High U.S. drug prices are a financial strain for patients, employers, and state and federal governments. In the following charts, we present the findings from a number of studies on prescription drug costs and spending in the United States with other high-income countries to reveal the main culprit: high U.S. prices for brand-name drugs.
The data for this chartpack come from the following sources: the Commonwealth Fund’s 2020 International Health Policy Survey; 1980–2020 pharmaceutical spending data from the Organisation for Economic Co-operation and Development (OECD); 2020 individual-level administrative claims or registry data compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC); and IQVIA’s MIDAS database for 33 OECD member countries for 2018.
When a woman gets a caesarean section at the gleaming new Van Ness location of Sutter Health’s California Pacific Medical Center, the price might be $6,241. Or $29,257. Or $38,264. It could even go as high as $60,584.
The rate the hospital charges depends on the insurance plan covering the birth. At the bottom end of the scale is a local health plan that serves largely Medicaid recipients. At the top are prices for women whose plans don’t have the San Francisco hospital in their insurers’ network.
The nation’s roughly 6,000 hospitals have begun to reveal the secret rates they negotiate with insurers for a range of procedures. The data offer the first full look inside the confidential deals that set healthcare rates for insurers and employers covering more than 175 million Americans. The submissions also illuminate how widely prices vary—even for the same procedure, performed in the same facility—depending on who is paying.
Author(s): Anna Wilde Mathews, Tom McGinty and Melanie Evans