OBJECTIVES In many countries there is an ongoing debate about pharmaceutical pricing. Especially in Germany there is common belief that pharmaceuticals are more expensive than in other countries. Payers are making use of this belief when negotiating prices with pharmaceutical companies. We wanted to know if there is scientific evidence for this conception. METHODS We conducted a systematic literature review in order to identify price comparison studies comparing Germany with at least three other countries. We searched Pudmed and six other databases to identify relevant articles published between 1998 and today. Furthermore we developed a quality rating tool based on the approaches from Andersson (1993) and Danzon/Kim (1998). RESULTS Our review delivered 4.927 articles from which 28 met our inclusion criteria. Study quality was quite heterogeneous, ranging from 3 to 13 points with an average score of 8.8 out of 15. Some studies use old data back from 1992 and no study considers the recent changes in German legislation (AMNOG). In addition no study includes rebates and selection of compared pharmaceuticals is often arbitrary. Reviewed studies report German pharmaceutical prices slightly above international average. High quality studies (upper quartile, quality score: >9) find German prices below international average, whereas low quality studies (lower quartile, quality score: <7) find German prices above international average. CONCLUSIONS Results of the review suggest that there is a misconception of pharmaceutical pricing in Germany. Within a price comparison study any desired result can be achieved by deliberately choosing different approaches. At the end of the day payers and policy makers should stop comparing prices with other countries. Instead resources should better be spent on making value based reimbursment decisions in the respective health care setting.