The rising cost of prescription drugs has been a big part of the health care debate in the past few years. Users of life-saving drugs like insulin, epinephrine, people dependent on drugs for cancer treatment, rheumatoid arthritis and a host of other debilitating diseases, have seen the price of their medicine going up astronomically in the past decade. The big pharmaceutical companies work hard to justify these increases, and spend millions in political donations and lobbying to keep the system that feeds their profits.

Big Pharma has been shielded from competition in many ways. Drug companies do have patent protection, allowing them to recoup to the cost of research and development, and getting through the regulatory approval maze. But they have also been shielded from having to negotiate prices with Medicare. While other countries negotiate down drug prices, Americans continue to pay top dollar, and are prevented from buying their drugs across borders.

It is time for government to introduce the concept of competition back into the pharmaceutical industry. It can start with the U.S., Mexico, Canada (USMCA) trade agreement that is hung up in Congress. It should remain hung up until a provision is removed that would protect pharmaceutical companies from competition for ten years when “biologic” drugs are reproduced as cheaper “biosimilar” drugs.

Big Pharma’s “your money or your life” pricing policies will only change when government forces companies to face honest competition in the marketplace.