As recently reported by PBS, America continues to outspend other rich countries on pharmaceuticals, spending almost $1,000 per person on prescription drugs in 2013. Canada, the second highest spender, spent about $700 per person. This is despite one in five Americans skipping doses or a script due to cost, as well as an extremely high percentage (84% in 2011) of prescriptions being written for generic medications.
So what’s up? Well, for one, our drug prices are much higher. Our latest analysis of brand-name drugs sold by international online pharmacies found that their prices were 88% lower when compared to a pharmacy in New York City.
Major drug price differences aren’t the only reason for higher U.S. spending. PBS explains that Americans, sadly, fill more scripts due to higher rates of obesity, diabetes, and high blood pressure, which of course equates with greater numbers of prescription drug purchases. Another factor is that it’s relatively easy for drug companies to get new drugs approved and in to the U.S. market.
I was a bit surprised that PBS didn’t mention direct-to-consumer advertising as a possible reason for why we use more drugs. New Zealand is the only other country that allows direct-to-consumer advertising, but they have much lower drug prices than the U.S., due to government regulations.
For the newly insured, Obamacare might mean lower prices for consumers, but that doesn’t mean overall national spending will go down. Lower out of pocket costs from better co-pay or co-insurance models will likely just mean higher premiums and increased reimbursement to drug manufacturers by insurance companies. Look at it this way: if you spend $20 less on a drug per month, but your premium is $20 more, you’re not really any better off.
Interestingly, U.S. drug spending decreased slightly last year, thanks largely to patent expirations resulting in more generic drugs penetrating the market. While PBS mentions that the decline is expected to last another 2-3 years, I’m not so optimistic. For one, generic drug prices are rising, sometimes by thousands of percent. Second, more coverage under Obamacare means more prescriptions, and naturally more spending. Only time will tell…
