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There is an international patent treaty that a lot of countries are party to. I'm no expert, but I think that the problem with it is that it requires the signatory to honor the patent in the sense that they will enforce the rule that he who owns the patent is the only person who can sell the patented product, but it does not tell them that they cannot regulate the price of that product.

So if Biogen comes up with a miracle drug, then they can market it in China, and China will honor their right to be the exclusive seller of that drug during the life of the patent. But there is nothing that says the Chinese government can't regulate the price of the drug at a low level.

Either that, or these countries are simply violating the treaty. Or maybe they are misinterpreting it.

Regardless of the situation, though, it is clear to me that the US is the only country that really ascribes to the notion that drug companies ought to be able to charge what they want during the life of the patent, so as to encourage R&D. The US policy is a good one in that it encourages R&D. But since no one else in the world ascribes to that policy, the US consumer is funding all of this R&D, and foreign consumers are receiving the benefit of that R&D free of charge.

What good is a patent if you don't have the freedom to set the price at a high level? The whole purpose of the patent is to increase the return on R&D investment by allowing you to charge a monopoly price during the life of the patent. If you can't charge the monopoly price, then having a monopoly really doesn't help you fund R&D.