The point is moot since pharmaceutical companies are already highly profitable beyond their R&D expenses, as the OP acknowledges. So drug prices could be significantly lowered in the US while maintaining current research levels.
The main argument (U.S. prices subsidize global innovation) is weakened further by two facts: 1/ many major pharmaceutical companies (like Novartis, Roche, or Sanofi) aren't even American; 2/ the current system mainly incentivizes the development of marginally improved drugs for already-treated conditions, rather than true medical breakthroughs.
When other developed nations successfully regulate drug prices while maintaining access to innovation... it's quite a reversal of responsibility that's played here. The real, glaring question is more why the U.S. continues to resist implementing similar price controls that have proven effective elsewhere.
many major pharmaceutical companies (like Novartis, Roche, or Sanofi) aren't even American
While true, their ability to charge so much more for the drugs they produce in US markets make them much more profitable than they otherwise would be. Money that they in theory can spend on innovation. Of course this leads them to prioritise drugs that are primarily targeting rich Americans and which in turn leads to your second point.
The main argument (U.S. prices subsidize global innovation) is weakened further by two facts: 1/ many major pharmaceutical companies (like Novartis, Roche, or Sanofi) aren't even American; 2/ the current system mainly incentivizes the development of marginally improved drugs for already-treated conditions, rather than true medical breakthroughs.
When other developed nations successfully regulate drug prices while maintaining access to innovation... it's quite a reversal of responsibility that's played here. The real, glaring question is more why the U.S. continues to resist implementing similar price controls that have proven effective elsewhere.