iFHP and HCCI Release 2022 International Health Cost Comparison Report

Data show loss of patent and loss of exclusivity are lowering the costs of some drugs in the US, the US continues to lead in inpatient costs across every measured intervention, however outpatient costs in the US are not always higher than other countries.

LONDON, July 20, 2022 /PRNewswire/ -- The International Federation of Health Plans (iFHP), an executive network of the global health insurance industry based in London, in partnership with the Health Care Cost Institute (HCCI) in the United States, and iFHP member companies in multiple countries, today published the latest International Health Cost Comparison Report.

The expanded report compares the cost of a selection of inpatient treatments, outpatient treatments and prescribed drugs as reported by iFHP members in eleven countries in 2019.

Data in the report demonstrate that where you live continues to have an enormous influence on the cost of your healthcare. Several types of care may be up to ten times more expensive in some countries over others that are otherwise geographically, politically, and economically similar.

"While healthcare in the United States is commonly thought to be among the most expensive in the world, this latest report suggests this may no longer be true for all health costs," said Chris Watney, CEO of iFHP. "Although international comparisons need to be made carefully, it's our hope that strategies employed to challenge the status quo on drug pricing and some outpatient procedures are starting to bring some median US costs in line with, or better than international benchmarks."

Drug Cost Comparison

iFHP and HCCI compared the price of fifteen drugs in 2019 across nine countries worldwide. The drugs were chosen for the relative cumulative cost they represent as a proportion of the overall drug expenditure of private health insurers. Prices represent the median cost per drug.

Key Findings:

While US drug prices remained higher than other countries for many of the drugs studied, a look at generic drugs provides a clearer picture of the price shifts that occur when a drug loses its patent or exclusivity protection in a market.

Drug costs in most countries were less than half the US costs for nearly all of the non-generic administered, and prescription drugs included in this study.
The prices paid for Sertraline (generic Zoloft), an antidepressant, were lower in the US than in any other country surveyed.
Similarly, the price of Escitalopram (generic Lexapro), also an antidepressant, was lower in the US than any country surveyed except Kazakhstan.

Inpatient Procedures Costs Comparison

The study compares the median claims cost of nine inpatient treatments in 2019 across eleven countries worldwide. As in previous studies, the median costs borne by private insurers for health care services in the United States were almost always higher than those reported in the other countries included in the study.

There is significant variability in the costs across countries which can be attributed to several variables. For instance, some of the variability can be explained by international differences in the number of days a patient will stay in the hospital.

Key Findings:

The survey's latest findings are broadly consistent with those of previous studies, with the United States consistently presenting the highest costs for inpatient treatments, and usually significantly so.

Prices in Kazakhstan were the lowest among all countries for most of the services included in the study.
Outside of the US, prices in Switzerland and New Zealand were often among the highest prices in the study.
Coronary bypass surgery and gallbladder removal (cholecystectomy) were less than half the price of the US in all the other countries included in the study.
Spain had among the lowest prices for hip and knee replacements with costs less than 25% of the US price. The median cost of a knee replacement in Switzerland was the closest to the US at nearly 70% of the price.

Outpatient Procedure Costs Comparison

iFHP and HCCI compared the median cost of ten outpatient treatments in 2019 across eleven countries worldwide. The treatments were chosen for the relative cumulative cost they represent as a proportion of the overall treatment costs expensed by private health insurance companies. Outpatient procedures may be performed in a hospital/facility setting or in an office/non-facility setting.

The objective of this study is to highlight price disparities internationally. Due to the differences in billing practices, it is not always possible to provide an exact match between what is measured in each claim per country, and those differences are noted in the survey.

Key Findings:

The picture has changed since the report of 2017 data, when costs in the United States outstripped other countries' costs in all but one category (cataract). In 2019, the US data trended more towards the centre of the countries studied, and the US price was not the highest for any procedure.

Outside of the US, prices in New Zealand were often among the highest prices for many of the procedures included in the study.
Kazakhstan, Chile and Germany reported the lowest prices for several of the procedures surveyed.

Comparisons across different countries are complicated by differences in market dynamics and fee schedules, and prices may not be representative of prices paid by other plans in that market. The study attempts to minimize these limitations by focusing on services with very specific definitions enabling respondents to match the procedures that are the basis of the US payment system. The drugs costs are taken from claims data and as such they are influenced by both list price and confidential contractual agreements or rebates. All drug prices were adjusted to reflect the most commonly prescribed standard dosage and units.

About the International Federation of Health Plans

Representing 70+ private and statutory health insurers in over 24 countries and 6 continents, covering a total of more than 250 million lives, the International Federation of Health Plans (iFHP) supports equitable access to healthcare for all populations across the world and the sustainability of the private and statutory health insurance industry.

About the Health Care Cost Institute

The Health Care Cost Institute (HCCI) is an independent, non-profit organization with leading health claims datasets that enable research, policy, and journalism. HCCI stands for truth and consensus around the most important trends in health care, particularly those economic and policy issues that are critical to a sustainable, equitable, and accessible high-quality health care system.

About the Study

The 2022 International Health Cost Comparison Report compares the cost of a selection of inpatient treatments, outpatient treatments and prescribed drugs as reported by iFHP members in ten countries in 2019. (Note: 2019 represents the most complete and recent dataset not affected by the COVID-19 pandemic.) The drugs and treatments featured in the study were selected due to the high cumulative cost they typically represent in total claims for health plans around the world. The objective of this study is to highlight cost disparities as a basis for further research into the contributing factors to those disparities.

The full 2022 report is available at https://healthcostinstitute.org/images/pdfs/international_health_cost_comparison_report_2022.pdf

The prior report, published in 2019, is available at: https://healthcostinstitute.org/hcci-research/international-comparisons-of-health-care-prices-2017-ifhp-survey?highlight=WyJpZmhwIl0=