No they don't lag behind, because as I mentioned, once they're developed the drugs are available globally, and often reverse engineered and re-sold by less scrupulous countries that don't care about intellectual property.
As to your first question, I don't have an answer for you off hand.
Okay, what are the sources of this claim? I'm kind of surprised that Germans and the British steal American technology developed though bankruptcy inducing childbirths.
edit: Hmm, if that's true then US must be actually behind because every now and then the UK or some Europeans might invent something but the Americans won't have it because they respect intellectual property. Which means Americans will have only American stuff but the Brits and the EU will have Europeans stuff too.
Okay, can you provide some literature on that claim? Do you, by any chance refer to the European governments buying directly from the pharma companies, thus getting solid discount? Or is it the case that European companies simply copy the drugs and move on? If that's the case, is the US healthcare expensive because pharma companies need to make money from the US sales only?
As to your first question, I don't have an answer for you off hand.