A November 2010 report from the International Federation of Health Plans (iFHP) highlighted differences in health care prices across different countries. It is no surprise that the U.S. leads the world in costs and prices for the 14 different services and procedures, which ranged from hip replacements to MRIs. The real concern, of course, is that our health outcomes are not better, and in fact, worse than many of the other countries that spend far less than the U.S. does on health care.
Receiving less attention is the reported differences in drug pricing across the three countries. In the report, iFHP examined pricing for Lipitor, Nexium, and Plavix, finding more than a 4-fold difference in pricing for Lipitor, a 6-fold difference in pricing for Nexium, and more than a 3-fold difference for Plavix.
Keep in mind that these prices are not all directly comparable. In fact, I threw out France, Australia, and the Netherlands because of fundamental differences in reporting. In addition, the U.S. data may not have fully captured rebates. That said, the average price for Plavix in the U.S. was $152 compared with $57 in the UK and $76 in Canada, two countries that do allow for comparison. For Lipitor, the average U.S. price was $129 while UK and Canada paid less than $40.
As with costs for other healthcare services, the finding of much higher drug prices in the U.S. is not new information, and it is fortunate that generics are available for two of these medications. However, this report is a reminder that we are using more of and paying more for pharmaceuticals than other industrialized countries, often without clear evidence of value. The link between pharmaceutical spend and clinical outcomes in the real-world is still in its infancy and represents an opportunity for those organizations willing to tackle the tough questions of value and equity.