Presentation (CTI)

OBJECTIVES: The US has the highest healthcare spend per capita and among the highest drug prices in the world. The Inflation Reduction Act (IRA) aims to reduce drug prices for Medicare through direct price negotiation between payers and manufacturers for high spend drugs. The negotiated prices (maximum fair prices) for the first 10 Part D drugs will take effect in 2026. These include discounts of up to 79% compared with 2023 prices. The objective of this research is to evaluate how the maximum fair prices of these drugs for US Medicare compare with the prices of the same drugs in other countries that also have high healthcare spending per capita.
METHODS: Current manufacturer drug prices for the first 10 Part D drugs undergoing Medicare price negotiations were identified for countries with the highest healthcare spending per capita (US, Switzerland, Germany, Norway, Netherlands, Austria, Belgium) from respective pricing databases. Approximate monthly costs were calculated and compared between the countries.
RESULTS: The comparison showed that the costs of the 10 drugs included in the Part D negotiations (Januvia, Fiasp/NovoLog/NovoRapid insulin products, Farxiga/Forxiga, Enbrel, Jardiance, Xarelto, Eliquis, Entresto, Stelara, and Imbruvica) were still lower in other countries even after price negotiations. Stelara was the only drug for which US Medicare maximum fair price was similar to that in another country (Germany).
CONCLUSIONS: Despite substantial discounts provided by Medicare price negotiations, US maximum fair prices remain generally higher than prices applied in other countries with high healthcare spending per capita. A limitation of the analysis is the approximation of monthly drug costs without utilization data.