OBJECTIVES: The lack of federal pricing regulations and healthcare spending reaching $4.5 trillion in 2022, made the US the world's most attractive market for the pharma industry. Per capita data show that the US spend on drugs 38% more than Germany, 80% more than France and 122% more than the UK. The objective of this study was to compare prices of new oncology treatments in the US, Germany, France and the UK.

METHODS: We considered new cancer products, indicated for the treatment of an oncologic condition approved in Europe in the years 2021-2023. Initial manufacturer list prices in countries of scope were compared considering the same or similar packaging. Products with a price in the US and at least one of the other countries were included in the analysis.

RESULTS: 33 of 50 preselected products (66%) had at least two prices, including in the US, to allow the comparison. Most often products were approved for lung cancer (6) followed by products for breast cancer, multiple myeloma and non-Hodgkins lymphoma (4 products in each indication). Most products had an orphan designation in the US and Europe (12) or only in the US (10).

Pricing differences between the US and selected European countries varied from the price of efgartigimod alfa 30% lower in the US than in France and Germany to the price of relugolix approximately 1100% higher than in Germany and the UK. On average, prices in the US were 95%, 111% and 168% higher than in France, Germany and the UK, respectively.

CONCLUSIONS: The US continues to be more attractive than European markets, with prices in oncology usually around double the European prices or even higher for non-orphan drugs. However, higher pricing of cancer treatments is strongly linked with the increased per capita spending, which fuels discussions about regulating prices in the US.