This is not like IT where the Americans are completely dominant and clearly superior.

The European pharma companies are doing more than fine, despite their main market being heavily regulated and price-controlled.

The less charitable explanation is that US companies want to charge outrageous prices, and the American system let them to, so they do it.

That's what the USA are: a machine to prioritize profits over people. Sometimes it turns out fine, like for the startup scene. Sometimes it's terrible, like when lives at stake.

Other explanations sound like heavy copium to me.