I've had a theory for a while that the way world drug companies make up for low profitability in those markets is in gouging in the US where it's a free-for-all and one should grab for as much as one can get.
The totality of US healthcare is a big, complicated $3+ trn/yr pie but there's flagrant abuse all over the system (and a variety of intl players, profitably for them, contribute) and pharmaceutical companies are eager to be in on the game.
I wonder what would happen to healthcare globally if the US were able to downsize its 20%-of-gdp system to something on the order of Western Europe or Japan which is to say 10% of gdp? That is, the revenue the system generates would drop by half.
Needless to say, there'd be resistance tantamount to, let's call it, institutional violence. US doctors' earnings cut in half? You've got to be kidding.
It's much simpler. They don't "make up" for anything, they just grab as much as they can get, everywhere. It just happens that in the US they can get more, and as the amoral, self-interested entities they are, they don't leave any money on the table.
No major company will say "Our profits are up in market A, so we should reduce profit in market B to compensate."
A lot of things that doctors do (because people want doctors and doctors want doctors to be in demand) could be done by nurses with special training.
That you think they are somehow related strongly undermines the rest of your post, as it suggests you are very weakly acquainted with the details of our healthcare system.
And in terms of drug prices in Western Europe, it really depends. One example, orphan drugs for rare diseases, the prices are actually pretty comparable to the US. These are the drugs that are several hundred thousand dollars per year.
A good example is Glybera, a gene therapy never approved in the US. The price in Germany was ~$1M USD.