Drug Costs Vary Substantially Among High-Income Countries

Universal healthcare can impact spending on prescription drugs.

Prescription drug costs are on the rise in the United States, making access to treatment difficult for some patients with costly conditions. Numerous studies highlight the variability of drug pricing throughout the world.

A new analysis published by the Canadian Medical Association Journal suggests that drug costs may vary over 600% among 10 high-income countries with universal healthcare.

The authors examined the volume and cost of primary care prescription drugs in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the UK. The utilization of drugs used in-hospital were not included. The United States was not included due to the high cost of prescription drugs and lack of universal healthcare, according to the authors.

The investigators focused on 6 common categories of prescription drugs used in primary care, which are typically purchased at pharmacies. These drugs include hypertension medications, pain drugs, cholesterol-lowering drugs, non-insulin diabetes treatments, gastrointestinal drugs, and anti-depressants. Frequency of use was measured by the average number of days purchased per prescription.

The authors discovered that hypertension drugs accounted for the highest number of days per therapy for all countries. Among the 5 countries with universal, single-payer coverage of drugs, the average cost was $77 per person, according to the study.

Among 4 countries with universal social insurance for prescription drugs, the average cost per patient was $99, while it was $158 in Canada, which has both private and public financing, according to the study.

"The volume of therapy purchased in Canada was about the same as that in the comparator countries; however, Canadians spent an estimated $2.3 billion more than they would have in 2015 if these primary care treatments had had the same average cost per day in Canada as in the 9 comparator countries combined," the authors wrote.

The authors noted that higher costs of drugs and the therapies chosen accounted for a large portion of the cost differences discovered between the countries, according to the study.

These findings suggest that prescription drug costs vary even among countries with universal healthcare. Specifically, countries with a single-payer coverage were observed to have the lowest costs for drugs prescribed in a primary care setting, according to the study.

"Average expenditures are lower among single-payer financing systems, which appear to promote lower prices and selection of lower-cost treatment options within therapeutic categories," the authors concluded.