HIGH-COST PRESCRIPTION DRUGS: PRICE COMPARISON USA – FRANCE Care2care’s offer to remedy this problem
By André Wencker, CEO of Care2Care Medical Travel
In august this year, a team of researchers produced a study on the annual and per-member-per-month (PMPM) spending on prescription medications for Harvard Pilgrim Health Care (HPHC), compared to the total health care spending. This study covered 6 years from 2011 through 2016, and about one million members in four New England states.
Here are the main findings:
- Spending on outpatient prescription medications, net of rebates by this commercial health plan, including those administered in physicians’ offices, went up to about 25% of total health care spending, largely due to increasing prices of specialty medications (total health care spending includes spending on inpatient and outpatient care, professional services, and medications)
- In 2016, approximately 75 percent of the plan’s pharmaceutical spending was paid under the pharmacy benefit and 25 percent under the medical benefit
- The overall member-level use remained stable at about one dispensing PMPM (not shown), and one specialty medication dispensing per 100 members per month. Members taking specialty medications received between three and four specialty medication dispensings per month.
- For members who received specialty medications, specialty medication spending accounted for 30 percent of total plan health care spending and amounted to an average of $1,092 PMPM (that is 13,104$/year), only on specialty medications.
These findings are somewhat consistent with those of two other studies published a the beginning of this year by HCCI, we referred to in a former article:
- Prescription drug spending growth from 2011 through 2016 was mainly induced by price increases (+23.4%), while level of use was staggering (+1.8%), resulting in a total rise in spending of +27.2%
- Drug spending amounted to 21% of the total spending
- Drug spending was concentrated on what was called “Top Spenders”, 5% of the insured population, accounting for more than 50% of the total expenditure. Among them the “Persistent Top-Spenders” (2% of the population) who spend on average $23,087 per year on prescription drugs (specialty drugs and others).
(To see more, you can download our whitepaper at : https://www.care2caremedicaltravel.com/white-book-employers/ )
Most interesting in that study was the chart called “Exhibit 4: Top 10 Products Reimbursed By Harvard Pilgrim Health Care, By Value, 2016”
Source: Authors’ analysis of claims for fully-insured Harvard Pilgrim Health Care members. Notes: N = 495,206 in 2016. aProducts are listed by generic names; bin 2016 dollars.
We decided to compare US and French prices for the 20 products
Finding drug prices in the US proved a real treasure hunt, barely easier than finding medical procedure prices. We ended up using GoodRx and drugs.com that have the good idea to provide an “average retail price” in addition to local discounted prices when available. In France, on the contrary, pricing is very transparent: there is only one price, set by a government agency, after a rigorous evaluation process by different bodies, easily available in publicly accessible databases.
The chart below presents striking results: for every kind of drug listed, prices in France are 4 to 6 times less expensive than those in the USA!
Price Comparison US – France | Top 20 Drugs Reimbursed by HPHC, 2016
Care2care Medical Travel
Care2care offers to assist US patients willing to get their 3 to 6 month supply in France with the following benefits:
- strict compliance with regulations applicable in both France and the USA
- delivery of prescription drugs exactly matching the US prescription
- communication using a fully secured patient portal to guarantee privacy and confidentiality of patient’s data
- fully transparent drug prices and service cost