It's not just the advertising and promotion in the US that drives drug costs so high, John.
A huge factor is liability, insurance....all tied to fear of litigation!
Lawyers.
You know what they call a dead lawyer at the bottom of the ocean, right?
A good start.

Don't forget R&D costs. They may try hundreds or thousands of "mixtures" with clincical trials involving thousands of people, millions in equipment, etc. and get only a single marketable drug.

Supply and demand doesn't hurt them either.

I realize we are now way off topic, but drug prices have little to do with R&D costs. Prices are set based on demand, competition and production costs. The drug companies are trying to recoup their R&D investment, and they direct their R&D based on how much money they think they can make on a potential drug. But when the drug finally comes to market, it is a matter of maximizing the Gross Margins on that particular drug. That is done on a country by country (and insurance company by insurance company) basis. Liability concerns will determine whether a company will bring a drug to market (or take it off the market) but does not factor specifically into pricing. R&D and Liability are the reasons the Drug Companies use when they testify before Congress for the healthy profits they achieve.

I thought there were laws that protect drug manufacturers against lawsuits in ways other manufacturers can only dream about. I know this is true with legal claims for complications from vaccines. Anyone know if this is so?

I am going with 3 friends to San Diego in Sept. Tiajuana is on our list of places to go. My mom is convinced I will end up like Clare Danes on Broke Down Palace...lol...Do you have any suggestions to avoid ending up in a Mexican jail??? Thank for your help.
Sam

Just 3:
1) Walk, don't drive across the border.
2) Don't drink.
3) Get back before dark.

By the way it is Tijuana NOT Tiajuana as some hve spelled it, but however it is spelled it is still a terrible place to see any resemblance of Mexico. Stay in San Diego and go to "Old Town" or drive to Los Angeles one day and go to Olvera Street for authentic Mexican products and souvenirs..if that is what you want.Enjoy San Diego. Do not miss the Del Coronado Hotel.