US drugs cost up to 4 times more than drugs in similar countries, GAO finds

Retail prices for prescription drugs in the U.S. are up to four times higher than the prices in Australia, Canada and France, an analysis released April 28 from the Government Accountability Office found. 

The GAO estimated prices for 20 brand-name drugs in the U.S. in 2020 and compared them to publicly available prices for the same drugs in Australia, Canada and France. The GAO estimated the net prices using data from sources that included estimates of Medicare Part D rebates and other price concessions and commercially available data. 

Five key takeaways from the analysis: 

  1. U.S. retail prices were two to four times higher than prices in Australia, Canada and France.

  2. In the U.S., the same drug could cost between $22 and $514 depending on the consumer's coverage.

  3. Out-of-pocket costs for prescription drugs varied within all four countries, but varied greater within the U.S. and Canada, where multiple payers have a role in setting prices and designing cost-sharing for consumers. In Australia and France, prescription drug pricing is nationally regulated, and prescription drug coverage is universal, so prices for each drug are less varied there.

  4. Rebates and other discounts for prescription drugs in the U.S. are confidential, and the GAO took this into account for the U.S. prices, but publicly available prices for the comparison countries don't reflect such discounts. As a result, the actual differences between U.S. prices and those of the other countries are likely larger than the GAO's estimates.

  5. While U.S. net prices for prescription drugs were mostly higher than gross prices in the other countries, sometimes by as much as 10 times, some drug prices were lower. 

Read the GAO's full report here

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