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  • This is an EpiPen.

  • It's a device that injects you with adrenaline if you're having a possibly deadly allergic reaction.

  • If you have severe allergies, you basically need it.

  • And if you live in the UK, an EpiPen will cost you the equivalent of 38 US dollars.

  • But if you live in the US, it'll cost you $300.

  • And it's not just the EpiPen.

  • Let's look at five of the top selling prescription drugs in the world.

  • Advair, a brand-name asthma inhaler: more expensive in the US.

  • Lantus, a type of Insulin: more expensive in the US.

  • Sovaldi for hepatitis C?

  • Yup. Costs more in the US.

  • Humira for arthritis?

  • Crestor for cholesterol: more expensive in the US.

  • So here's an unsurprising chart.

  • Americans spend more on prescription drugs than anyone else in the world.

  • Why?

  • The first thing you have to understand is that in the US, drugs get to patients differently than almost everywhere else.

  • Let's look at that popular hepatitis C drug, Sovaldi.

  • In 2014 Sovaldi became the first drug to completely cure hepatitis C.

  • Here's how it got to market in, for example, the UK.

  • First a government agency had to decide that Sovaldi was safe and that it actually worked.

  • Then it was evaluated by a regulatory agency to see if was worthwhile.

  • Are there too many side effects?

  • Is there already a similar drug?

  • Is there a cheaper option?

  • Sovaldi was deemed worthwhile.

  • Next, they negotiated the price.

  • In the UK, the government buys the stock of medicine for the country.

  • That means they're usually able to get a lower rate, kind of like a bulk discount.

  • Which keeps prescription drugs cheaper for UK citizens.

  • In almost every developed country besides the US, this is what the system looks like.

  • Safety evaluation, assessment of whether the country needs it, price negotiations, sold to patients.

  • Now let's look at the system in the United States.

  • First, the drug is evaluated for safety, but that's it.

  • If it's safe, they can sell it, end of story.

  • Drugs are sold by the drug companies to patients, usually through insurance.

  • And since the US system lets them sell it for any price, Gilead, the company that makes Sovaldi, charged Americans more for it.

  • When it first came to market, the entire treatment cost $84,000 in the US.

  • In the UK?

  • Just about $58,000 US dollars.

  • That's still a lot of money, but it's a full 30% less.

  • So it seems like the UK has the better system right?

  • Well, it's complicated.

  • These photos are from protests in the US against the high price of EpiPens.

  • And these are photos from protests in the UK, over the lack of access to a cystic fibrosis drug called Orkambi.

  • That's because when there's a committee that determines whether a new drug is worthwhile, sometimes they say no.

  • And when they negotiate the price, sometimes they don't come to an agreement and hit a standoff.

  • That's what's happening with Orkambi.

  • Both systems require trade-offs.

  • Regulated drug markets tend to make drugs more affordable, but some drugs are completely unavailable.

  • And while the US has more drugs technically available, they're often too expensive to actually afford.

  • Americans without insurance are the most likely to skip medication because of the cost.

  • Even Americans with insurance, are second.

  • But the commonality between these two systems is the drug companies.

  • Developing new drug products isn't cheap and they're for-profit businesses.

  • If Gilead didn't think that researching and developing a hepatitis C cure, would make them money in the end, they might not have.

  • And with these regulated markets keeping costs down, the only place drug companies can really make their money is, you guessed it, the US.

  • Americans are essentially subsidizing the cost of drugs for the rest of the world.

  • In other words, a big part of why prescription drugs are more expensive in the US is because they're cheaper everywhere else.

  • If you'd like to continue exploring the importance of easier access to medicine and vaccines, then I highly recommend a documentary called "Viruses: Destruction and Creation".

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This is an EpiPen.

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