OBJECTIVES: Analyze launch prices of high-revenue drugs across Canada, EU4, UK, and the US to determine trends in price differentials.

METHODS: This study investigates the launch prices of high-revenue drugs across seven markets, including Canada, the US, France, Germany, Italy, Spain, and the United Kingdom. 24 drugs were selected based on having the highest global revenue between 2020 to 2023 and commercial availability in the selected markets. Annual ex-manufacturer prices (WAC / list price) were calculated to assess differences in launch prices across each market. Subsequent analyses were performed based on orphan status, therapeutic areas, and categorization as biologics versus non-biologics.

RESULTS: Among the 24 drugs analyzed, no evident trends in list price differentials can be observed. European launch prices generally trend 10-20% higher than Canadian prices, although the variation in the sample indicates that this is only a directional estimation. Launch prices in the United States are approximately 131% higher than those in Canada. The absence of a consistent trend may be attributed to various factors, including evaluation processes and list-to-net differentials (often confidential).

CONCLUSIONS: There are significant differences between Canadian, European and American launch prices. A myriad of factors (e.g., launch timing, international reference pricing, payer price and reimbursement dynamics) influence the lack of a consistent trend in launch prices across markets. Additionally, confidential net discounts may result in prices being more comparable across markets, adding a layer of complexity to the observed pricing dynamics. Therefore, manufacturers must recognize the importance of considering broader market dynamics (payer evaluation criteria, policy, etc.) and the landscape (competitive landscape, access and reimbursement, etc.) to appropriately define their launch pricing strategy.