Top 10 Drugs Are On Average 9 Times More Expensive in the US vs the UK - My Personal Research
Introduction
I have always been amazed to hear that US drug prices are amongst the highest in the world. According to a paper in JAMA from August 2016:
"Per capita prescription drug spending in the United States exceeds that in all other countries, largely driven by brand-name drug prices that have been increasing in recent years at rates far beyond the consumer price index."
"In 2013, per capita spending on prescription drugs was $858 compared with an average of $400 for 19 other industrialized nations. In the United States, prescription medications now comprise an estimated 17% of overall personal health care services."
I thought I might do some armchair research and see how prices for drugs compare here (in the UK), to prices in the US.
I have summarised the data into a table and graph. Sorry for the small size but I was having difficulty fitting them on the page.
(Edit - I have tried inserting larger versions doesn't seem to make much difference).
The markdown version I tried of the table looked terrible!
Results - TLDR
1. All top 10 prescribed medications are more expensive in the US compared to the UK.
2. The mean (average) is a ninefold difference.
3. The Smallest difference is a multiple of 3.4 and the largest is 21.5 amongst the ten drugs listed.
Results As a Bar Chart:
Results As a Table:
Of particular note are the prices for Lantus (a long acting insulin which I take myself) which is 21.5 times more expensive in the US and Crestor (an anticholesterol drug) which is over 10 times more expensive!
Data Sources and Limitations
I was only able to find data for the top US prescribed Drugs for 2015. It is taken from this Medscape Report there is an easier to read version of the top 10 on WebMD here.
The data source for the report is listed as IMS.
US Drug pricing Data is taken from the latest report dated 2017-01-25 on the Medicaid.gov website - the National Average Drug Acquisition Cost.
I also did a quick comparison using the WebMD recommended website GoodRx to check if prices were in the same ballpark.
UK Drug Pricing is taken from the online version of the British National Formulary (https://www.evidence.nhs.uk/formulary/bnf). These are the official prices that it costs the NHS for each drug.
Where exact same versions of drugs were not available e.g. Ventolin is 90 mcg in the US, the UK version is 100mcg - the closest available dose was used.
This should not make any difference as patients can only buy those particular doses so that is what doctors will prescribe.
Dollar to pound exchange values were calculated using the Google Finance Tool.
UK Prescription Pricing
In the UK the current prescription charge is £8.40.
This means that no matter what the cost of the medication this is what you pay. If you are on multiple medications then you can buy a prescription prepayment certificate for £104 per year.
That covers the cost of all your prescriptions.
This does not reflect the true cost of the medication to the NHS though which is what we all actually pay via our National Insurance contributions.
That is why I used the BNF data.
Why is There Such A Disparity?
To be honest I am not sure. I will need to see if I can source the full text of the JAMA article as I was only able to see the abstract which says this:
"High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits"
Does this mean that there is actually more competition in the UK - that doesn't really make sense to me?
One other factor I can think of is collective buying power.
Since the NHS negotiates prices as a whole it may give it more ability to bargain with the drug companies. Then again wouldn't insurance companies in the US have similar power?
Anyway if you are in the US perhaps you can enlighten me a bit more on why this would be.
I think I might have to do some more research on this.
References
Kesselheim, Aaron S., Jerry Avorn, and Ameet Sarpatwari. 2016. “The High Cost of Prescription Drugs in the United States: Origins and Prospects for Reform.” JAMA: The Journal of the American Medical Association 316 (8): 858–71.
“The 10 Most-Prescribed and Top-Selling Medications.” 2015. WebMD. May 8. http://www.webmd.com/drug-medication/news/20150508/most-prescribed-top-selling-drugs.
Burgan, Tareq, Gerard Housey, Tamo Xachapuridze, Harry Plummer, R. R, Rosita Yap, Andre Kruger, et al. 2015. “100 Best-Selling, Most Prescribed Branded Drugs Through March.” Medscape. May 20. http://www.medscape.com/viewarticle/844317.
“BNF January 2017.” 2017. Accessed January 28. https://www.evidence.nhs.uk/formulary/bnf/current/.
“Pharmacy Pricing | Medicaid.gov.” 2017. Accessed January 28. https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html.
McMillen, Matt. 2017. “Apps That Find Best Prescription Prices « Gadgets and Apps.” WebMD. Accessed January 28. http://blogs.webmd.com/gadgets-and-apps/2016/03/apps-that-find-best-prescription-prices.html.
Thank you for reading
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Hello.
An interesting coincidence. This morning I stumbled upon this site -> http://www.pharmaskeletons.com/
Lol I have heard of that. Looks like Shrekli has turned whistle-blower now!
Exactly. Some interesting days ahead :)
For sure I think they may be shamed into changing.
Aren't you a bit too optimistic? They all have very thick hides. And they are scrupulous, of course. They are above us.
Sorry to be cynical and pessimistic about the outcome of this feud...
Yes but they might care about the bad PR.
Big Pharma was one of the largest donators to the Ocare propaganda campaign. Pre-ACA, I paid $5 a month for my scrip. Post ACA, I pay $30
Weird that it should go up - I don't really understand how they can justify it then!
thats the eternal problem with giving the State control over the economy. rent-seekers and do-gooders are going to trade off favors and insane economic demands and the market is going to be the one that suffers
Or maybe the bigger problem is the closeness between the government and large companies? I think we have all seen how they sponsor politicians to favour them.
in this case, these companies (similar to the bankers that wanted "forced" loans earlier in the century) were the rent-seekers, happy to give over control of the market in guarantee for higher payouts.
It doesn't matter if it's crony capitalists or syndicated socialism or Hitlers' "Third Way"; the more a state interferes with a market, the worse that economy will be.
The problem is no government will allow a free market.
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Thanks:)
Pharmaceutical system needs a change. They don't even value the purpose of why these prescriptions drugs are made in the first place.
Hopefully it will come. Another big problem is lack of investment in new antibiotics because the drug companies don't see it as profitable - it is much better to make something that people take for a lifetime rather than a few days!
First, we starts taking pills and then our body can not function properly without them! I try to do without drugs! And the body's own resources included in the job!
That is not true.
I do not take drugs for about 15 years and feel great !!!
Yes but sometimes you have to. Like insulin for example.
That's right !! I would not say that that bad !!! Just a pity that we can not refuse it
Certainly if you can get away without it is better!
Interesting. Thank you for doing all this research!
No problem glad you liked it:)
thanks
You're welcome!
Pharmaceutical drugs do not have any actual relationship to cost.
The price charged is how much the society is willing to pay.
With insurance paying part of the bill, it is easy to monkey with prices.
You'd think the insurance companies would stop it though.
Pardon? That doesn't make any sense.
It does to me. One would assume the insurance companies would want to pay as little as possible wouldn't they?
I don't assume the insurance companies would want to pay as little as possible, I assume the opposite. That, is not exactly true either.
The insurance companies and big pharma wrote Obombacare.
It is designed to destroy america. Doctors are not being paid twice as much. Drugs do not cost twice as much to manufacture. So, why does healthcare now cost twice as much?
The whole plan is to drain as much resources from americans as possible.
And big-pharma and big-medical are just paying each other. Passing money back and forth, as expenses, lowers taxes.
So they are in collusion then?
@Cryptofiend,
Collusion, lobbying, favors, kick-backs, regardless of what it is called, to me equals corruption. I strongly believe long-term corruption is the problem.
I take three of the medications on the list, and if it weren't for good insurance, I would be one of the people selling my home to pay for the meds. (Although, the insurance payments can hardly be considered "affordable" on my income.)
great post! nice research
Thank you:)
I take Lyrica and use the prepayment card, saves me a fortune :)
I use it too!
What dosage are you on?
I don't mean the same medication - I mean I use the prepayment. I do use Lantus which is on the list here though.
Ahh got ya :)
:)