How U.S. Medicare Prices Compare to Other Rich Nations

Marcus Lu
2025-04-16 12:55:00
www.visualcapitalist.com

How U.S. Medicare Prices Compare to Other Rich Nations

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Medicare, the U.S. government’s health insurance program primarily for seniors, covers nearly 65 million Americans—but at what cost?

Despite its massive scale, Medicare often pays significantly more for prescription drugs than health systems in other rich nations. In this infographic, we compare the prices for a 30-day supply of 10 prominent drugs using data from Peterson-KFF.

Data & Discussion

A provision in the Inflation Reduction Act of 2022 required Medicare to negotiate prices with pharmaceutical companies for 10 high-expenditure drugs that lack generic competition.

The Medicare prices shown in this graphic were published on Aug. 15, 2024, and will go into effect for Medicare enrollees on Jan. 1, 2026.

Data for the first seven drugs in this graphic ($0 to $350 scale) are listed below:

Country	Eliquis	Jardiance	Xarelto	Farxiga	Januvia	Entresto	NovoLog/Fiasp
U.S.	$249	$204	$206	$182	$117	$314	$134
Switzerland	$104	$70	$98	$71	$53	$155	$63
Germany	$91	$87	$138	$87	$57	$154	$70
Belgium	$91	$54	–	$54	$24	$146	$33
Austria	$83	$50	$88	$55	–	$161	$45
Japan	$79	$35	$128	$47	$31	$64	$43
Netherlands	$72	$45	$69	$47	$40	$145	$38
UK	$72	$50	$68	$50	$45	$124	$41
Canada	$72	$61	$63	$60	$72	$162	$48
France	$64	$42	$62	$42	$20	$155	$27
Sweden	$60	$43	$60	$43	$16	$128	$31
Australia	$45	$41	$43	$40	$27	$137	$111
Peer Average	$76	$52	$82	$54	$39	$139	$50

Within this group, drugs with the largest Medicare price premium are:

• Jardiance (Diabetes): +289%
• Farxiga (Diabetes): +236%
• Eliquis (Blood thinner): +228%

Finally, data for the last three drugs ($0 to $11,000 scale) are listed below:

Country	Enbrel	Imbruvica	Stelara
U.S.	$2,335	$10,619	$4,490
Switzerland	$1,021	$5,500	$3,734
Germany	$1,003	$6,615	$5,158
Belgium	$496	$6,515	$1,502
Austria	$660	$5,655	$2,827
Japan	$457	$4,958	$2,092
Netherlands	$690	$6,010	$2,830
UK	$904	$5,814	$2,714
Canada	$1,049	$5,955	$3,353
France	$517	$5,082	$1,987
Sweden	$718	$4,974	$2,222
Australia	$563	$5,292	$2,624
Peer Average	$734	$5,670	$2,822

The Medicare-negotiated price for Enbrel is +218% higher than the average peer group price, while Imbruvica and Stelara have a smaller premium (+87% and +59% respectively).

Who Makes These Drugs?

The 10 drugs included in this analysis come from a variety of pharmaceutical companies, though most are produced by U.S. firms.

Drug	Manufacturer
Eliquis	Bristol-Myers Squibb
Jardiance	Boehringer Ingelheim Eli Lilly
Xarelto	Janssen (Johnson & Johnson)
Farxiga	AstraZeneca
Januvia	Merck & Co.
Entresto	Novartis
NovoLog / Fiasp	Novo Nordisk
Imbruvica	Janssen (Johnson & Johnson) Pharmacyclics (AbbVie)
Stelara	Janssen (Johnson & Johnson)
Enbrel	Amgen

Why Are U.S. Prices So Much Higher?

Peterson-KFF outlines several factors for why Americans often pay more for their drugs.

For starters, Medicare “exists in the context of a fragmented system of multiple payers, including commercial insurers who negotiate their own drug prices.” In many of the peer group countries, governments are more involved in setting universal drug prices.

Second is the absence of generic or biosimilar medications available in the United States. The introduction of generics typically reduces the prices of brand-name drugs due to increased competition.

For 8 out of the 10 drugs included in this analysis, there was at least one peer group country that offered a generic alternative.

Differences in U.S. and international patent laws, as well as differences in the regulatory groups that approve medications for public use, help to account for why generics may be available in other countries but not the United States.

Finally, there are key differences in how Medicare negotiates prices with manufacturers.

Medicare evaluates the costs to manufacturers to research, develop, and produce the drug when setting prices (something only 2 of the 11 peer group countries consider).

The alternative would be value-based pricing, which evaluates the effectiveness of a drug instead. Furthermore, Medicare does not consider drug prices in other countries when negotiating its own prices, a practice that 8 of the 11 peer group countries employ.

Learn More on the Voronoi App

If you enjoyed today’s post, check out this graphic on Life Expectancy At Birth, which compares the U.S. to the same 11 country peer group.

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