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International Prescription Drug Price Comparisons: Current Empirical Estimates and Comparisons with Previous Studies

Publication Date
Andrew W. Mulcahy, Christopher M. Whaley, Mahlet Gizaw, Daniel Schwam, Nathaniel Edenfield, Alejandro U. Becerra-Ornelas

Key Findings

Policy discussion surrounding U.S. prescription drug prices focuses on whether prices in the United States are too high or appropriate relative to the benefits that they offer to patients.

  • Systematic comparisons of drug prices among countries are based on data from a broad set of drugs, and, unlike comparisons of drug spending among countries, they focus narrowly on differences in prices absent the influences of different volumes and mixes of drugs.
  • Price indexes are an effective way to focus on prices alone without the risk of interference from other variables—in this case, differences in drug volume share or mix. Calculations in this report are based on 2018 data comparing prescription drug prices in the United States with those in 32 comparison countries.
  • Along with overall price comparisons, researchers focused on subsets of brand-name originator drugs, unbranded generic drugs, biologics, and nonbiologic drugs.

Prices in the United States are higher than those in all comparison countries

  • U.S. prices were 256 percent of those in the 32 comparison countries combined. In comparisons with individual countries, U.S. prices ranged from 170 percent of prices in Mexico to 779 percent of prices in Turkey.
  • The gap between U.S. prices and prices in other countries was larger for brand-name originator drugs.
  • U.S. prices were 84 percent of prices in all non-U.S. countries for unbranded generics.
  • U.S. prices were 190 percent of prices in other countries after adjusting U.S. prices downward to account for rebates and other discounts.