Don't want to wander too far off the reservation, but you just touched a real sore point with me.
The reason the drug is only $45 in Paris, is that there is only one purchaser of Rx drugs in France...the French Government, through their national insurance program. Glaxo either sells to them at the government's price, or they don't sell at all.
In the USA, most end users only pay a small fraction of the $250-$350 price due to co-payments, etc. The insurance companies are large enough purchasers of these drugs to secure much lower prices. Probably close to the $45 you quote above. Medicare probably pays something close as well.
The only ones that get charged the highest price are the uninsured, who are the least likely to be able to afford either insurance or the drugs. Medicaid helps the truly destitute, but those caught without health insurance due to loss of a job or spouse are really screwed. Pretty much the same deal with hospitals and doctor fees.
We in the USA say that we want to have a free market when it comes to medical services and Rx drugs. The reality is that the market for these goods and services is anything but free. It likely never will be free so long as the government is the largest purchaser and fixes the price through their programs.
Rant over. Back to our regularly scheduled program,
gatorcpa