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I follow you but I also wonder, if no one can afford those drugs to begin with how viable is a plan like this? If the giant margins are ending, people have no income to purchase medicine with, and the US isn’t subsidizing it, how exactly are these meds getting to the public? Suspending sales globally to court poor Americans who can only dream of paying for meds doesn’t seem like an especially bright plan
So we CAN afford these drugs to begin with, because employer sponsored health plans with minimal coverage cost around $14000 and have $6500++ copays (I don't remember today's limits for copays, but you have to pay those copays out of pocket before an insurance company covers drugs typically.) The actual drugs cost pennies to make but sell for hundreds to thousands to hundreds of thousands. The prices that are listed for these drugs at retail are not actually what the insurance pays for these drugs, we're never going to see those figures, but they're aligned to maximize profits from the industry. Pharmacy benefit managers also collude by using a third party service to recommend pricing.
I'm too lazy to find good sources of material, but revenue in the US for pfizer is more in the US than the rest of the world combined. https://www.statista.com/statistics/267877/revenues-of-pfizer-in-submarkets-worldwide/ (I was able to view this without a subscription.)
Last year they had about ~63600 million in revenue. ~38691 million last year was in the US alone.
~16057 for "developed markets" aka europe and wealthy nations ~8879 for "developing nations" e.g. africa, latin america, poor asian countries.
So 38 billion in the us vs 63.6 billion total revenue.
If you have to choose between keeping US revenue or keeping non-us global revenue, you're gonna choose the US. It's not even close.
I'm guessing they can license their drug to some other business to sell internationally and get out of first party sales, but it's possible they may have a legal mechanism to skirt this already since it's typical for the US business to be a separate company than the holding company, and all the international businesses are separate companies under said holding company, it's hard to say. I don't have any inside information for today's strategy.
The US isn't subsidizing. Most of the cost of a drug is marketing and paying obscene amounts for small biotechs and then shifting that cost into drug prices.
Also nearly no one pays Sticker Prices in the US for Drugs and Healthcare. They have to charge an insane price, so some insurance guy can negotiate an astronomical "discount"