The International Federation of Health Plans (iFHP), an executive network of the global health insurance industry based in London, in partnership with the Health Care Cost Institute (HCCI) in the United States, and iFHP member companies in multiple countries, today published the latest International Health Cost Comparison Report. The report compares the median prices paid by a sample of private health insurance companies for 34 specific health care services in eleven countries in 2019. Comparisons across different countries are complicated by differences in sectors, fee schedules, and prices may not be representative of prices paid by other plans in that market. We attempted to minimize these limitations by selecting services with very specific definitions and wording survey questions to match the procedures that are the basis of the US payment system.

The median prices paid by private insurance in 2019 for health care services in the United States were generally higher than the median prices in the other countries included in the iFHP study. 

Prescription and Administered Drugs

iFHP and HCCI compared the price of 15 high-cost drugs (11 brand name and 4 generic) in 2019 across ten countries worldwide. The drugs were chosen for the relative cumulative cost they represent as a proportion of the overall drug expenditure by private health insurers. Prices represent the median cost per drug for the most commonly prescribed dosage and units. (see service definitions documentation below for details). Figure 1 shows the prices paid for prescription and administered drugs in each country as a percent of the US price.

 Key Findings:

While US drug prices remained higher than other countries for many of the drugs studied, a look at generic drugs provides a clearer picture of the price shifts that occur when a drug loses its patent or exclusivity protection in a market.

• Drug prices in most countries were less than half the US price for nearly all of the brand administered and prescription drugs included in this study.

• For both insulins studied, US prices far exceeded the prices in any other country studied. 5 syringes of Humalog were $524 in the US and ranged between $79 dollars in Germany and $32 in South Africa. 5 syringes of Lantus were $419 in the US and ranged between $107 in the UAE and $52 in Kazakhstan.

• The prices paid for Sertraline (generic Zoloft), a medication used to treat conditions including depression and panic attacks, were lower in the US than in any other country surveyed. 

Figure 2 shows the prices paid for prescription and administered drugs in 2019, converted at prevailing 2019 exchange rates to US dollars. Select specific services using the buttons on the top right of the figure.

Hospital Admissions

The survey compares the median price of 9 inpatient hospital admissions in 2019 across 11 countries worldwide. There is significant variability in the costs charged across countries. Some of the variability can be explained by differences in the number of days a patient will stay in the hospital. Figure 3 shows the prices paid for inpatient hospital admissions in each country as a percent of the US price.

Key Findings:

The US consistently presents the highest costs for inpatient hospital admissions.

• Prices in Kazakhstan were the lowest among all countries for most of the services included in the survey.

• Outside of the US, prices in Switzerland and New Zealand were often among the highest prices in the survey.

• Bypass surgery and gallbladder removal were less than half the price of the US in all the other countries included in the study.

• Spain had among the lowest prices for hip and knee replacements with prices less than 25% of the US price. Prices for knee replacements in Switzerland were the closest to the US at nearly 70% of the price.

Figure 4 shows the prices paid for inpatient hospital admissions in each country in 2019, converted at prevailing 2019 exchange rates to US dollars. Select specific services using the buttons on the top right of the figure.

 Outpatient/Office Procedures

iFHP and HCCI compared the median cost of 10 outpatient treatments in 2019 across several countries worldwide. The treatments were chosen for the relative cumulative cost they represent as a proportion of the overall treatment costs expensed by private health insurance companies. Outpatient procedures may be performed in a hospital/facility setting or in an office/non-facility setting. Figure 5 shows the prices paid for outpatient/office procedures in each country as a percent of the US price.

 Key Findings:

In 2019, US data trends towards the middle of the countries studied, and the US price was not the highest for any procedure.

• Prices in New Zealand were often among the highest prices for many of the procedures included in the survey.

• Kazakhstan, Chile and Germany had the lowest prices among several of the procedures surveyed.

Figure 6 shows the prices paid for outpatient/office procedures in each country in 2019, converted at prevailing 2019 exchange rates to US dollars. Select specific services using the buttons on the top right of the figure.