@rieyin The US allows certain drugs to be sold inside the United States, where the same drug is also sold in, eg, Canada. The drug might be produced by the same manufacturer, in the same plant, for both countries.

But if you try to bring that first-sold-in-Canada drug across the border, the US imposes its steep “tariff” in the form of legal risk.

The arrangement, like a tariff, protects the ability of sellers inside the US to charge much higher prices than prevails elsewhere. 1/

@rieyin But a tariff is charged based on where the manufacture took place, but with pharma, the “charge” comes by virtue of where the drug was first (legally) sold. /fin