Why Singapore brand drugs are cheaper
It’s cheaper on the public list because ACE decides the subsidy and a national buyer buys the vial. Singapore is not in RAND, so the cents below are modeled. In the US, each PBM bargains a rebate off a high list — the sticker stays high.
ACE list + Group Procurement Office
How it works
The Agency for Care Effectiveness decides which drugs get subsidy. The Group Procurement Office bulk-buys for public hospitals. A 340B-style hospital-outpatient markup on the vial is not the product. Private pharmacies can charge more. They do not reset the public list.
Why it holds
Singapore is not in RAND’s 33 OECD countries, so the brand ¢ on this tab is modeled — not a Table B.1 invert. The machine is still a national list plus a bulk buyer. Manufacturers sell in Singapore. They do not get US list as the public price. A specialty year at 28¢ is a labeled model, not a claims extract.
The invoices
See RAND drugs (Singapore is not in RAND; brand ¢ is modeled). 30-day list prices: CMS 2023, Inflation Reduction Act round 1.
Twenty brands — US sticker vs Singapore
Ranked by the US number. 30-day list is CMS 2023 (Inflation Reduction Act round 1). Infusion doses are our hospital commercial bill. Singapore 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×.