On 1000-Fold Pharmaceutical Price Markups and Why Drugs Cost More in the United States than in Mexico Leslie V. Boyer, MD The American Journal of Medicine

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On 1000-Fold Pharmaceutical Price Markups and Why Drugs Cost More in the United States than in Mexico Leslie V. Boyer, MD The American Journal of Medicine Volume 128, Issue 12, Pages 1265-1267 (December 2015) DOI: 10.1016/j.amjmed.2015.08.007 Copyright © 2015 Elsevier Inc. Terms and Conditions

Figure Contributions to patient charges for 1 vial of antivenom. Values are approximate, based on typical Latin American manufacturing costs for a single arthropod antivenom product, secondarily licensed and distributed in the United States. Model assumes a 10-year development cycle, orphan product fee structure, partial support of clinical trials by government grants, midrange hospital markup, and midrange insurance reimbursement by private third-party insurance. FDA = Food and Drug Administration; R&D = Research and Development. Source: Venom Immunochemistry, Pharmacology, and Emergency Response Institute (VIPER), University of Arizona. The American Journal of Medicine 2015 128, 1265-1267DOI: (10.1016/j.amjmed.2015.08.007) Copyright © 2015 Elsevier Inc. Terms and Conditions