The 5% · Austria · Brand drugs

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

SKUUnited StatesAustria
Brand originators on the US dollarsourced$1.0026¢
All drugs on the US dollarsourced$1.0036¢
Specialty year at the brand indexmodeled$150,000~$40,000

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×.

DrugUnited StatesAustriaOn the US $
Keytruda (pembrolizumab)hospital dosemodeled$16,800$4,43626¢
Opdivo (nivolumab)hospital dosemodeled$15,000$3,96126¢
Alteplase (tPA) stroke dosehospital kitmodeled$15,000$3,96126¢
Imbruvica (ibrutinib)30-day listsourced$14,934$3,94326¢
Stelara (ustekinumab)30-day listsourced$13,836$3,65326¢
Herceptin-class (trastuzumab)hospital dosemodeled$9,200$2,42926¢
Neulasta-class (pegfilgrastim)hospital dosemodeled$8,900$2,35026¢
Avastin-class (bevacizumab)hospital dosemodeled$8,100$2,13926¢
Enbrel (etanercept)30-day listsourced$7,106$1,87626¢
Rituximab biosimilarhospital dosemodeled$6,800$1,79626¢
Remdesivir coursehospital coursemodeled$4,200$1,10926¢
Humira-class (adalimumab) clinicclinic syringemodeled$2,400$63426¢
Ozempic (semaglutide)30-day listmodeled$969$25626¢
Entresto (sacubitril/valsartan)30-day listsourced$628$16626¢
Jardiance (empagliflozin)30-day listsourced$573$15126¢
Farxiga (dapagliflozin)30-day listsourced$556$14726¢
Januvia (sitagliptin)30-day listsourced$527$13926¢
Eliquis (apixaban)30-day listsourced$521$13826¢
Xarelto (rivaroxaban)30-day listsourced$517$13726¢
NovoLog / Fiasp (insulin)30-day listsourced$495$13126¢

Also: Why Austria hospital prices · Who bargains with whom · Bargaining chips · The rulebook · Problems / solutions · National debt · Drug voices · Back to The 5%