Medbelle

2019 Medicine Price Index

At Medbelle, we’ve seen first-hand how digitisation can make high-quality medical care more accessible for everyone. While conducting research into the cities with the best hospital systems, we became aware that one of the biggest disparities across the world when it comes to access to care is the price of medicine. This lead us to commission a study in order to help shed light on this imbalance, in the hope that addressing this important global issue will provide a pathway to greater medical accessibility. The result is a comparative index across 50 countries which reveals the differences in cost of some of the most widely recognised and indispensable medications.

We began the study by selecting thirteen prevalent pharmaceutical compounds in order to make a comparison on a euro-for-euro basis of how much medicines cost in different countries, regardless of whether covered by a healthcare system, or paid directly from the individual’s pocket. The medications chosen for comparison span a variety of common conditions; from heart disease and asthma, to anxiety disorders and erectile dysfunction. The average prices of both the brand compound and their generic versions were included in order to have a complete profile of each medication. Lastly, we normalised the dosage size in order to make the price comparable.

Once all these figures were collected, we were able to calculate the median price for each compound around the world, as well as how far the actual price per dose in each country deviates from the median global cost. The results range from a +306.82 % deviation in the United States, to -93.93% in Thailand, highlighting a disparity in what patients pay for the same medicine across the world.

The final index compares costs and deviations from the average to reveal the differences in medication prices worldwide.

Below you will find two tables. The first table shows the percentage price deviation above or below the global median for each medication. The final three columns show the total price deviation from the global median in each country. Each column is filterable, from highest to lowest, and vice versa.

The second table features a drop down box where it is possible to select a drug, one at a time, to see its total deviation and the actual prices of both the original and generic compounds in each country.

Please note: due to differences in the availability of patents in each country, some locations in the table feature the price of the generic compounds only.
The totals for generic, branded and combined medicines were calculated as follows: (Country average - Median of all country averages) / Median of all country averages
The full methodology explaining how the prices and deviations were calculated can be found at the bottom of the page.

Condition Erectile Dysfunction Epilepsy, Fibromyalgia, Generalized Anxiety Disorder, among others Cardiovascular Disease, High Cholesterol Asthma, Chronic Obstructive Pulmonary Disease Bacterial Infection Diabetes Type I and II Immunosuppression, Transplant Rejection Prevention Female Contraception Depression, Bulimia, Obsessive-compulsive disorder (OCD), among others Anxiety and Panic Disorder High Blood Pressure Hepatitis B, HIV/AIDS Arthritis, Bowel Disease, Skin Disorders, among others
Branded drug Viagra Lyrica Lipitor Ventolin Zithromax Lantus Prograf Yasmin Prozac Xanax Zestril Viread Humira Total
Pharmaceutical Compound Sildenafil Pregabalin Atorvastatin Salbutamol Azithromycin Insulin Glargine Tacrolimus Drospirenone / Ethinylestradiol Fluoxetine Alprazolam Lisinopril Tenofovir Adalimumab Branded Drug Generic Drug Branded and Generic Drugs
% Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price % Deviation from Median Price
# Country
1 USA 660,24 % 1071,17 % 2175,83 % 1191,01 % 1755,25 % 557,86 % 86,45 % 785,99 % 2124,89 % 2568,75 % 2682,56 % 217,02 % 482,91 % 421,74 % 97,41 % 306,82 %
2 Germany 82,09 % 199,89 % 256,92 % 272,56 % 206,99 % 36,35 % 165,41 % 121,59 % 77,86 % 186,70 % -2,23 % 40,71 % 80,05 % 105,44 % 855,53 % 125,64 %
3 UAE -23,70 % 32,29 % 251,61 % -1,56 % 9,83 % 50,78 % 34,39 % -35,56 % 160,33 % 69,68 % 187,35 % 147,71 % 80,30 % 75,52 % 1021,33 % 122,03 %
4 Italy 70,19 % -2,26 % 133,85 % -16,70 % 26,88 % 27,08 % 40,41 % 69,32 % -12,51 % 183,20 % 42,41 % 22,46 % 61,19 % 55,58 % 830,92 % 90,36 %
5 Denmark 56,90 % 148,80 % 249,23 % 61,67 % -27,42 % 19,85 % 75,00 % -28,41 % 0,40 % 95,80 % 354,85 % 121,08 % 37,19 % 66,71 % 662,25 % 79,53 %
6 Qatar 38,23 % 69,84 % 389,34 % 2,48 % 51,86 % 56,56 % 83,33 % -21,64 % 201,40 % -16,14 % 170,31 % - 99,19 % 74,82 % -78,12 % 78,87 %
7 Spain 84,55 % 84,38 % 1,54 % -33,36 % 3,23 % 4,34 % -30,23 % 44,32 % -74,18 % -44,06 % -2,23 % 86,75 % 33,56 % 32,08 % 895,18 % 78,34 %
8 Netherlands 26,25 % -47,80 % -56,92 % -5,35 % -44,09 % -11,84 % 2,62 % -55,68 % -91,39 % -30,07 % -63,87 % -44,83 % 38,72 % 34,13 % 848,76 % 75,01 %
9 Israel 34,45 % 109,94 % -22,91 % 48,11 % -6,90 % 41,31 % 192,54 % 46,93 % -12,86 % 326,65 % 19,20 % 200,32 % 92,57 % 88,21 % -3,45 % 56,44 %
10 Iceland 84,74 % 148,93 % 80,59 % 274,75 % 298,71 % 138,15 % 85,93 % 21,93 % 84,61 % 345,44 % - 131,35 % -8,58 % 27,39 % 627,54 % 56,01 %
11 Brazil -22,96 % 85,32 % 159,74 % 37,40 % 16,04 % 44,34 % -61,83 % 54,49 % 81,39 % 180,10 % 171,60 % -59,32 % 135,27 % 90,91 % -67,55 % 51,49 %
12 Lithuania 11,78 % -0,04 % -67,69 % -9,51 % -22,58 % -22,15 % -32,27 % -4,55 % -56,97 % 57,34 % -23,48 % 51,37 % -6,85 % 27,63 % 471,16 % 31,99 %
13 Finland 46,83 % -0,04 % 113,85 % 3,74 % -32,80 % -1,18 % 38,08 % 14,77 % -42,63 % 74,82 % 2,02 % 120,44 % -7,24 % 0,74 % 578,87 % 28,99 %
14 Argentina -81,42 % 38,39 % 167,39 % 46,66 % -41,67 % 169,96 % 105,64 % -20,87 % 78,23 % -46,07 % -3,85 % 27,39 % 86,13 % 54,61 % -22,42 % 22,09 %
15 Saudi Arabia -23,64 % 3,20 % -17,52 % -18,25 % 44,39 % 9,41 % 204,52 % -45,14 % 135,23 % -21,96 % 126,88 % 57,51 % 65,51 % 36,08 % -57,01 % 18,81 %
16 Ireland -90,57 % 24,40 % -50,77 % 22,42 % -34,68 % -21,88 % 11,05 % 13,64 % -58,40 % -37,07 % -10,73 % 0,48 % -10,74 % -13,81 % 514,02 % 14,60 %
17 Philippines 37,64 % 107,98 % 38,73 % 57,19 % -15,75 % 17,58 % 110,56 % 21,66 % 293,97 % 313,61 % 355,05 % -86,41 % 54,27 % 51,10 % -54,90 % 12,64 %
18 New Zealand -57,41 % -93,63 % -96,47 % -29,08 % -85,51 % -2,01 % -72,00 % 42,05 % 48,87 % - -90,25 % -88,24 % 8,67 % 62,50 % -87,59 % 10,37 %
19 Japan 108,26 % 109,26 % 83,27 % 79,56 % 93,30 % 2,23 % 142,09 % 371,78 % - -40,92 % 22,65 % 30,07 % 25,28 % 25,36 % -29,50 % 9,56 %
20 Switzerland 132,69 % 68,84 % 302,92 % 225,33 % 266,04 % 27,63 % 52,27 % 129,97 % 95,71 % 264,99 % 119,94 % 98,31 % 43,57 % 24,32 % 3,45 % 5,00 %
21 UK -26,45 % 57,96 % 75,38 % -14,68 % -17,47 % -28,26 % -9,12 % -43,57 % -75,72 % -48,70 % 39,14 % -27,89 % -11,56 % -20,85 % 470,37 % 4,98 %
22 Greece -9,87 % -25,58 % 21,54 % -47,75 % 259,14 % -5,42 % -47,09 % -9,09 % 0,40 % -37,07 % -10,73 % -6,95 % -17,12 % -13,55 % 395,20 % 4,75 %
23 Slovakia 92,91 % -61,12 % -43,08 % -9,51 % -25,81 % -20,84 % -34,88 % 14,77 % -71,31 % -33,57 % -61,74 % -21,16 % -23,76 % -15,46 % 423,55 % 4,19 %
24 Chile 68,23 % 147,85 % 278,15 % 354,85 % 14,94 % 168,17 % 52,91 % 182,65 % 256,66 % -76,71 % 434,16 % 154,85 % 20,02 % 31,38 % -12,29 % 2,02 %
25 Hungary 52,28 % -14,08 % -18,01 % -1,76 % 44,24 % -24,73 % -47,84 % -5,16 % -29,12 % -51,01 % -53,26 % 24,01 % -23,37 % -1,96 % 305,09 % 1,64 %
26 Czechia 14,98 % 34,05 % 161,99 % -19,42 % -9,50 % 0,28 % -6,10 % 6,07 % -51,11 % 23,77 % -41,22 % 40,80 % -29,32 % -19,45 % 388,33 % -1,64 %
27 Norway 64,55 % 49,80 % -9,23 % 67,93 % 70,64 % -5,51 % 3,90 % 172,07 % 78,47 % 27,00 % -16,39 % 109,75 % 26,00 % 12,30 % -15,18 % -5,26 %
28 Austria 89,91 % -20,03 % 15,38 % 148,62 % 79,84 % 68,49 % 27,03 % 40,91 % 116,59 % -5,60 % 70,04 % 8,08 % -35,32 % -34,42 % 401,89 % -10,75 %
29 Belgium 53,58 % -37,80 % -18,46 % 133,61 % 69,35 % -19,44 % -34,30 % 10,23 % 95,07 % 260,12 % 36,03 % -22,62 % 22,82 % 10,21 % -45,77 % -12,79 %
30 Poland 23,61 % -66,77 % -66,37 % -27,89 % -29,79 % -30,29 % -34,57 % -37,76 % -68,31 % 49,66 % -56,96 % -84,53 % -36,27 % -23,06 % 300,66 % -13,72 %
31 Bulgaria 1,10 % -68,20 % -73,26 % -11,72 % 26,45 % -3,98 % 9,10 % -16,33 % -61,86 % -78,55 % 8,67 % -24,63 % 7,05 % 16,00 % -76,97 % -14,50 %
32 France 27,11 % -25,58 % -38,46 % 24,94 % -10,22 % -21,11 % -4,94 % -9,09 % -18,24 % -33,57 % -17,11 % 15,59 % -31,77 % -32,98 % 329,10 % -15,63 %
33 Portugal 50,37 % -8,92 % 129,23 % -17,21 % -9,41 % -6,15 % -17,44 % -17,05 % -56,97 % -40,56 % -23,48 % 67,21 % 24,91 % 4,09 % -60,99 % -15,76 %
34 Mexico 4,82 % 54,96 % 277,38 % 198,52 % 224,03 % 53,32 % 36,57 % 47,05 % 322,76 % 449,06 % 234,57 % 40,53 % 10,39 % -1,37 % -69,78 % -17,47 %
35 Canada 20,25 % 55,40 % 164,84 % -4,79 % 17,63 % 0,77 % -4,90 % -17,39 % 135,11 % 125,41 % 48,69 % 35,40 % 25,10 % 5,55 % -58,62 % -17,58 %
36 Taiwan 152,18 % 16,30 % 82,81 % -12,40 % -64,10 % 13,29 % 94,94 % 59,16 % -83,46 % -54,34 % -66,24 % - -4,92 % -5,44 % -59,93 % -18,29 %
37 Sweden 46,95 % 65,30 % 12,41 % 38,11 % -22,04 % -14,56 % 18,03 % -48,03 % 0,00 % 29,68 % -45,86 % -3,18 % -44,04 % -29,64 % 233,13 % -23,19 %
38 Colombia -69,85 % -60,33 % 321,91 % 8,95 % 118,43 % -29,55 % -43,35 % -33,02 % 618,57 % 198,10 % 590,78 % -61,07 % 9,91 % -0,74 % -82,85 % -24,01 %
39 China 21,00 % 184,46 % 203,72 % 3,27 % -49,96 % 141,04 % 64,95 % 86,85 % 146,30 % -83,91 % 57,08 % -72,11 % -48,58 % -8,86 % 13,22 % -24,82 %
40 Australia -62,02 % -50,72 % -63,97 % 8,89 % 92,84 % 143,45 % -19,92 % 74,38 % -46,08 % 218,90 % -12,24 % 40,88 % -1,89 % -7,09 % -36,46 % -25,05 %
41 South Korea -14,25 % -14,60 % -13,99 % -43,95 % -55,28 % -10,37 % 43,73 % -9,29 % -7,65 % -44,32 % 18,23 % -97,99 % -13,69 % -22,74 % -66,53 % -33,98 %
42 Egypt -89,24 % -44,85 % 25,13 % -68,32 % -83,50 % -43,51 % -29,62 % -73,18 % -87,20 % 28,73 % 209,94 % -80,24 % -23,24 % -26,90 % -94,88 % -38,67 %
43 Turkey 14,82 % -53,40 % -53,24 % -66,37 % -52,33 % -33,93 % -61,94 % -21,92 % -62,53 % -62,91 % -60,29 % -65,61 % -51,99 % -56,96 % 226,13 % -41,57 %
44 Russia -7,43 % 4,53 % -57,29 % -56,54 % -12,06 % -28,54 % -64,72 % 16,69 % -24,57 % 1002,85 % -14,51 % -62,84 % -65,81 % -65,37 % 176,06 % -51,92 %
45 South Africa -76,40 % -20,81 % 37,33 % -14,11 % 70,64 % -22,95 % -9,23 % -14,98 % 23,25 % -10,83 % -56,89 % -91,62 % -32,84 % -38,61 % -75,63 % -53,72 %
46 India -41,20 % -91,13 % -84,82 % -64,76 % -88,46 % 6,62 % -87,46 % -54,94 % -84,43 % -73,21 % 31,37 % 162,87 % -74,20 % -87,41 % 92,41 % -73,82 %
47 Indonesia -50,82 % 80,83 % -86,44 % 112,72 % -45,55 % 22,97 % 5,83 % 92,43 % -16,83 % 66,86 % -90,36 % -82,78 % - -91,45 % -57,07 % -90,23 %
48 Malaysia 61,04 % 132,49 % 115,01 % 5,06 % -76,63 % 27,74 % 49,11 % 31,65 % 174,35 % 21,59 % 119,44 % - - -89,67 % -79,04 % -90,80 %
49 Kenya -29,54 % 18,93 % 83,84 % -44,68 % 21,75 % 17,31 % -74,13 % -5,13 % 50,06 % 32,81 % 227,41 % - - -92,79 % -90,30 % -93,76 %
50 Thailand 40,26 % 24,04 % -2,15 % -46,18 % -35,97 % -3,65 % 85,50 % -53,95 % 30,71 % -77,06 % -57,92 % -83,88 % - -92,94 % -93,11 % -93,93 %
% Deviation from Median Price and Branded and Generic Price per Dose for all Compounds
All currency figures are in EUR.
Condition
Branded drug
Pharmaceutical Compound
% Deviation from Median Price Branded Drug Price/Dose Generic Drug Price/Dose
# Country

Methodology

The 2019 Medicine Price Index compares and analyses the cost of medicine around the world. The study takes a comprehensive look into the cost of 13 prevalent medications, examining the average price per dose of both the original (brand name) drugs, and their generic versions. It also analyses how far the price of each medication deviates from the global median. The individual percentages are then aggregated to reveal the total deviation from the global median on a country level for all 13 medications. As a UK-based enterprise, the total deviations were calculated from the medicine price in GBP. Due to this, there may be minimal differences in the deviations in other currencies.

For the purposes of the study, the terms ‘branded drug’ (e.g. Viagra) and ‘generic drug’ (e.g. Sildenafil) were defined as follows according to the European Patients Academy on Therapeutic Innovation (EUPATI) project: “Branded medicines are medicines which have a name given to them by a company for the purpose of advertising. The names of branded medicines are different from the International Nonproprietary Name (INN), also known as the generic name. Branded medicines may be the original medicine developed by a company or several companies may make the same generic medicine, to which each company gives its own brand name.”

Please note: due to differences in the availability of patents in each country, some locations in the table feature the price of the generic compounds only.

Below you can find a description of how each deviation was calculated, how the prices were collected, as well as each medication within the study and the sources used.

Calculation of Deviation:

Branded and Generic, Deviation from Median Price

In order to determine the deviation from the median price, the average price of branded and generic drugs was calculated for every country. The deviation from median is calculated using the following formula:

(Xi - Median of all country averages) / Median of all country averages

Branded drugs, Deviation from Median Price

In order to determine the deviation from the median price, the average of the prices for branded drugs was calculated for every country. The deviation from median is calculated using the following formula:

(Xi - Median of all country averages for branded drugs) / Median of all country averages for branded drugs

Branded and Generic, Deviation from Median Price

In order to determine the deviation from the median price, the average price of branded and generic drugs was calculated for every country. The deviation from median is calculated using the following formula:

(Xi - Median of all country averages) / Median of all country averages

Generic drugs, Deviation from Median Price

In order to determine the deviation from the median price, the average of the prices for generic drugs was calculated for every country. The deviation from median is calculated using the following formula:

(Xi - Median of all country averages for generic drugs) / Median of all country averages for generic drug

Compounds, Deviation from Median Price

In order to determine the deviation from the median price, the median price for each compound (branded and generic drugs) was calculated. The deviation from median is calculated using the following formula:

(Average of Xbranded drug and Xgeneric drug - Median of all branded and generic prices for a compound) / Median of all branded and generic prices for a compound

Price Collection:

The price was collected from online pharmacies, governmental websites and information portals around the globe.
The prices for the branded and generic drugs were collected according to the profiles laid out in the section condition and compounds (below). If more than one generic drug was available, the drug with the cheapest regular price was chosen.
For the UK, in addition to the indicative price pharmacy fees, fees such as the single activity fee and the fee for controlled drugs were added to the price to enhance comparability.

Price per Dose

The price calculated by 1 unit or 100g/ml of the medication, e.g. per tablet (100g), capsule (100ml), syringe (unit) or inhaler (unit).

Condition and Compounds

Erectile Dysfunction (Sildenafil)

Sildenafil is a compound used to treat erectile dysfunction.
The original brand is Viagra, manufactured by Pfizer.
Data was mainly collected for the following specifications:
Compound strength: 50 mg
Package size: 4 tablets
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Epilepsy, Fibromyalgia, Generalized Anxiety Disorder, among others (Pregabalin)

Pregabalin is used to treat epilepsy, neuropathic pain, fibromyalgia, restless leg syndrome, and generalized anxiety disorder.
The original brand is Lyrica, manufactured by Pfizer.
Data was mainly collected for the following specifications:
Compound strength: 75 mg
Package size: 30 capsules
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Cardiovascular Disease, High Cholesterol (Atorvastatin)

Atorvastatin is used to prevent cardiovascular disease.
The original brand is Lipitor, manufactured by Pfizer.
Data was mainly collected for the following specifications:
Compound strength: 20 mg
Package size: 30 tablets
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Asthma, Chronic Obstructive Pulmonary Disease (Salbutamol)

Salbutamol (also known as Albutol) is used to treat asthma, including asthma attacks, exercise-induced bronchoconstriction, and chronic obstructive pulmonary disease (COPD).
The original brand is Ventolin, manufactured by GlaxoSmithKline.
Data was mainly collected for the following specifications:
Compound strength: 100 mcg per dose
Package size: 1 inhaler (200 doses)
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Bacterial Infection (Azithromycin)

Azithromycin is an antibiotic used for the treatment of a number of bacterial infections including middle ear infections, strep throat, pneumonia, traveler's diarrhea, other intestinal infections and sexually transmitted infections (e.g. chlamydia and gonorrhea).
The original brand is Zithromax manufactured by Pfizer. In Eastern Europe, it is also known as Sumamed and is manufactured by Pliva.
Data was mainly collected for the following specifications:
Compound strength: 500 mg
Package size: 3 tablets
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Diabetes Type I and II (Insulin Glargine)

Insulin Glargine is a long-acting Insulin used in the treatment of type I and type II diabetes.
The original brand is Lantus, manufactured by Sanofi-Aventis.
Data was mainly collected for the following specifications:
Compound strength: 100 Units per ml
Package size: 5 pens with 3 ml
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Immunosuppression, Transplant Rejection Prevention (Tacrolimus)

Tacrolimus is an immunosuppressive drug which is used after organ transplantation to lower the risk of rejection.
The original brand is Prograf, manufactured by Astellas.
Data was mainly collected for the following specifications:
Compound strength: 1 mg
Package size: 50 capsules
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Female Contraception (Drospirenone/Ethinylestradiol)

The birth control pill is used to prevent pregnancies.
The original brand is Yasmin, manufactured by Bayer.
Data was mainly collected for the following specifications:
Compound strength: 3 mg Drospirenone and 0.03 mg Ethinylestradiol
Package size: 21 tablets. In some countries, the package contains 28 tablets, but 7 of them come without a compound.
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Depression, Bulimia, Obsessive-compulsive disorder (OCD), among others (Fluoxetine)

Fluoxetine is an antidepressant used to treat major depressive disorder, obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), bulimia nervosa, panic disorder, premenstrual dysphoric disorder, and trichotillomania.
The original brand is Prozac, manufactured by Eli Lilly.
Data was mainly collected for the following specifications:
Compound strength: 20 mg
Package size: 30 capsules
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Anxiety and Panic Disorder (Alprazolam)

Alprazolam is a benzodiazepine used for the treatment of anxiety disorders, specifically panic disorder or generalized anxiety disorder (GAD).
The original brand is Xanax, manufactured by Pfizer.
Data was mainly collected for the following specifications:
Compound strength: 1 mg
Package size: 8 tablets
If this profile was unavailable in a country, the closest available compound strength and package size was used.

High Blood Pressure (Lisinopril)

Lisinopril is an ACE inhibitor used to treat high blood pressure, heart failure, and after heart attacks.
The original brand is Zestril, manufactured by AstraZeneca.
Data was mainly collected for the following specifications:
Compound strength: 20 mg
Package size: 28 tablets.
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Hepatitis B, HIV/AIDS (Tenofovir)

Tenofovir disoproxil is a medication used to treat chronic hepatitis B and to prevent and treat HIV/AIDS.
The original brand is Viread, manufactured by Gilead Sciences.
Data was mainly collected for the following specifications:
Compound strength: 245 mg
Package size: 30 tablets
If this profile was unavailable in a country, the closest available compound strength and package size was used.

Arthritis, Bowel Disease, Skin Disorders, among others (Adalimumab)

Adalimumab is a compound used to treat autoimmune diseases like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriasis, hidradenitis suppurativa, uveitis, and juvenile idiopathic arthritis.
The original brand is Humira, manufactured by AbbVie.
The generic drug in this case is not technically a generic drug, but a biosimilar.
Data was mainly collected for the following specifications:
Compound strength: 40 ml per 0.4 ml solution
Package size: 2 syringes
If this profile was unavailable in a country, the closest available compound strength and package size was used.

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