The last point is important.

Suicide, firearm deaths, deaths from obesity, deaths from smoking are all higher in America.

Opioid deaths are way, way higher, which pulls life expectancy way down because the age of death is tragically so young.

Your first point I'm not sold on. The US pharma system is beyond inefficient. They may output more but there certainly exists a system which could do 10x as much with the same funding.