1. Educational Teleconference
Getting to Lower Prescription Drug Prices in the United States: How Do Other Countries Do It?
Educational Teleconference
Tuesday, September 25, 2018
2:00 p.m.

2. Robin Osborn Shawn Bishop
INTRODUCTION
Robin Osborn
Shawn Bishop
Vice President and Director, International Health Policy and Practice Innovations, the Commonwealth Fund
Vice President, Controlling Health Care Costs and Advancing Medicare, the Commonwealth Fund
Educational Teleconference| September 25, 2018

3. Steve Morgan
Professor, Health Services and Policy, The University of British Columbia
Educational Teleconference| September 25, 2018

4. STEVE MORGAN
Expenditure on primary care prescription drugs in the United States versus ten comparable high-income countries, 2015
Under the most favorable assumptions for USA (assume 50% brand rebates in USA only)
$-billions
Same idea, if the USA had Canada’s use and cost levels
Spending at US Rx use and cost levels
$44.9
$39.9
Cost at comparators’ use and cost levels
$23.0
Total difference
$21.9
$17.0
Difference because of more (or less) medicine use
-$4.2
$0.6
Difference because of prescribing patterns
$6.7
$4.4
Difference because of prices
$20.1
$12.0
Comparators: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom
Drug classes: hypertension, pain, cholesterol, non-insulin diabetes, gastrointestinal preparations, and antidepressants
Source: Morgan et al, Health Policy, 2018 Sep, 122(9): doi: /j.healthpol

5. Ruth Lopert
Adjunct Professor, George Washington School of Public Health, former Chief Medical Officer, Australia’s Therapeutic Goods Administration
Educational Teleconference| September 25, 2018

6. Australian Pharmaceutical Benefits Scheme
RUTH LOPERT
Australian Pharmaceutical Benefits Scheme
National program providing comprehensive pharmaceutical coverage in the community, established nearly 70 years ago
Comparative cost effectiveness a mandatory criterion for formulary inclusion since early 90s
A drug cannot be listed at a higher price than existing alternatives unless for some patients at least it provides an increment in clinical benefit
Concept of ‘purchasing outcomes’ rather than drugs – focus is on value for money rather than price

7. Australian Pharmaceutical Benefits Scheme
RUTH LOPERT
Australian Pharmaceutical Benefits Scheme
Two levels of patient co-payments
For general beneficiaries, up to AUD (USD 28.80) per item
For concessional beneficiaries, AUD 6.40 (USD 4.70) per item
Co-payment amounts are adjusted on 1 January each year in line with the Consumer Price Index (CPI).
Safety Nets (calendar year) – apply to individuals, couples and families
For general beneficiaries, AUD 1, (USD1108), thereafter co-payments at the concessional rate
For concessional beneficiaries, AUD (USD 280), thereafter items dispensed without co-payment

8. James Robinson
Leonard D. Schaeffer Endowed Chair in Health Economics, University of California Berkeley
Educational Teleconference| September 25, 2018

9. Question and Answer
Educational Teleconference| September 25, 2018