The 5% · Australia · Brand drugs

Why Australia brand drugs are cheaper

It’s cheaper because Australia 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.

PBS — bargain the whole list as a country

How it works

The Pharmaceutical Benefits Scheme lists a drug only after PBAC says it is cost-effective. Then the Commonwealth bargains the price. Take-it-or-leave-it. Private extras do not reset that floor.

Why it holds

Australia is 27 million people and still about 20¢ on US brands (RAND: US 5.00×). Manufacturers list on the PBS because that is how you sell in Australia. They still get Keytruda on the PBS. They do not get US list.

The invoices

SKUUnited StatesAustralia
Brand originators on the US dollarsourced$1.0020¢
All drugs on the US dollarsourced$1.0027¢
Specialty year at the brand indexmodeled$150,000~$30,000

See RAND drugs. 30-day list prices: CMS 2023, Inflation Reduction Act round 1.

Twenty brands — US sticker vs Australia

Ranked by the US number. 30-day list is CMS 2023 (Inflation Reduction Act round 1). Infusion doses are our hospital commercial bill. Australia 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 StatesAustraliaOn the US $
Keytruda (pembrolizumab)hospital dosemodeled$16,800$3,35720¢
Opdivo (nivolumab)hospital dosemodeled$15,000$2,99720¢
Alteplase (tPA) stroke dosehospital kitmodeled$15,000$2,99720¢
Imbruvica (ibrutinib)30-day listsourced$14,934$2,98420¢
Stelara (ustekinumab)30-day listsourced$13,836$2,76520¢
Herceptin-class (trastuzumab)hospital dosemodeled$9,200$1,83820¢
Neulasta-class (pegfilgrastim)hospital dosemodeled$8,900$1,77820¢
Avastin-class (bevacizumab)hospital dosemodeled$8,100$1,61920¢
Enbrel (etanercept)30-day listsourced$7,106$1,42020¢
Rituximab biosimilarhospital dosemodeled$6,800$1,35920¢
Remdesivir coursehospital coursemodeled$4,200$83920¢
Humira-class (adalimumab) clinicclinic syringemodeled$2,400$48020¢
Ozempic (semaglutide)30-day listmodeled$969$19420¢
Entresto (sacubitril/valsartan)30-day listsourced$628$12520¢
Jardiance (empagliflozin)30-day listsourced$573$11420¢
Farxiga (dapagliflozin)30-day listsourced$556$11120¢
Januvia (sitagliptin)30-day listsourced$527$10520¢
Eliquis (apixaban)30-day listsourced$521$10420¢
Xarelto (rivaroxaban)30-day listsourced$517$10320¢
NovoLog / Fiasp (insulin)30-day listsourced$495$9920¢

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