International Drug Price Comparison
| Drug | US Price (monthly) | Canada Price | UK Price | Savings vs. US |
|---|---|---|---|---|
| Humira (adalimumab) | $6,000 | $1,400 | $1,200 | 75–80% |
| Eliquis (apixaban) | $600 | $120 | $100 | 80–83% |
| Ozempic (semaglutide) | $900 | $200 | $180 | 78–80% |
| Keytruda (pembrolizumab) | $15,000 | $3,500 | $3,000 | 77–80% |
| Xarelto (rivaroxaban) | $500 | $100 | $90 | 80–82% |
Why the Gap Exists
The US drug pricing gap exists because: (1) the US does not negotiate drug prices at the national level (unlike every other developed country); (2) the US rebate system creates perverse incentives to maintain high list prices; (3) US patent protections are stronger and longer than in other countries; and (4) the US market is the most profitable in the world, so manufacturers charge what the market will bear.
The Employer Opportunity
IQ Insight
International drug sourcing is one of the highest-ROI cost management strategies available to employers. A plan spending $500,000 annually on Humira can reduce that cost to $100,000–$125,000 through international sourcing — saving $375,000–$400,000. For plans with multiple high-cost specialty drugs, international sourcing can save $500,000–$2 million annually.