I've been looking at this data for reference:
https://www.wada-ama.org/sites/default/files/2023-01/2021_anti-doping_testing_figures_en.pdf
Where do you get your claims?
Either way, as another guy pointed out US athletes have a really quite absurdly high rate of TUEs. Maybe that's just because the average American is unhealthy, maybe that's just because the US healthcare system catches more of those things, but it's still odd that those athletes coincidentally take performance-enhancing drugs as medication for their medical condition. It's also odd how low the TUE rate is in other countries in comparison - WADA seems more willing to approve requests from the US, which maybe explains part of the discrepancy.