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Why drugs cost more in America

Vox | November 18, 2025



How an EpiPen can cost $300 in the US and $38 in the UK.
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Prescription drugs cost more in the United States than anywhere else in the world. One big reason why is America’s particular system for how drugs get to patients, which is unlike almost any other country’s. But it’s also because the American prescription drug market is so profitable that the money it generates powers the entire global pharmaceutical industry.

Check out our other video, on how Americans got stuck with endless drug advertisements: https://www.youtube.com/watch?v=_5jnn1AIt7Q

Check out more of Sarah Kliff’s reporting:
https://www.vox.com/science-and-health/2016/11/30/12945756/prescription-drug-prices-explained

And the Commonwealth Fund’s research on US drug prices: https://www.commonwealthfund.org/publications/issue-briefs/2017/oct/paying-prescription-drugs-around-world-why-us-outlier

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Written by Vox

Comments

This post currently has 38 comments.

  1. @Vox

    November 18, 2025 at 2:48 pm

    Hi everyone, we accidentally made this video public around 9pm ET last evening, and had to take it down. We're releasing it now as a new video, sorry for the confusion and to anyone who may have gotten a notification last night for a video that they were unable to watch!

  3. @thomasryan2679

    November 18, 2025 at 2:48 pm

    I've enjoyed great health until this year. I had 30 years without one sick day at work. Now just 8 months later. My medications cost 17k monthly. If it wasn't for insurance, I would buy a case of Jack Daniels instead.

  4. @rjj479

    November 18, 2025 at 2:48 pm

    A combined system is the best

    Private pharmacies and hospitals so people have the freedom of choice

    Then public hospitals and pharmacies to cover essential healthcare to all citizens.

    The public system competes with the private keeping prices down etc

  5. @Johnny_Fairy

    November 18, 2025 at 2:48 pm

    Why drug prices are lower in the EU than in the US:
    1) Price Regulation: In the EU, governments or public health authorities negotiate or regulate drug prices, keeping them lower.
    2) Free Pricing in the US: In the US, pharmaceutical companies can freely set prices without centralized regulation, often resulting in high launch prices.
    3) Market Entry Controls: EU countries typically require a cost-effectiveness or benefit assessment before setting a price, unlike the US where high prices can be charged immediately after approval.
    4) Generics and Patent Rules: The EU generally enables earlier access to generics and biosimilars, increasing competition and reducing prices.
    5) Negotiation Power: Public healthcare systems in Europe negotiate collectively and exert stronger bargaining power than the fragmented US insurance system.
    6) Public Pressure: European societies view access to affordable medicines as a public good, creating political pressure to keep prices low.
    => The main reason for high drug prices in the US is the lack of centralized price regulation, not the EU’s pricing policies. Even without the EU as a "low-price market," US prices would remain high due to weak competition, limited generic access, and low bargaining power of insurers.

  10. @Johndnguyen1982

    November 18, 2025 at 2:48 pm

    I went to pickup hepatitis and cancer treatment pills for my dad. 30days supply cost $26k. I’m shocked is so expensive. Without insurance, I don’t know how he can afford it. Why healthcare treatment so expensive in US? Now I understand. So sad

  11. @itsfoggy

    November 18, 2025 at 2:48 pm

    Why did you skip PBMs when describing the US system, you haven’t even mentioned how the insurance affects the price- this video is literally disinformation for people

  12. @STEVE-lk2ft

    November 18, 2025 at 2:48 pm

    If prescription drugs are cheaper in another country what is stopping US citizens from buying prescriptions from another country? Why do I suspect it’s the fault of US politicians?

  14. @dcs668

    November 18, 2025 at 2:48 pm

    Every single socialised medicine country should be THANKING the US instead of criticising it since they indirectly subsidise our systems in two ways:

    1. US is the most medically innovative country in the world – more lifesaving medication, procedures & research come out of the US vs any other country, hands down.
    US citizens, have to pay more for these so they can maintain the maintain their innovative edge. All socialise medicine countries, Govt however, buy these at a FIXED price.

    2. Countries with generous social programs, pay for paternity leave, vacation etc… spend their money on these rather than spend their $ on the agreed upon 2% of GDP for NATO defense spending. US then subsidizes and pays even more than European countries & Canada put together.
    So, a thank you to the US would be more appropriate.

    3. Socialised medicine country drug prices will soon increase as the Us Govt has selected certain medicines to also have a fixed price.
    Ones whose patents should be over & are older drugs.

  19. @rafishaikh3598

    November 18, 2025 at 2:48 pm

    ECONOMICS IS BASED ON SUPPLY & DEMAND. When DEMANDS ARE high = so does supply & PRICE ,,,,especially those OPIOIDS = HIGHLY ADDICTIVE DRUGS,,,,PAIN KILLINGS & FEEL GOOD DRUGS,,,,get up ,,workout ( EXERCISE),,,FEEL GOOD,,,EAT HEALTHY & DRINK PLENTY OF WATER ( do NOT WORRY, BE HAPPY ) ,,,RAFI MAINE USA

  23. @abiean222

    November 18, 2025 at 2:48 pm

    honestly, if the drugs we do have access to are too expensive to afford and use, then its like we don't have access anyway. at that point the access is worthless. and healthcare is vital, drug companies shouldn't be for profit, they should be subsidized by the governments of the world. each country providing scientists and funding dedicated to improving the health of the world. limiting things by greed and borders helps no one in the end.

  28. @rossg9361

    November 18, 2025 at 2:48 pm

    When will American rise up? Someone told me that there is no paid maternity leave in the US! None, so you pop out a baby and return immediately to the office. That’s dystopian, I still find it hard to believe. 🤯

  31. @kokesgaliza

    November 18, 2025 at 2:48 pm

    It is not true that the US awful system is paying for the rest of the world, I am wondering if Vox is worth to follow anymore if that's the way they do research…

  35. @dragonore2009

    November 18, 2025 at 2:48 pm

    Look I also don't like US high cost of drugs, because in my view we don't have enough Capitalism. There is too much state intervention in the economy which contributes to high cost of drugs. I realize Socialist would disagree with me and blame "Capitalism" (we don't have it) for the problem. Forgetting that for a moment though. Despite the high cost of drugs in our heavy state interventionist and very little Capitalism economy, there are ways to reduce your cost.

    Drug manufacturers don't make money unless folks are taking there drugs and if the cost is too high, then the patient suffers, dies, or cuts back on medication which actually hinders profit. So it is in the financial interest of the drug company that the drugs are affordable. So, you might need a biologic that is priced retail $6000. Now insurance will cover some of it, perhaps most of it, maybe an 80/20 plan where they will cover 80% or $4800. You need to come up with $1200. Well $1200 is certainly better than $6000, but still that is unaffordable, and you not paying that means you don't get the drug and that is a lost sale for the drug manufacturer. So what manufacturers do is sometimes provide copay assistance. They will cover all or most of the $1200 you owe. So now you owe maybe anywhere from $0 to $50. Why would they do this? Well, the drug company is happy, they are giving some profit up, but they get you as a patient continually to use the medication which in the long term is more money for them. So despite the high cost of drugs, drug companies have a direct financial incentive to help you out, so next time call them up and ask for help.

  36. @barbaraadams8347

    November 18, 2025 at 2:48 pm

    Trust me, our government is getting subsidies for their support of these Pharma companies. Why do you think so many of our politicians retired as millionaires. The citizens are getting forced to pay the high prices for their health to live. Insulin prices have risen to such high prices that some diabetics have cut back on how much they use to survive. There is NO reason for these high prices.

  37. @JasonB808

    November 18, 2025 at 2:48 pm

    Looks like they had to take it down, change the ending to “US is the victim of the rest of world getting cheaper medicine”. If US bulk ordered medicine and negotiated price like many other countries, the drug companies would need to lower their prices to sell anything. They wouldn’t be making so many ads in US, they would be forced to accept the negotiated price of medicine not currently available to other countries, thus making more medicine available in other countries. Finally all the profits they earn doesn’t go to the researchers, it goes into pockets of executives and investors.

  38. @Basta11

    November 18, 2025 at 2:48 pm

    In almost every other good, governments have a big role in determining price as they are usually the largest buyer.

    In the US, drug companies have been able to pass laws stopping the Medicare from negotiating these drug lawsprices so they can charge at almost any price.

Comments are closed.

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