OBJECTIVES: This study aims to examine the impact of international reference pricing as a policy to set prices on on-patent medicines. The impact is analyzed on the price level of medicines, on the power of this policy to reduce the health costs of governments, on the availability of medicines over time, on affordability, and on research and development investment in new medicines.

METHODS: The study focuses on the influence of Leopold, Kanavos and Persson, where their hypothesis about goals and drawbacks of IRP are applied as theoretical framework that lead to a selection of variables and a creation of relevant hypothesis. This hypothesis are tested using an OLS estimator where the dependent variables are, respectively for each regression and by country, the price level, pharmaceutical expenditure per capita, the time from when a medicine receives approval to be marketed until it becomes available , an approach to the affordability and investment in R&D of pharmaceutical companies.

RESULTS: The price level, the time to price and the investment in R&D turn out to be correlated according to the literature review. In turn, there is no statistical evidence that IRP has a significant influence on per capita pharmaceutical spending and affordability.

CONCLUSIONS: Regarding the objectives of the IRP, it has been shown that its implementation reduces the level of medicine prices, but it is not demonstrable that this reduction is transferred to pharmaceutical spending. Regarding the potential consequences observed in the literature: it has been shown that the implementation of large downward pressure on prices is associated with negative implications regarding access and investment in R&D. It has not been possible to infer that the policy objective of improving affordability is related to IRP. In addition, the objective policy of reducing the price of medicines is fulfilled.