The cost of prescription drugs in the United States has long been a source of concern for policymakers and patients alike. One major player in the provision of healthcare, Medicare, has historically been unable to negotiate drug prices directly with pharmaceutical companies. This article explores the reasons behind the lack of negotiation and the recent changes that have paved the way for Medicare to actively engage in negotiating drug prices. Additionally, it delves into the factors contributing to lower drug prices in Canada and Western Europe, providing insights into potential solutions.