I analyze drug development for a living. That guy has no idea what he is talking about with regards to R&D costs. The costs for bringing a drug from bench to market varies widely dependent on the underlying technology, trial indications, site locations and count, and a whole host of other factors. About 90% of drugs that enter the clinic never make it to submission. For every one of those that even make it to the clinic, there are dozens that never leave the research phase.

Your understanding of the FDA is a bit flawed. They don’t deal with drug prices because it’s not their job. Just like the EMA doesn’t set drug prices. The CMS is the US entity that decides drug prices for government insurance (Medicare/medicaid). Drug manufacturers must also negotiate with each insurance company independently. It’s this fragmentation of payers (vs single-payer in most other regions) that results in higher drug prices.

All that said, when you look at pharma revenues by region it becomes very apparent that the rest of the world benefits tremendously from the amount of money pharmacy companies make in the US. It varies by company, but the US market makes up about 45-50% of all drug sales. If that money pot suddenly decreased due to something like Medicare 4 All, it would result in a massive slow down of pharmaceutical R&D globally.

I bring this up because the rest of the world likes to shit on America for our broken medical system (rightfully so), but few who do actually realize how much medical innovation the US subsidizes for them through disproportionate product sales and government funding for early research.