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  • U.S. Versus International Costs of Ophthalmic Drugs

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD
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    Journal Highlights

    Ophthalmology, October 2019

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    Health expenditures in the United States are expected to grow to 20% of the gross domestic product by 2025. As prescrip­tion drugs represent the health care category with the largest increase in real per-capita spending in the past four decades, Gong et al. conducted an observational study to compare the costs of common ophthalmic drugs in the United States and other countries. They found that costs are substantially higher in United States, especially for topical medications. They also noted large price variations between the countries studied as well as between brand and generic products.

    The study focused on 25 commonly prescribed ophthalmic medications (22 topical and three intravitreal). Third-quarter 2017 data were obtained, including U.S. average wholesale price, drug-acquisition costs, and consumer pricing. Data sources included U.S. government health insurance plans (Veterans Affairs [VA], Medicaid, Medicare Parts B and D), commercial drug plans (CVS Caremark and Navitus Health Solutions), Costco (for online pricing without insurance), and government-sponsored health plans in Canada, Japan, Italy, Spain, and Turkey. Curren­cies were converted to U.S. dollars.

    The authors found that aflibercept and ranibizumab were priced similarly in the United States, and each was more expensive than dexamethasone. Afliber­cept and ranibizumab were less expen­sive in Italy, Spain, Turkey, Canada, and Japan than in the United States—by as much as 84.3%. The price of topical medications in the United States varied significantly by drug class and accord­ing to whether the drug was generic or branded. In general, ophthalmic drugs were less expensive if obtained through VA and Medicaid plans instead of the other U.S. sources, but the lowest costs were attained through hospital-employee drug insurance plans.

    As a partial solution to these drug pricing issues, the authors recommend­ed developing an easy-access online database that shows true out-of-pocket costs for patients with each type of insurance.

    The original article can be found here.