A vial of insulin costs far more in the U.S. than it does in Canada.
Drug prices are set by Canada’s Patented Medicine Prices Review Board which sets price caps by comparing drug prices across a group of 11 countries. The US used to be included in the formula, but was removed from the group in 2022 — because US drug prices are an insane global outlier.
https://en.wikipedia.org/wiki/Patented_Medicine_Prices_Review_Board
A group of Pharma companies including Pfizer and Merck have asked the Trump administration to put pressure on Canada. They are accusing the country of unfair trade practices.
Because a bunch of Americans get their drugs from Canada (mail order or driving across the border if you're close), and it really pisses off the pharma companies that they're losing that money.
And it was a Republican idea to let Americans buy from Canada.
You don't get how CEOs think - if you made huge amounts of money but felt entitled to GIGANTIC amounts of money, then you lost imaginary money and need to be compensated.