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Making new medications costs money. It’s not free to do the research, development and testing, and then obtain U.S. Food and Drug Administration approval.

So after a pharmaceutical company spends millions of dollars on the discovery of a new compound, it only makes sense that itÌýneeds to recoup its investment.

But what if the medication costs 10 times as much if you live in the United States than if you live in Canada? Or if the same pill you took at age 64 suddenly jumped in price when you go on Medicare at 65?

Does pharmaceutical pricing make any sense?

and , Democratic candidates for president, have both recently brought up a little known issue regarding rising medication costs. Despite the government having the power to negotiate prices for patients in the Veterans Administration program and even in the Medicaid system, there are legal bans on any price negotiation for those who have Medicare Part D insurance plans.

That’s thanks to the Medicare Modernization Act of 2003.

Doctors have known this for years:

• Coupons found easily in magazines, online or at pharmacies and doctors’ offices for various medications cannot be used for anyone over 65.

• Samples aren’t available in many offices anymore, and if your prescription drugs are covered by Medicare, you are not eligible to use the same copay cards that are readily available to anyone with commercial insurance. These cards often reduce the cost of expensive medication to the same as a generic pill.

While Medicare is particularly hard hit because of its lack of ability to negotiate better prices, the fact is that Americans in general pay more for their medicine than residents of other countries.

Why are medications cheaper everywhere else than in the United States, and why are the highest prices of all charged to our senior citizens? Look no farther than Canada to find out.

One of the biggest differences in the pricing for medicine for Canadians is the fact that their government negotiates better deals because they have a nationalized drug benefit plan.

Pharmaceutical companies have to lower their price if they want to have any market share in Canada at all.ÌýPatients get their medicine cheaper, if not free, and the taxpayers benefit from the lower costs.

The entire population has access to some of the very same drugs we have here, but at a lower price. Why? Because Canada can bargain hunt. If itÌýdoesn’t like the deal, it can demand a better one. How can such a system work? Well the drug manufacturers know they can make their money south of the border, in the United States.Ìý

Laws banning bargaining apply only to the federally run Medicare program. Other private health insurers are able to reduce costs by negotiating a lower price directly with the pharmaceutical supplier.

The formulary of covered medications reflects the preferred pricing program. Each formulary contains tiers of preferred medications for the particular insurance plan. The lowest cost is often for generics, then a preferred brand name medicine comes next. Every January, there is the annual shuffle when companies change their preferred brand, and patients are left to call their doctor’s office to find a substitute, or pay the higher price for their medication.

But with Medicare Part D, no negotiation is allowed. That costs patients, and taxpayers who fund the program.

Some might suggest that we just get our medications from Canada, where the cost is cheaper. Well, if you live in the U.S., you are out of luck again. It’s currently illegal to import prescription medication into the country. The FDA says that’s for our own protection, since it can’t monitor the medication brought in from somewhere else. But sometimes, the very same manufacturer provides the pills. How different could they be?

So what if the laws were changed to equal the playing field?

Well, it’s hard to take back something that has already been given away. The U.S. has allowed this inequity to exist for far too long already.ÌýWith the strong lobbying from the pharmaceutical companies, unless there is some type of executive action,

Almost $125 million has been spent this year on ÌýWhat does all this buy? Lobbying efforts have focused on resisting government-run health care, quicker approval for drugs and other products entering the market, and strengthening intellectual property and patent protections. Limiting availability of generic competition is one of the goals, which leads to a greater bottom line for the companies who make the more expensive brand name versions.

Since 2003, the legal restriction against any price negotiation for Medicare beneficiaries has led to a guarantee of top-dollar prices to the pharmaceutical industry for any drug covered on a Part D Medicare benefit plan.

While Medicare is particularly hard hit because of its lack of ability to negotiate better prices, the fact is that Americans in general pay more for their medicine than residents of other countries.

In fact, the companies themselves are no longer hiding their pricing schemes. Many are openly charging more for their medication here, using the rationale that the U.S. is one of the wealthiest countries and can afford to pay more and subsidize the rest of the world.

That argument might work in the developing world, barely, but it doesn’t really explain why we pay significantly more than other countries in Ìýfor the same medications. are a particular area where the costs in the U.S. are alarmingly out of proportion to the rest of the world.Ìý

The cost of medications is going up as people are living longer, so it’s only a matter of time before the entire system starts to collapse. The best thing that can happen to our seniors in the Medicare plan might just be having the government begin to bargain on their behalf.

After all, doesn’t everyone like a good deal?