Why Austria brand drugs are cheaper
It’s cheaper because Austria sets one price for the drug. Every hospital and pharmacy pays that (or a cap under it). In the US, each insurer and PBM bargains a rebate off a high list, and the sticker stays high.
Reference pricing (Erstattungskodex)
How it works
Austria reimburses from a code (Erstattungskodex). Reference pricing puts a ceiling on a class. If the brand wants more, it argues added benefit. Social-insurance funds pay the scheduled price.
Why it holds
The class price is the ceiling. You cannot bill a job plan ASP-plus on top. RAND: US brands 3.79× Austria — Austria is about 26¢. Same immunology vial, Austrian list.
The invoices
See RAND drugs. 30-day list prices: CMS 2023, Inflation Reduction Act round 1.
Twenty brands — US sticker vs Austria
Ranked by the US number. 30-day list is CMS 2023 (Inflation Reduction Act round 1). Infusion doses are our hospital commercial bill. Austria column is that US sticker × this country’s RAND brand index. Gross list, not rebates. Even after a US rebate haircut, RAND says brands stay more than 3×.