Contextual citation impact...
Percent of collaboration-based publications...
(graphs from SciVal analytics)
We host 11 of the top 20 earning pharmaceutical companies on the world in terms of revenue, income, and R&D.
If you want to talk about facts, let's talk about this one: Most new drugs are developed in the United States. According to Forbes Magazine, 80 percent of all new drugs are developed in the United States
A manufacturer that is, say, Canadian doesn't have to redo the R&D cost that US companies bear. Once a product in the United States has been developed and tested and received FDA approval, there is nothing preventing companies outside the United States from making a similar product. A significant portion of savings lie therein. And no, re-importation does not solve that problem.
Getting into an argument about means testing and administrative cost reduction leads into much murkier waters -- in the future, the United States may ultimately opt for a Medicare-inspired single payer system. I don't dispute that. But for now, in terms of present day deficit reduction, I am not especially willing to experiment with something that alters the balance of the global pharmaceutical market.