[jstelly]

I like this idea but it is probably difficult to implement. Can't drug companies make slightly different versions of drugs and work around this kind of arrangement? In that case the US would get the "best" version of the drug since it's paying the most, but that's not the solution you want (e.g. lower prices) because it's fighting the fundamental fact that the US will pay more for the same drug. I'm not a drug expert so maybe there are some drugs where this is impossible or improbable. But this is pretty typical in other industries so I would expect the same thing to happen here if it became necessary.

[RcouF1uZ4gsC]

I don't think they can get around it that easily because both the patent protections and the FDA approval are based on the "active ingredient" and delivery method and thus they cannot easily introduce a new variant without going to a lot of expense.

[voxic11]

But they already have to get their drugs certified independently in other countries so yes it costs more to introduce multiple varients to the US market but it does not cost much more to introduce different varients to multiple countries that require independent verification of the drugs anyways.