"IS THE GRASS GREENER ON THE OTHER SIDE?" GLOBALISATION OF INTERNATIONAL PRICE REFERENCING FOR MEDICINES
Author(s)
Sabine Vogler, Dr, Valentin Kandler, ., Verena Knoll, MA, Friederike Windisch, Mag., Melanie Walter, PhD, Katharina Kieslich, PhD.
Pharmacoeconomics, Gesundheit Osterreich GmbH (GÖG) / Austrian National Public Health Institute, Vienna, Austria.
Pharmacoeconomics, Gesundheit Osterreich GmbH (GÖG) / Austrian National Public Health Institute, Vienna, Austria.
OBJECTIVES: The United States “Most Favoured Nations” policy relates to the concept of comparing with medicine prices in other countries, as guidance on setting one’s own country’s prices. While such pricing approach is new for the United States, it is well-established in several other countries, frequently referred to as “external price referencing” (EPR). The research examines current implementation of EPR globally, including key methodological features.
METHODS: 50 countries were included in this study, encompassing all 27 European Union member states, the four countries of European Free Trade Association, most Western Balkan countries, some countries in Central Asia as well as countries outside the WHO European Region (e.g., Australia, Brazil, Canada, Republic of Korea, Saudi Arabia, South Africa). Since all countries studied are members of the Pharmaceutical Pricing and Reimbursement Information (PPRI) network of competent authorities, information was sourced from PPRI publications, the “PPRI Indicators” database as well as internal repositories.
RESULTS: In 2026, 43 countries studied had EPR in place, at least for some medicines. Armenia did not regulate prices, and Australia, Germany (since 2025), Kosovo, Singapore, Sweden, and United Kingdom used other pricing policies. 35 EPR-applying countries implemented this policy in outpatient and hospital sectors, while six countries applied it for outpatient medicines only and Denmark in hospitals only. 15 countries determined the benchmark price based on the average or median of the prices in the reference countries, whereas 7 countries used the lowest price in the reference countries (no or specific calculation methods in remaining countries). 11 countries had more than 21 reference countries in their basket, 8 countries between 11 and 20 reference countries, and the remaining countries had smaller baskets
CONCLUSIONS: EPR is a frequently used pricing policy in European countries and beyond. However, the methodological design varies across countries.
METHODS: 50 countries were included in this study, encompassing all 27 European Union member states, the four countries of European Free Trade Association, most Western Balkan countries, some countries in Central Asia as well as countries outside the WHO European Region (e.g., Australia, Brazil, Canada, Republic of Korea, Saudi Arabia, South Africa). Since all countries studied are members of the Pharmaceutical Pricing and Reimbursement Information (PPRI) network of competent authorities, information was sourced from PPRI publications, the “PPRI Indicators” database as well as internal repositories.
RESULTS: In 2026, 43 countries studied had EPR in place, at least for some medicines. Armenia did not regulate prices, and Australia, Germany (since 2025), Kosovo, Singapore, Sweden, and United Kingdom used other pricing policies. 35 EPR-applying countries implemented this policy in outpatient and hospital sectors, while six countries applied it for outpatient medicines only and Denmark in hospitals only. 15 countries determined the benchmark price based on the average or median of the prices in the reference countries, whereas 7 countries used the lowest price in the reference countries (no or specific calculation methods in remaining countries). 11 countries had more than 21 reference countries in their basket, 8 countries between 11 and 20 reference countries, and the remaining countries had smaller baskets
CONCLUSIONS: EPR is a frequently used pricing policy in European countries and beyond. However, the methodological design varies across countries.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR102
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Medical Technologies
Topic Subcategory
Pricing Policy & Schemes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas