The U.S. market's high prices create the large profit pool necessary to fund risky drug development. If the U.S. adopted price negotiation like other countries, the global incentive for pharmaceutical innovation would shrink, resulting in fewer new drugs being developed worldwide.

The market is currently ignoring the long-term impact of deep cuts to research funding at agencies like the NIH. While effects aren't immediate, this erosion of foundational academic science—the "proving ground" for new discoveries—poses a significant downstream risk to the entire biotech and pharma innovation pipeline.

The NIH's cancellation of mRNA research is a profound strategic error. The technology's key advantage is speed, which is critical not only for future pandemics but also for personalized cancer treatments. These therapies must be developed for individual patients quickly, making mRNA the most promising platform.

Building the first large-scale biological datasets, like the Human Cell Atlas, is a decade-long, expensive slog. However, this foundational work creates tools and knowledge that enable subsequent, larger-scale projects to be completed exponentially faster and cheaper, proving a non-linear path to discovery.

Pure, curiosity-driven research into quantum physics over a century ago, with no immediate application in sight, became the foundation for today's multi-billion dollar industries like lasers, computer chips, and medical imaging. This shows the immense, unpredictable ROI of basic science.

Major pharmaceutical companies are now willing to deploy the "nuclear option" of pulling planned R&D investments to express displeasure with national drug pricing policies. This tactic, seen in the UK, represents a direct and aggressive strategy to pressure governments into accepting higher prices for innovative medicines.

The disruption to the U.S. biomedical research ecosystem is not necessarily a targeted reform of science itself. Instead, it's viewed by many as 'collateral damage' in a larger political culture war against universities and perceived 'woke leftist ideologies,' with NIH funding being used as leverage.

Responding to Wall Street pressure to de-risk, large pharmaceutical firms cut internal early-stage research. This led to an exodus of talent and the rise of contract research organizations (CROs), creating an infrastructure that, like cloud computing for tech, lowered the barrier for new biotech startups.

Despite the NIH Director publicly prioritizing research on HIV and long COVID, a recent analysis shows that clinical trials in these exact areas were disproportionately affected by the agency's funding cuts. This signals significant internal policy incoherence and undermines stated public health goals.