title: Cancer drugs in 16 European countries, Australia, and New Zealand: a cross-country price comparison study.
abstract: BACKGROUND
  Cancer drugs challenge health-care systems because of their high prices. No cross-country price comparison of cancer drugs for a large number of countries has been published. We aimed to survey the prices of cancer drugs in high-income countries (Europe, Australia, and New Zealand).
  
  
  METHODS
  Based on comparability in terms of the economic situation and of the pharmaceutical system, we surveyed official list prices per unit at ex-factory price level of 31 originator cancer drugs in 16 European countries, Australia, and New Zealand as of June, 2013. Drug price data for the European countries were provided by the Pharma Price Information (PPI) service; Australian and New Zealand drug price data were retrieved from the respective pharmaceutical schedules.
  
  
  RESULTS
  In Austria, Denmark, Finland, Germany, Italy, Norway, Sweden, and the UK, price information was available for all or all but one drug surveyed whereas the availability of price data was restricted for some drugs in other countries, especially in New Zealand and Portugal. The difference of a drug price between the highest priced country and the lowest priced country varied between 28% and 388%. A few drugs had lower outliers, especially Greek and UK prices, and upper outliers (particularly prices in Switzerland, Germany, and Sweden). Overall, Greek prices ranked at a low level, whereas Sweden, Switzerland, and Germany showed price data in similarly high ranges.
  
  
  CONCLUSIONS
  Our results showed variations in ex-factory prices of originator cancer drugs in the 18 surveyed countries. However, the surveyed prices do not include discounts negotiated by funding organisations because these discounts are confidential. Because pricing authorities can also only use these official undiscounted prices when they set prices through the common policy of external price referencing, they risk overpaying. Our findings provide an evidence base for policy makers to decide whether further policy measures related to drug prices are needed.
  
  
  BACKGROUND
  None.
authors.affiliation: WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Health Economics Department, Austrian Public Health Institute, Vienna, Austria. Electronic address: sabine.vogler@goeg.at.
authors.forename: Sabine
authors.initials: S
authors.lastname: Vogler
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: Agnes
authors.initials: A
authors.lastname: Vitry
authors.affiliation: Division of Pharmacy Practice, School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Zaheer-Ud-Din
authors.initials: ZU
authors.lastname: Babar
mesh_terms: D022126:Access to Information; D000970:Antineoplastic Agents / Q000191:economics*; D001315:Australia; D016527:Drug Costs / Q000706:statistics & numerical data*; D004465:Economic Competition / Q000191:economics; D005060:Europe; D006801:Humans; D009520:New Zealand
chemical_list: D000970:Antineoplastic Agents