Report Shows How Much Price of Adalimumab, Insulin Glargine, Varies Globally

How much does the price of common drugs vary across the globe? A UK digital healthcare startup collected that information to display the disparities across 50 countries for 13 often-used pharmaceuticals, including adalimumab and insulin glargine.

Medbelle compared the drugs on a dollar-for-dollar basis, regardless of payer; the company included the average prices of both the reference product and the generic or biosimilar. Dosages were also normalized in order to make the price comparable. They then calculated the median price for each compound, as well as how far the actual price per dose in each country deviates from the median global cost.

Not surprisingly, the United States ranks number 1 in the world across all categories, except for a drug used to prevent organ transplant rejection: Saudi Arabian patients taking tacrolimus pay 204.52% above the median global cost.

Overall, US drugs in the interactive report deviated 306.82% from the median price for both branded and generic drugs; looking at branded drugs separately, the United States was 421.74% higher, and generic drugs were 97.41% higher.

For adalimumab (Humira), the difference ranged from 482.91% above the mean in the United States to —74.20% in India.

Unlike 23 other countries on the list, the United States has no biosimilars for adalimumab and won’t until 2023. Humira’s maker, AbbVie, has patent settlements that prevent competitors from launching until then, including Pfizer’s newly approved Abrilada, Hyrimoz (developed by Sandoz), Cyltezo (Boehringer Ingelheim), Hadlima (Samsung Bioepis), and Amjevita (Amgen).

For insulin glargine (Lantus), the difference ranged from a high of 557.86% above the median in the United States, compared with —43.51% in Egypt, where the price of 1 dose is equivalent to $6.87 for the branded product, compared with $90.57 in the United States.

Medbelle said it collected pricing information from online pharmacies, government websites, and other portals. The price per dose was calculated by 1 unit or 100g/ml of the medication, eg, per tablet (100g), capsule (100ml), syringe (unit), or inhaler (unit).

The other drugs in the report include sildenafil, pregabalin, atorvastatin, salbutamol, azithromycin, drospirenone/ethinyl estradiol, fluoxetine, alprazolam, lisinopril, and tenofovir.

The cost of drugs in the United States has been the focus of numerous hearings in Congress and a variety of bills, as well as the subject of a drug pricing blueprint released in 2018 by the Trump administration.

However, last week, HHS Secretary Alex Azar said President Trump was still not satisfied with his plan, which included an international price index, whereby certain drugs covered by Medicare would be linked to prices in other nations. Now, Azar said, the president wants the prices to be the lowest of all countries by invoking “most favored nation status.”