Ron, it was one of those mornings for me and I should'a just kept my mouth shut. It's obviously a touchy spot with me because of working for "them" for 30 years and it grows tiring hearing them singled out as if they're the only profit-center in the US with lower prices offshore. I'm sorry to jump your butt. We can't solve it, so it's one of those things best left alone, eh?
Part of the issue is that a lot of the drugs sold in countries other than the US may have been produced in other countries, too. Abbott had so many non-US manufacturing sites, as do the others, it's hard to tell where drugs to Canada may have come from. Offshore manufacturing costs are almost always lower than here, both because of tax incentives and lower labor costs.
There are price controls in some countries, too, and governments negotiate prices, so in those places a corporation will lower prices just so they make some money rather than none. It's sort of like the "dumping" we see some nations do here. Add in the lower average income and savvy marketing folks take that into account, too. We both know that economies and prices are very complex beasts that mean one sector can't be singled out as a culprit. The bottom line is everyone is trying to take as big a piece of the pie as can be. I know for certain I never offered to turn down a raise so the corporation could help hold costs down.
Phil, my wife worked for a lot of the top people in the same company. We had a rule we couldn't talk about all the secrets she heard. Once in awhile, though, you'd hear stuff like 6 of the top honchos flew out to the desert in the company jet to play golf in some tournament sponsored by some hospital corporation the company was courting, or the honchos from there would be flown out here. She just said, "duck hunting in Mexico is another good example." "Perks" like that are just considered the cost of business and seem to be very common. It's very common with big pharma to "sponsor" graduate projects at big universities and have high-dollar professors on the roles as "consultants" as a way of having access to their brightest grad students. All sorts of crap went on all the time that could easily piss off the common man. All of that contributes to the higher prices, but not in a great way.
The biggest contributor is the fact we are one of the wealthiest nations on earth, and prices are higher because it's perceived we can afford them. A lot of places, you can't even get the drugs or a set of monster tires for our jacked up 4x4 to haul our $30,000 bassboat to the reservoir.