I'm sure there will be cutouts for companies that do favors or whatever. Just like everything else he's doing.

How would this actually be enforced? Unlike other countries with socialized healthcare, the US doesn't negotiate prices with these companies directly. Perhaps there's some mechanism I don't know of, but I doubt it, we're kind of all about empowering capitalists to fuck people over.

The bigger catch is that this would almost certainly go to the supreme court and get overturned.

Monkey's paw it's for drug wholesalers on import prices but just so their profit margins increase one billion percent when prices to end users stay the same.

I'm kinda trying to unpack it too.

I don't really understand enough about healthcare in different countries (I'm in Australia).

Meds in the US are stupid expensive because of freedom or something. In Australia all meds are purchased by a central organisation so they have bargaining power.

IDK all the factors involved in negotiating a price, but presumably Australia has some cards to play like buying adjacent meds from non-US vendors.

What I mean is, US vendors would already be extracting as much from Australia as they reasonably can, and an EO from POTUS doesn't really change the factors that are balancing the market.

Another issue is ethics. HIV antiretrovirals are very expensive in Australia, suppose $1,000 USD per month. That's fine, the government pays for that. The countries that have crazy high rates of HIV generally have a much lower GDP per capita, it's just unethical to withhold medication from them when the cost to manufacture a month's supply is $1.

Finally I suspect it's simply the usual supply / demand type factors. A company can make more profit by selling 10 million doses at $1 than they can selling 0 doses at $100.

As usual, it's a poorly considered blunt instrument expected to address a complex and nuanced issue. It makes sense to Trump because it's grandiose and logical within the confines of his adversarial transactional paradigm.

In practice though, I suspect that American pharmaceutical producers aren't happy about this, and if it does have any effect on prices for impoverished countries it will put a lot of pressure on other countries to respect the intellectual property rights on those meds.