OBJECTIVES: With health-expenditure of 12.1% of GDP, Austria is well above the European average, regardless, the share of pharmaceutical expenditure (13%) is below average. In Austria, there are intensive price regulations inside and outside the reimbursement regulations, which force drug prices downward. In addition, various forms of price models (PMs) are in place. The purpose of the present price-comparison is to focus on 50 medicines that account for comparatively high expenditure for Austrian public payers. A bilateral drug price-comparison is carried out versus Germany.

METHODS: 47 medicinal products (191 SKUs; Stock Keeping Units) were compared at manufacturing and reimbursement price-level. Price data were derived from IQVIA, the Austrian list of products ("Warenverzeichnis") and the LAUER-TAXE® Online 4.0. In case that no uniform pack-sizes and/or dosage were available, German prices were recalculated. Weighted and unweighted averages prices were determined for a variety of product groups: total products, identical products, products PMs in place in Austria, products with discount-agreements in Germany, GREEN BOX products (freely prescribable), YELLOW BOX products (prescribable with approval), NO-BOX products (only reimbursable with individual approval), oncology products (ATC L01+02), products without PMs and without discount-agreements.

RESULTS: The weighted-average manufacturing-price of the products without PMs [AT:-26.5%; p-value 0.049], GREEN BOX products [AT:-39,7%; p-value 0.014] and NO BOX products [AT:-28.9; p-value 0.009] show a significant price difference. Overall, manufacturing prices are 10.7% lower than in Germany [-161.5 m€ reduced expenses according list price]. Products without PM or discount-agreement generate real lower expenses of 58.2 million€. There is a PM agreement for 50% of products [88 SKUs]. At the reimbursement-price level, the differences increase [-19.3%].

CONCLUSIONS: Despite comparable socio-economic indicators the Austrian drug prices of the cost intensive drugs are lower compared to Germany. The price-comparison is based on list prices, repayments due to PMs are not considered.