“America is the piggy-bank of the pharma world,” gripes David Mitchell of Patients for Affordable Drugs, a consumer lobbying group. There is some truth to this. America is the world’s largest pharmaceutical market, with $630bn in sales in 2022, or 42% of the worldwide total. Its contribution to profits—65% of the global haul—is greater still. American patients have long borne the burden of these juicy returns.“美国是制药界的存钱罐,”消费者游说组织平价药物患者组织的戴维·米切尔抱怨道。这有一定道理。美国是全球最大的医药市场,2022 年销售额将达到 6300 亿美元,占全球总销售额的 42%。它对利润的贡献更大——占全球利润的 65%。美国患者长期以来一直承受着这些丰厚回报的负担。