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U.S. sales of the 20 top-selling drugs totaled $101.1 billion in 2020, while sales of these drugs to the rest of the world totaled only $57 billion, highlighting how Americans massively overpay for drugs, a new Public Citizen report found.
Some drugs saw greater disparities than others. For example, AbbVie earned $16,112,000,000 from U.S. sales of the autoimmune drug Humira, compared to $3,720,000,000 from international sales, or more than four times as much. For 17 of the 20 top-selling drugs worldwide, Big Pharma made more from U.S. sales than from sales to all other countries combined, and for 11 of the 20, U.S. sales revenue was double that of the rest of the world or more, the report found.
Additionally, 11 of the 13 pharmaceutical companies selling these top drugs made more money in the U.S. from these drugs than they did in the rest of the world combined.
The analysis offers a glimpse of how much these businesses benefit from the American health care system overpaying for drugs. The U.S. is one of the only high-income countries not to negotiate the price of drugs. Granting Medicare the authority to push back against pharmaceutical company profiteering would mean an end to decades of overpaying for medicines and would save the U.S. billions of dollars.
"This eye-popping rip off Big Pharma is getting away with is an insult to the American people," said Rick Claypool, a Public Citizen research director and co-author of the report. "Empowering Medicare to push back against inflated drug prices is the responsible and commonsense way to stand up to the industry's greed - which, certain members of Congress should be reminded, lawmakers in both parties have been promising to do for years."
"Millions of American families ration medicine to help pay the bills. Until now, the U.S. government has not even asserted power to help by negotiating more reasonable prices," said Peter Maybarduk, director of Public Citizen's Access to Medicines program. "Drug corporations clearly are taking advantage of that weakness, and abusing their monopoly privileges - and everyone in the U.S. is paying for it."
Read the full report here.
Public Citizen is a nonprofit consumer advocacy organization that champions the public interest in the halls of power. We defend democracy, resist corporate power and work to ensure that government works for the people - not for big corporations. Founded in 1971, we now have 500,000 members and supporters throughout the country.
(202) 588-1000"Children are not incidental victims; they are directly affected, facing forced recruitment, sexual violence, unlawful detention, torture, and a lack of medical care," Amnesty International USA stressed.
Demands for a ceasefire in Sudan's three-year civil war mounted this week amid reports that more than 300 children have been killed or injured in the northeastern African nation this year alone, mostly by drone strikes.
The United Nations Children's Fund (UNICEF) said Modaysu that "children across Sudan continue to bear the brunt of a war that is becoming increasingly deadly, with at least 330 children reported killed or injured during the first six months of 2026. Darfur and Kordofan states continued to record the highest levels of child casualties."
"The situation in and around al-Obeid, and more broadly across North Kordofan, is particularly alarming," UNICEF continued. "Since May 2026, drone strikes and other attacks have reportedly resulted in more than 35 child casualties in the state, including at least 18 children killed and more than 17 injured. The affected children ranged in age from just 2 months to 17 years. According to reports, drone attacks accounted for 60% of these casualties, highlighting the growing impact of this method of warfare on children and families."
"Repeated drone strikes and shelling have also damaged civilian infrastructure, including homes, schools, health facilities, water systems, and markets; disrupted supply routes; and placed essential services under increasing strain," the agency added. "With an estimated 500,000 civilians at risk in and around al-Obeid and across North Kordofan, any further deterioration could expose even more children to death, injury, displacement, and other grave protection risks."
Amnesty International USA said Monday that both the Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF) rebels "have committed numerous human rights violations, including deliberate attacks on civilians."
"Ethnic targeting has resulted in assaults on non-Arab communities, with women and girls subjected to sexual violence and exploitation," Amnesty added. "Children are not incidental victims; they are directly affected, facing forced recruitment, sexual violence, unlawful detention, torture, and a lack of medical care."
On Monday, the United Nations Human Rights Council approved a measure proposed by five European countries—Germany, Ireland, the Netherlands, Norway, and the United Kingdom—condemning escalating RSF-led violence in and around al-Obeid.
While both the SAF adnd RSF have committed documented human rights crimes, an independent United Nations panel released a report earlier this year detailing allegedly genocidal crimes committed by RSF rebels during last October's offensive in Darfur, where thousands of people were killed and others tortured, raped, and starved during the capture of el-Fasher.
The UN experts found that “genocidal intent is the only reasonable inference that can be drawn” from RSF's actions.
The ceasefire demands from UNICEF and Amnesty follow similar calls from governments, including France and the United Arab Emirates, as well as other UN agencies.
On Friday, UN High Commissioner for Human Rights Volker Türk warned that "another human rights catastrophe is unfolding" in al-Obeid.
"The signs from #ElObeid are clear & unmistakable: another human rights catastrophe is unfolding in #Sudan," @volker_turk told the @UN Human Rights Council.
"This is not a drill. It is a red alert that needs to land on the desks of Heads of State & Government around the world." pic.twitter.com/zH3bVIpX34
— UN Human Rights Council (@UN_HRC) July 3, 2026
“Civilians have been subjected to siege-like conditions for 18 months, battered by relentless drone attacks as the Sudanese Armed Forces and the Rapid Support Forces battle for control over areas surrounding the city," Türk noted.
“Some people are selling their belongings to finance their escape from the city," he continued. "For many, the exorbitant cost of transport and constant attacks on vehicles along exit routes, make leaving impossible."
"We have documented patterns of summary executions, abductions, torture and ill-treatment, sexual violence, and looting along the routes taken by displaced people across the Kordofan region," Türk added. "This is not a drill. It is a red alert that needs to land on the desks of heads of state and government around the world."
Since April 2023, Sudan's conflict has killed at least 59,000 people, displaced around 13 million others, and fueled famine in different parts of the country of approximately 52 million inhabitants. More than 30 million Sudanese are also in need of humanitarian assistance.
"We need robust enforcement of antitrust and fair trade practice laws to finally protect producers from meatpackers’ fundamentally unfair and illegal practices," said one campaigner.
A leading government accountability watchdog group on Monday ripped the Trump administration's move to rescind Biden-era rules enacted to protect ranchers and farmers from abuse by meatpacking corporations and boost competition in the key industry.
The US Department of Agriculture (USDA) has announced the reversal of three Biden administration rules under the Packers and Stockyards Act of 1921. One of the rules prohibits meatpackers, swine contractors, and poultry companies from retaliating against producers for actions like joining associations, speaking with regulators, or seeking other buyers.
Another rule mandated improved transparency in poultry grower contracts. The third rule‚ which was set to take effect this month, would have limited how poultry companies use the tournament payment system.
USDA said it plans to start the revocation process with proposed rulemakings scheduled for later this month and October.
Farm groups and antitrust advocates argue the move removes protections against monopolistic, deceptive, and retaliatory practices by dominant meatpacking and poultry companies.
“For years, meat corporations have abused hardworking farmers and ranchers. Now, the Trump administration is proposing to undo long-overdue progress made to level the playing field," Emily Miller, staff attorney at Food & Water Watch, said Monday in a statement. "This move is a slap in the face to all those who have long fought for fair treatment in livestock and poultry markets."
The USDA's move comes amid increased meat sector consolidation, which studies by Food & Water Watch, More Perfect Union, and others have found results in higher consumer prices and lower farmer profits.
Over the course of his two terms in office, Trump has boosted the meatpacking industry at the expense of worker rights, competition, and public health. His administration refused to issue binding rules requiring businesses to institute safety measures amid the Covid-19 pandemic, and he invoked the Defense Production Act to classify meatpacking plants as critical infrastructure and force them to stay open even as the coronavirus ravaged industry workers.
Trump has also supported corporate monopolization in meatpacking, and his administration has shut down a Department of Justice antitrust probe of alleged industry collusion. Just four meatpackers control approximately 80% of the market. Meanwhile, cattle producers who in 1980 received 63 cents for every dollar paid by consumers for beef were receiving just 37 cents four decades later.
"We need robust enforcement of antitrust and fair trade practice laws to finally protect producers from meatpackers’ fundamentally unfair and illegal practices," Miller said on Monday. "These rollbacks will do the opposite. We won’t rest until USDA does its job by putting producers above corporations.”
The panel found that the imprisoned doctor's detention is "arbitrary."
A United Nations rights body said Monday that the detention of Palestinian Dr. Hussam Abu Safiya by Israel was "arbitrary" and likely an indication of "a widespread or systematic practice of arbitrary detention in the country" as it demanded the physician be released immediately.
“The appropriate remedy would be to release [him] immediately and accord him an enforceable right to compensation and other reparations, in accordance with international law,” said the UN Working Group on Arbitrary Detention, warning that Israel has violated multiple articles of the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights by holding the doctor in detention since December 2024, when he was captured along with staff and patients at Kamal Adwan Hospital in Gaza.
Abu Safiya has been held without charge ever since, as Israel has accused the doctor of being a member of Hamas, pointing to Gaza's Military Medical Services records that show him listed as a "colonel" and a photo of him seated next to members of the group.
But medical and human rights groups note that there is no evidence that Abu Safiya has had a command combat role and that Hamas, which announced the dissolution of its government on Monday, has governed Gaza through its political wing, likening Abu Safiya's role to that of the US surgeon general.
The working group issued the call following Abu Safiya's recent transfer to the underground Rakefet interrogation facility at Nitzan Prison, which is known for abuse of prisoners.
The doctor recently told his lawyer, Nasser Odeh, after being transferred on June 24: "This is the last time you will see me… They brought me here to kill me. I don't see myself surviving. This is the end."
Odeah reported after visiting the prison on July 2 that Abu Safiyah was nearly unrecognizable and had suffered injuries to his "head, eyes, ears, and neck" and was having trouble breathing. He was "in a state of extreme weakness and was constantly on the verge of losing consciousness mid-conversation," according to his lawyer's account.
"I have visited Dr. Abu Safiya several times since his detention, but the individual I encountered during this latest visit was not the same person I had previously met," said Odeh in a statement. "His physical and psychological state, the severe injuries visible on his body, and his personal testimony leave no room for doubt: his life is in immediate danger. He must be transferred out of the Rakefet facility immediately and granted an urgent, independent examination."
On Monday, the American Human Rights Council (AHRC) was among those demanding Abu Safiya's immediate release, pointing to reports from his legal team that he is in "imminent danger" and potentially at risk of death if he remains in Israeli detention.
"Since his arrest on December 27, 2024, Dr. Abu Safiya has reportedly been subjected to torture, abuse, and prolonged solitary confinement," said the group. "His health continues to deteriorate, and he has been denied communication with his family and legal team. Reports indicate he was recently transferred to an isolated cell, raising further alarm about his safety and wellbeing."
AHRC noted that Abu Safiya placed "his patients’ lives above his own safety" as he continued to provide medical care and to publicly call on Israel not to target healthcare facilities during the Israeli assault on Gaza that began in October 2023.
"He refused to abandon the hospital or leave the wounded behind despite repeated Israeli demands and threats," said AHRC. "He continued his humanitarian mission under bombardment, siege, and near-total depletion of medical supplies."
Imad Hamad, executive director of the group, called on physicians' groups and international medical associations to urgently demand Abu Safiya's release, as hundreds of people in Tel Aviv also assembled in solidarity with the doctor.
"We urge everyone to take a stand and push for the good doctor's release," said Hamad. "This is not about politics; this is about medicine and human rights."
At Amnesty International, Erika Guevara Rosas, the senior director for research, advocacy, policy, and campaigns, called the details that have emerged recently about Abu Safiya's condition "truly horrifying."
"It is unconscionable that a pediatrician, who has dedicated his life to saving others in the occupied Gaza Strip, is being subjected to torture and other ill-treatment—including severe physical and psychological abuse and prolonged solitary confinement—while being detained without any justification," said Guevara Rosas.
She added that Odeh's account "must serve as an urgent wake-up call for states around the world, particularly Israel’s allies," such as the US.
"It is utterly reprehensible that a doctor who refused to abandon his patients, and who became one of the most prominent voices denouncing the devastation of Gaza’s healthcare system, remains arbitrarily and unlawfully detained under Israel’s baseless designation as an ‘unlawful combatant,'" said Guevara Rosas. "He continues to be deprived of his most fundamental rights, including the right to be protected against torture and other ill-treatment, and his rights to a fair trial and due process."
"Expressions of concern alone are little more than a cynical fig leaf for states’ inaction in the face of Israel’s crushing of Palestinians’ human rights," she added. "Amnesty, alongside other human rights organizations, is not simply calling for Dr. Hussam Abu Safiya’s immediate release. This is a call for urgent and effective intervention to save his life.”