New GAO Study Finds U.S. Pays Two to Four Times More for Prescription Drugs than Other Nations

Ahead of President Biden's first address to a joint session of Congress and as his administration considers policies to lower drug prices, the U.S. Government Accountability Office (GAO) Wednesday released a report commissioned by Sen. Bernie Sanders (I-Vt.) finding that the U.S. pays more than two to four times higher prices for a selected sample of 20 single source, brand name drugs than Australia, Canada, and France. The result is that Americans suffering from blood clots, bronchitis, emphysema, and Hepatitis C pay vastly more for life-saving treatment than patients in other industrialized countries.

"This important GAO study confirms what we all already know: the pharmaceutical industry is ripping off the American people," said Sen. Sanders. "The time is long overdue for the United States to do what every major country on earth does: negotiate with the pharmaceutical companies to lower the outrageous price of prescription drugs. I would urge the President to put this proposal in the American Families Plan and use the savings to expand and improve Medicare for older Americans. We can no longer tolerate the American people paying, by far, the highest prices in the world for prescription drugs."

The study found that last year, the U.S. paid 4.36 times more than France, 4.25 times more than Australia, and 2.82 times more than Canada for the selected drugs, which represent a sample of the drugs with the highest Medicare Part D expenditures and use. The publicly available data for the comparison countries were gross prices that did not reflect potential discounts. As a result, the actual differences between U.S. prices and those of the other countries were likely much larger than GAO estimates.

While France and Australia operate universal, publicly funded health systems that include prescription drug coverage, both Canada and the U.S. have a significant number of people who do not have prescription drug coverage. But even when comparing the full cash retail prices of selected drugs, the prices quoted to individuals without prescription drug coverage, GAO found that prices were two to eight times higher in the U.S. than the same drugs from pharmacies in Canada. For example:

• The cash price of Epclusa (28 tablets), which treats Hepatitis C, or an infection that attacks the liver, is $36,743 in the U.S. but $17,023.63 in Canada.
• The cash price of Harvoni (28 tablets), which also treats Hepatitis C, is $46,570.33 in the U.S. but $19,084.54 in Canada
• The cash price of Xarelto (30 tablets), which treats blood clots, is $558.33 in the U.S. but $85.44 in Canada
• The cash price of Incruse Ellipta Inhalation Powder (30 inhalations), which treats chronic obstructive pulmonary disease (COPD), or a group of lung diseases which block airflow and make it difficult to breath, is $411.33 in the U.S. but $53.31 in Canada
• The cash price of Anoro Ellipta Inhalation Powder (30 inhalations), which also treats COPD including bronchitis and emphysema, is $514.33 in the U.S. but $84.99 in Canada
  Source: Appendix V, Table 10 of report

Because France and Australia have universal health systems that cover prescription drugs, Australians would pay up to a $28.09 copay for a month supply of these medicines, while patients in France would pay anywhere from $0 to $34.03 for the drugs. The maximum copay that high income seniors with prescription drug coverage in Ontario, Canada would pay for the drugs is $4.67.

Read the full GAO study here.