U.S. has a complex and fragmented reimbursement system without any national pricing controls. Drug prices are set between the drug makers and insurers. This is often done through less-than-transparent pharmacy benefit managers (PBMs) who act as the middleman. In other nations, especially in Europe, the governments negotiate directly with the drug makers, and often with only one payer, the governments have leverage

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