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Differences in generic drug prices between the US and Canada

  • Original Research Article
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Applied Health Economics and Health Policy Aims and scope Submit manuscript

Abstract

Background

It has long been recognized that brand name prescription medications are more expensive in the US than in Canada. However, non-peer-reviewed reports contend that this is not the case for generic medications.

Objective

To compare prices for generic prescription medications in the US and Canada.

Methods

A telephone and internet survey of pharmacies was conducted for the top 19 dispensed generic medications available in both countries. Twelve pharmacies in total were selected: six from the US (three online and three ‘walk-in’) and six from Canada (three online and three walk-in). Data were collected from March to April 2007.

The main outcome measure was the total purchase price in $US at the day’s exchange rate in 2007, obtained from each of the 12 pharmacies, for 100 doses of each of the 19 selected drugs.

Results

Using the lowest quote for each selected drug, 12 of the 19 (63%) generic medications were least expensive in the US, with an average saving of 47% per drug for these 12 drugs. Seven of the 19 (37%) drugs were least expensive in Canada, with an average saving of 29% per drug for these seven drugs. Overall, there was a sizable variation in prices for the same generic medications within and between the US and Canada.

Conclusions

The lowest priced generic medications were not consistently found in either the US or Canada. The price controls and ensuing savings applied in Canada to prescription patented medications do not fully extend to generic medications.

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References

  1. Skinner BJ, Rovere M. Canada’s drug price paradox 2007. Vancouver (BC): The Fraser Institute, 2007

    Google Scholar 

  2. Danzon PM, Furukawa MF. Prices and availability of pharmaceuticals: evidence from nine countries. Health Affairs: web exclusive, 2003 Oct 29: W3-521-W3-536 [online]. Available from URL: http://content.healthaffairs.org/webexclusives/index.dtl?.year=2003 [Accessed 2008 Aug 8]

    Google Scholar 

  3. Graham JR, Robson BA. Prescription drug prices in Canada and the United States. Part 1: a comparative survey. Public Policy Sources 42. Vancouver (BC): The Fraser Institute, 2000

    Google Scholar 

  4. Openshaw MS. The economics of prescription drug prices, government intervention, and the importation of drugs from Canada. Nurs Econ 2005; 23(6): 307–11, 279

    PubMed  Google Scholar 

  5. Korcok M. Internet pharmacy: the tug-of-war intensifies. CMAJ 2004 Mar 16; 170(6): 946–7

    Article  PubMed  Google Scholar 

  6. Baker C. Would prescription drug reimportation reduce U.S. drug spending? Economic and budget issue brief. Washington, DC: Congressional Budget Office, 2004 Apr 29

    Google Scholar 

  7. Frank RG. Prescription-drug prices. N Engl J Med 2004 Sep 30; 351(14): 1375–7

    Article  PubMed  CAS  Google Scholar 

  8. Shepherd M. Drug importation and safety of drugs obtained from Canada. Ann Pharmacother 2007 Jul; 41(7): 1288–91

    Article  PubMed  Google Scholar 

  9. Anis AH. Pharmaceutical policies in Canada: another example of federal-provincial discord. CMAJ 2000 Feb 22; 162(4): 523–6

    PubMed  CAS  Google Scholar 

  10. Patented Medicine Prices Review Board [PMPRB]. Non-patented prescription prices reporting: Canadian and foreign price trends. Ottawa (ON): Government of Canada, 2006

    Google Scholar 

  11. Generic drug prices: a Canada U.S. comparison. Ottawa (ON): Palmer D’Angelo Consulting Inc., 2002 Aug

  12. Bren L. Study: U.S. generic drugs cost less then Canadian drugs. FDA Consum 2004 Jul–Aug; 38(4): 9 [online]. Available from URL: http://www.fda.gov/fdac/features/2004/404_generic.html [Accessed 2008 Aug 22]

    PubMed  Google Scholar 

  13. Frank RG. Prescription drug prices: why do some pay more than others do? Health Aff (Millwood) 2001 Mar–Apr; 20(2): 115–28

    Article  CAS  Google Scholar 

  14. Pharmaceutical trends: top 50 dispensed medications in Canada. Montreal (QC): IMS Health Canada, 2005

  15. Ministry of Health and Long-Term Care. Drugs funded by Ontario Drug Benefit (ODB) Program: e-formulary [online]. Available from URL: http://www.health.gov.on.ca/english/providers/program/drugs/odbf_eformulary.html [Accessed 2007 Feb 8]

  16. Kyriakos T. Canada’s top drug chains. Drug store news 2001 Apr 23 [online]. Available from URL: http://findarticles.com/p/articles/mi_m3374/is_6_23/ai_73847877 [Accessed 2006 Nov 20]

    Google Scholar 

  17. Pharmacy ratings and profiles [online]. Available from URL: http://pharmacychecker.com/rating.asp [Accessed 2006 Nov 20]

  18. Quon BS, Firszt R, Eisenberg M. A comparison of brand-name drug prices between Canadian-based internet pharmacies and major U.S. drug chain pharmacies. Ann Intern Med 2005; 143: 397–403

    PubMed  Google Scholar 

  19. Top 30 drug chains in dollar volume. Drug store news 2004 Apr 19 [online]. Available from URL: http://findarticles.com/p/articles/mi_m3374/is_6_26/ai_n6007390 [Accessed 2006 Nov 20]

  20. Verified internet pharmacy practice sites: for consumers; list of pharmacies [online]. Available from URL: http://www.nabp.net/ [Accessed 2007 Nov 23]

  21. Hwang SW. Mortality among men using homeless shelters in Toronto, Ontario. JAMA 2000 Apr 26; 283(16): 2152–7

    Article  PubMed  CAS  Google Scholar 

  22. Hansen KK, Zwanziger J. Marginal costs in general acute care hospitals: a comparison among California, New York and Canada. Health Econ 1996 May–Jun; 5(3): 195–216

    Article  PubMed  CAS  Google Scholar 

  23. McGlynn EA, Naylor CD, Anderson GM, et al. Comparison of the appropriateness of coronary angiography and coronary artery bypass graft surgery between Canada and New York State. JAMA 1994 Sep 28; 272(12): 934–40

    Article  PubMed  CAS  Google Scholar 

  24. XE: the worlds favorite currency site [online]. Available from URL: http://www.xe.com/ [Accessed 2007 Aug 15]

  25. Generic drug prices in the U.S. are lower than drug prices in Canada. FDA White Paper. Rockville (MD): Office of Planning, 2003 Nov

  26. Frank RG. Prescription drug prices: why do some pay more than others do? Health Aff (Millwood) 2001 Mar–Apr; 20(2): 115–28

    Article  CAS  Google Scholar 

  27. Zuger A. Rx: Canadian Drugs. N Engl J Med 2003 Dec 4; 349(23): 2188–90

    Article  PubMed  CAS  Google Scholar 

  28. Section A7: the U.S. drugs system. In: Fundamental review of the generic drugs market. Report prepared by OXERA for the UK Department of Health. Oxford: OXERA, 2001 Jul

  29. Top 10 products by U.S. dispensed prescription. Norwalk (CT): IMS Health, IMS National Prescription Audit PLUS, 2007 Mar

  30. Hoch SJ, Kim B-D, Montgomery AL, et al. Determinants of store-level price elasticity. J Mark Res 1995; 32: 17–29

    Article  Google Scholar 

  31. Sorensen AT. An empirical model of heterogeneous consumer search for retail prescription drugs [working paper 8548]. National Bureau of Economic Research, 2001 [online]. Available from URL: http://www.nber.org/papers/w8548 [Accessed 2008 Jan 9]

    Google Scholar 

  32. Mills RJ, Bhandari S. Health insurance coverage in the United States: 2002. Washington (DC): US Department of Commerce and Statistics Administration. US Census Bureau, 2003 Sep

    Google Scholar 

  33. Ministry of Health and Long-Term Care. Ontario drug benefit (ODB) [online]. Available from URL: http://www.health.gov.on.ca/english/public/program/drugs/drugs_mn.html [Accessed 2006 Nov 17]

  34. Ontario drug benefit program. 2005/06 report card for the Ontario drug benefit program. Toronto (ON): Ministry of Health and Long-Term Care, 2007: 12

  35. Cunningham PJ, Felland LE. Falling behind: Americans’ access to medical care deteriorates, 2003–2007. Track Rep 2008 Jun; (19): 1–5

    Google Scholar 

  36. Banthin JS, Cunningham P, Bernard DM. Financial burden of health care, 2001–2004. Health Aff (Millwood) 2008 Jan–Feb; 27(1): 188–95

    Article  Google Scholar 

  37. Veronin MA, Lee E, Lewis EN. “Insight” into drug quality: comparison of simvastatin tablets from the US and Canada obtained via the internet. Ann Pharmacother 2007 Jul; 41(7): 1111–5

    Article  PubMed  Google Scholar 

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Acknowledgement

Dr Bell is the recipient of a Canadian Institutes of Health Research (CIHR), Institute of Aging New Investigator Award. Both authors contributed to the conception and analysis of the data, the draft and revision of the manuscript and the statistical analysis. Mr Gooi acquired the data, and Dr Bell provided supervision.

The funding agency, CIHR, had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; or preparation, review and approval of the manuscript. The corresponding author had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

We thank Drs Allan Detsky, Don Redelmeier and Ron Wald for their helpful comments on the manuscript.

The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Faculty of Medicine, University of Toronto, Toronto, Canada

    Malcolm Gooi &  Chaim M. Bell

  2. Department of Medicine, University of Toronto, Toronto, Canada

    Chaim M. Bell

  3. Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada

    Chaim M. Bell

  4. The Institute for Clinical Evaluative Sciences, Toronto, Canada

    Chaim M. Bell

  5. Department of Medicine and Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Canada

    Chaim M. Bell

  6. St Michael’s Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    Chaim M. Bell

Authors
  1. Malcolm Gooi
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  2. Chaim M. Bell
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Corresponding author

Correspondence to Chaim M. Bell.

Appendix

Appendix

table AI for the 19 selected generic medications.

Table AI
figure Tab3

The 19 selected generic medicationsa

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Gooi, M., Bell, C.M. Differences in generic drug prices between the US and Canada. Appl Health Econ Health Policy 6, 19–26 (2008). https://doi.org/10.2165/00148365-200806010-00002

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  • DOI: https://doi.org/10.2165/00148365-200806010-00002

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