Public opinion is marked by frustration and skepticism regarding the U.S. designation of countries as major drug trafficking nations. Many commenters view the U.S. as hypocritical, questioning the motivations behind the designations and expressing concerns about underlying biases, especially towards countries like India. There’s also recognition of widespread drug use across various professional fields, with callers for a pivot toward rehabilitation and addressing addiction rather than punitive measures.

United States

India

Colombia

Why can't they say India is at a crossroads again...

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Everyone knows the new world produces the best drugs legal and illegal. 

Comprehensive_Main

This ties into Trump's plan to force pharma to raise drug prices aboard and lower them here, doesn't it?

WhisperBreezzze

&gt;DAYS AFTER imposing tariffs on European drug exports this summer, Donald Trump wrote to the heads of 17 big pharmaceutical firms, demanding that American prices be brought into line with the lower prices paid abroad. He pledged to use “every tool” to stop Americans from paying more than patients elsewhere.


&gt;The president’s frustrations over freeloading by foreign drug manufacturers are understandable. European and other rich countries consistently underspend on innovative medicines, shifting the burden of paying for medical progress onto Americans. That imbalance means Europe’s own biotech industry relies on American profits to remain viable. But if the White House’s plan for most-favoured-nation treatment goes ahead, Americans and Europeans alike would suffer, because lost revenues would mean less investment in the innovation that produces tomorrow’s medicines.

&gt;European leaders may bristle at Mr Trump’s charge that his country is subsidising global drug innovation. Many of the world’s top drug companies are European. European researchers contribute significantly to pharmaceutical R&amp;D. Yet the president isn’t claiming that Europe plays no role in innovation. Rather, he’s arguing that its drug industry would be untenable without the American market. Indeed, Novo Nordisk, Denmark’s pharma giant, surely had Americans—and their waistlines—in mind when it invested in the experimental research that culminated in Ozempic and Wegovy, blockbuster drugs for diabetes and weight loss.

&gt;Brand-name drugs often launch years earlier in America, cost around three times more than the OECD average and enjoy broader insurance coverage. As a result, America accounts for 70% of OECD-wide profits on patented medicines, even though it represents just over a third of OECD countries’ combined GDP, adjusting for purchasing power.

&gt;Biopharmaceutical innovation is a global public good. But it is both risky and expensive to carry out. On average, it takes a decade and more than $2bn to bring a medicine to market. Roughly nine in ten clinical trials fail. That creates a classic free-rider problem: countries want new medicines, but want others to pay the higher prices that produce the needed return on investment in R&amp;D.

&gt;Meanwhile, to save money, many European countries with public health systems suppress prices for new drugs as well as restrict their use. Italy discourages investment by clawing back payments to manufacturers if health-system spending on particular medicines exceeds certain thresholds. It also restricts access to costly drugs, delaying coverage.

&gt;Britain’s approach for gauging the cost-effectiveness of treatment values a patient’s additional year of health at just £20,000-30,000 ($27,000-40,000)—unchanged since 1999. This is far below valuations of $100,000–150,000 used in American cost-effectiveness studies. Britain’s National Health Service then demands steep discounts and limits access to drugs in line with its impossibly low valuations of a healthy life. Just 13% of new treatments are covered without restrictions.

&gt;Germany links new drug prices to older treatments, even generics, while France uses a combination of rebates, clawbacks and taxes to achieve some of the lowest drug prices in Europe. EU countries also delay pricing and reimbursement decisions: the average delay of 700 days (far beyond the 180-day EU legal limit) erodes both patient life and investment returns. In short, European health systems undercut the incentives needed to sustain drug development.
This situation is untenable. Without American patients helping to foot the bill, Europe’s pharmaceutical sector could not maintain its current pace of R&amp;D. To end this free riding, Mr Trump wants to cap American drug prices at the lowest level charged in any developed country.

&gt;Of course, if such a cap is implemented without European prices being lifted, biopharma innovators would suffer such steep falls in revenue that they would have to shut down R&amp;D projects. That would have global consequences, including for America. It would be better, therefore, to think of free riding as a trade issue.

&gt;NATO provides a useful model. The alliance currently requires member countries to spend at least 2% of their GDP on defence to ensure that the burden of collective security is shared equitably. Similarly, European and other high-income countries should adopt minimum spending targets for innovative medicines. A sensible target would be the per-head share of GDP that America spends—ie, nearly 0.8% of per-head GDP, according to EY, a professional-services firm. By contrast, Italy and Spain currently spend 0.5%, Germany 0.4% and France 0.3%. If those four countries alone matched the American share, biopharma revenues would jump by tens of billions of dollars. That would inevitably yield more new drugs, with health and economic benefits to match.

&gt;Guardrails would be needed. Spending thresholds should account for discounts, rebates and clawbacks. Reimbursements should reflect a drug’s value, determined by the private market ideally but at a minimum using a formula based on the cost-effectiveness thresholds that prevail in America. Europe must also better protect intellectual property. If governments delay pricing decisions beyond the 180-day legal limit, companies should receive automatic patent extensions. Otherwise, R&amp;D may remain too risky for many firms to undertake.

&gt;These reforms would not be burdensome. Rather, they would establish a fairer system in which advanced economies contribute in proportion to the medical innovation they depend on, while ensuring a healthy flow of new drugs. The reforms would not even require big new spending. It is already more expensive to fill a typical prescription in Europe than it is in America, because America fills a greater share of prescriptions with generics that on average cost half as much as they do in Europe.

&gt;In other words, by raising reimbursements for new drugs while increasing the use of cheaper generic therapies, Europe could spur more investment in lifesaving R&amp;D and defuse Mr Trump’s mutually destructive pricing push. Europe doesn’t need to spend more. It just needs to spend smarter.

Swampy1741

always get this guy confused with Thomas Philippon

Warm_Bug3985

Ridiculous premise. Europe is under no obligation to fund drug development if there isn't market demand for those drugs.

There is simply more demand in the US for new cutting edge medicine, and the US is richer, and so the US is willing to pay for it. If that demand decreases, there will simply be less medical research.

limaxophobiac

Lmao keep coping Donnie boy, we're not raising our medicine prices for the funsies.

SucculentMoisture

Nothing article. The problem isn’t the dastardly Europeans, it’s that Americans are incapable of reforming their healthcare system.

ForsakingSubtlety

Two parts are true.

Europeans, can collectively bargain to lower drug prices in their market. This is not anti free market. However, I am not sure if the EU always truly negotiates in good faith there, often they might act as a regulator and soft banning drugs/companies from the common market for lower prices.

Americans, do pay more for drugs: But their economy benefits from actually being the one that develops them, has more access to them, and has access to them earlier. 

Now, the question here is the following do we want more drugs? If we do we should have Europeans increase the prices they pay, Or Americans need to reduce regulatory barriers and legal avenues \[there are a few frankly laughable cases when it comes to drug harms\]. 

If we want a current higher standard of care for a lower cost, but we don't care that much about future diseases as well as for smaller market diseases then American collective bargaining and a cratering of prices is ideal.

I lean towards drug development being way more important than current affordability with \[perhaps a decrease in patent length\]. But as with most things in economics is a trade off.

P.S: I am European.

National-Return9494

We literally developed the COVID vaccine. Shut up.

KA1N3R

[deleted]

This thread reminding everyone that a lot of so-called American liberals are nothing but US exceptionalists and supremacists. I don't know whether to laugh or cry.

caligula_the_great

I’m on Trumps side here. European pharma makes their profits on US customers and uses that to fund r&amp;d while providing drugs at much lower cost to EU citizens. 

Maybe that’s because the EU nations are better at collective bargaining, and that’s fair game, but what that also means is that Trump demanding lower drug prices for the US is also collective bargaining and also fair game.

eric_he

Many medical and mental health providers.

Street-Quail5755

Restaurant workers and I'm not talking fast food.

12ohmygod

mistress6nine

Construction. So many companies are all about drug tests but those are so easy to cheat on. Shit still gets done

Alternative_Reason90

Car sales , no one’s doing more blow than those guys while at work

OkGarlic1745

Hamlerhead

If we're talking pain killers, my understanding is professional athletes, who often play with some sort of injury or pain almost 100% of the time. 

I've heard other reports of Adderall and amphetimines in various high pressure careers, like attorneys, programmers, accountants, and even medical professionals.

CatOfGrey

SagittariusPangolin

Suyeta_Rose

Bustamonte6

Skydreamer6

Potential_Top4116

half_ton_tomato

Politician. And every single dc agency has tons of alcoholics

lovely_orchid_

RetreatHell94

Restless_Soul-01

I think what we can gather from these comments is that there are a LOT more in people in general that are using drugs than anyone’s prepared to accept. What profession they are in isn’t  as stereotypical as it was in the past. It’s anyone anywhere, and everyone everywhere.

fireontheholodeck

Negeren198

As a former law student and current attorney who has never used powders or pills, I know I have been at a disadvantage a lot of the time. I can’t function on so little sleep or concentrate for such long periods as others. Joke’s on me, I guess.

RealGuyWhoCares

MartyPhelps

ImprovementNo1056

Ok-Biscotti-7777

RodneyBarringtonIII

Big_Surround_1100

Rehab staff. Cannibas is illegal in my state.  I sold pans of brownies to a contractor friend who sold them individually.  I went to rehab for my roxy addiction and randomly ran into him doing a job there. He told me after my stay that he got that contract because most of the staff were his brownie customers. I'm almost 5 years clean and it's not because of that place. I could've bought pills there my 1st day and possibly my own brownies. I don't sell brownies anymore either, but I'm still friends with the contractor.

14crickets

Brock_Savage

Any profession that doesn’t random drug test.

Ill-Cranberry978

Doctordelayus

ExtraDependent883

88Freida

RubyFleur33

basically everyone of us is high on the job, I use LSD

Attizzoso

I'm guessing medical. Wheely the drugs might be legal, they are not prescribed for them.

HVAC_instructor

DemonScourge1003

Grated it's legal in my state now, but when I first got to know my coworkers in child care better, the number of them that enjoy the devil's lettuce after hours surprised me.

Sam_Paige25

Whatisdissssss

Ski industry. Pick a job within it and guaranteed 9/10 use something at work.

Klstrphnky74

In this thread: People who think other people will be surprised that white collars do drugs.

WhydIJoinRedditAgain

Artists and gallery owners have way less than one might think. Weird, right?

anythingbutmetric

tx2316

Restaurant workers. I have that on reliable authority.

aslrules

Few_Day3332

All of them. Church leaders though is one people probably wouldn’t think about. I know several alcoholics at my job with USPS. A few of them maintain a drunk all day while delivering mail.

Vercingetorix_

acquaman831

My roomate was an engineer. Everyone in the engineering department was either caffeine addicted lsd  drinking or weed

Lekingkonger

Academia! Full of personality disorders since the whole thing is based on constant validation for your work/the quest to "beat" other academics in your field. Drug use and the desire to "harbour a secret despite being brilliant" go hand in hand with that culture.

Cyclekiller1

ConcertTop7903

Pinkhydra76

banmeagain42

PaddyVein

Usual_Foundation_353

Commercial fishing and offshore sportfishing

waynofish

DramaticQuality1711

razorduc

OhioValleyCat

x_rhea

PuzzleheadedLeader79

In my experience, machinists love opioids and alcohol.

RacerXrated

Consistent_Ad_8090

whatnowyouask

Being in the Navy, I'd say the Navy. A ton of underage drinkers too.

VenomSnake47

mchisto0450

jber1

Weed should be legal and alcohol illegal!
Or just legalize everything and see how the world will change it’s perspective

JoeBiv

VannaMalignant

ChrisKetcham1987

_Buck_Turgidson_

Lucky_Caterpillar_63

In high school my friend’s dad, an actual brain surgeon used to smoke weed with us all the time.

readmore321

Feeling-Lime-834

Cookies_and_Beandip

Anything with longer than 8 hours, or 8 hours with intense physical discomfort.

Thereal_maxpowers

doctors cuz they have access to the pill cabinet.

Charlie_redmoon

Ok_Instruction_7813

WhyHill88

Lawyers are pretty much all stoners and cokers.

robRigginsstar

You'd be shocked the amount of teachers using illegal drugs

AleroRatking

GranvilleTim

NASCAR pit crews are notorious for the amount of Meth and Cocaine in use

professor_goodbrain

Prestigious_Loan_989

passo_carrabile

thirstyimhungry-wnts

Jsm0922

President Donald Trump identified 23 countries as major drug transit or illicit drug producing nations, warning of serious consequences for non-compliance.

Drug Trafficking and Production Countries Designation

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