How much more does medication
cost in the US?
Can you put a price on a person's life? The answer, of course, is yes. Drug companies do it all the time, it's how they stay in business. At this point, it's a fact of life that drugs in America cost considerably more than they do elsewhere in the world. Way back in 1999, then-Congressman Bernie Sanders personally drove Vermont women over the Canadian border to buy drugs for breast cancer. Over the last few weeks, there were many people who wanted to personally drive over Martin Shkreli, the founder of Turing Pharmaceuticals. Shkreli is a hedge-funder whose personal quirks rose from post-hardcore enthusiast to mustache-twirling villain for raising the cost of an antimalarial drug associated with HIV treatments, pyrimethamine, from $13.50 a tablet to $750. Although Shrekli has promised to bring the cost down to some as-yet-unspecified price, the incident hammers home the reality of American exceptionalism: only here do people pay so much for drugs that could save your life.
To prove that point, we picked three very different prescription medications and compared the price for one-month of doses for people in cities around the world. We chose Nexium (20 mg), an acid reflux medication which is known for being overpriced in the US, Copaxone (20 mg), a drug that helps control the chronic degenerative illness multiple sclerosis, and Gleevec (400 mg), a very pricey leukemia drug. Above, you'll see our findings, and below, and explanation of each country's pricing. We found, perhaps unsurprisingly, that many of these medications have fairly consistent pricing once you get outside the US.
Creating this index wasn't as simple as it seems: though in the US, companies are free to set whatever price they like for medication, in many other countries, the government controls prices, at least on generics. It's in both countries' and pharmaceutical companies' interests to keep prices obscure: if you live across the border from somewhere where you can get drugs cheaper, like Bernie Sanders, you may be less likely to stick to your own country's prices.
New York, USA
The US price was sourced from the International Federation of Health Plans 2013 Comparative Price Report. The IFHP has been around since 1968 and is an international trade organization for insurance companies, "open to organizations offering health insurance coverage" from across the world. To get the prices for the US, the IFHP used a database averaging 100 million insurance claims for each drug. Drug prices, particularly of Gleevec, have risen substantially in America. While Obamacare has provided millions more Americans with insurance to cover unregulated drug prices, it hasn’t covered everyone nor are its drug options unlimited.
The United Kingdom numbers were also sourced from the International Federation of Health Plans 2013 Comparative Price Report. The prices are based on the cost of drugs in the public sector. The British National Health Service has long been a point of national pride, even making an appearance in the opening ceremony of the country's 2012 Olympics. However, not all is perfect: the NHS might be facing a strike of postgrad doctors over reforms they've deemed "unsafe and unfair."
Spain's price was sourced from the IFHP report. For Spain, the IFHP sourced this data from one private sector health provider, but their CEO, Tom Sackville, told Hopes&Fears that these numbers were "probably very similar to what the government pays" for the medications.
Spain's low costs stem from a few sources: it's 1978 post-Franco constitution guarantees universal healthcare paid for by the state. Though these numbers are from a private insurance company, the access to public health care keeps the prices lower than in the States. There's also a mandated price differential for generic drugs of thirty-five percent. It's worth noting that if you're an undocumented immigrant, none of this might apply to you: the current Spanish government has mandated that all but emergency services are off-limits for the undocumented, causing massive protests and possible rebellion from Spain’s autonomous regions.
Our Russian prices came from the Rosminzdrav, the Russian Ministry of Health. All three drug prices were available on their website. Health Minister Veronika Skvortsova recently bragged that sixty-seven percent of all vital drugs Russians need are made in Russia, with hopes up upping that to ninety percent by 2020. However, Russians complain that these locally made drugs simply do not work, and President Vladimir Putin has blamed the rising costs of imported drugs on "exchange-rate fluctuations".
Tel Aviv, Israel
A helpful Israeli government database provided the prices for prescription drugs in the country. In 1994, the Israeli government created what is referred to as a "Healthcare Basket" in which many drugs are placed to lower costs. All a citizen's drugs and needed services go into the basket, so the metaphor goes. However, the Israeli newspaper Haaretz has found that under Prime Minister Benjamin Netanyahu, "the mechanism for funding the basket shifted from a progressive one (relying on the health tax and general tax revenues) to a partly regressive one (relying also on direct payments)." As a result, over a fifth of the population chooses to go without health care. It's also worth noting that health care services in Gaza and the West Bank still stand in devastation after the 2014 Israeli incursion, forcing many Palestinians to seek Israeli health care.
Japan's information on Gleevec prices was found in this study on leukemia medication from the journal Blood. The Nexium prices were found in a press release from pharmaceutical company Daiichi Sankyo. Copaxone was only approved for use in Japan two days ago, so we haven't included the price here.
Japan’s health care system is widely seen as effective, and the Prime Minister Shinzo Abe's government has taken to marketing it to nearby countries, like Vietnam, through exhibitions. Generic drugs are currently used in fifty percent of all cases, Abe’s government wants to see that number increased to eighty percent. Japanese drug laws are famously strict, with recent cases of American executives and tourists being busted for bringing drugs legal in America into the country.
Author: David Grossman
Photo: Lia Bekyan for Hopes&Fears