President Trump is right that Americans often pay too much for prescription drugs, and that other countries aren’t pulling their weight. The status quo isn’t merely unfair — it’s unsustainable.  

But to fix the problem without deterring the massive research investments that spur economic growth, job creation, and health gains, policymakers will need to address the true drivers of high prices here at home, while simultaneously pressing our allies to contribute more abroad.  

American leaders can start by tackling the bloated middle of the drug supply chain. Middlemen who neither invent nor administer medicines to patients now collect more in rebates, discounts, and fees than the total price of drugs in many other countries.   

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