Sen. Bernie Sanders (I-Vt.), whether or not in Congress or as a presidential candidate, has all the time taken sturdy positions towards the excessive price of pharmaceuticals. Since turning into the chair of the influential Senate Well being, Schooling, Labor and Pensions Committee this 12 months, he is made decreasing drug prices a prime precedence.

It is subsequently not shocking that the senator would, throughout a current Sunday morning TV interview, rail towards excessive drug costs in the US and examine what Individuals pay with what folks in different international locations should fork over.

“We pay by far the best costs on this planet for pharmaceuticals, in some instances 10 instances greater than the folks of another nation,” Sanders stated on CNN’s “State of the Union” final month.

In spite of everything, it’s a common political speaking level. However 10 instances as a lot? That was a little bit of a head-snapper. We determined to test it out.

An advanced market

We first requested the senator’s workplace for the paperwork to assist Sanders’ claims. However our repeated requests went unacknowledged.

So, we began digging round on our personal. What we discovered was that, as anticipated, Sanders was proper in asserting that drug costs in the US usually exceed these in different international locations. The magnitude of the distinction, nonetheless, varies relying on the medication and the international locations included within the comparability, amongst different components.

And irrespective of how the research we examined sliced the info, the drug value distinction virtually by no means reached Sanders’ acknowledged stage. Nonetheless, consultants informed us his level has benefit. “I feel the quote is on track, if a bit obscure in scope,” stated Andrew Mulcahy, a senior well being economist on the Rand Corp., a world coverage suppose tank.

Take, for instance, the oft-cited 2021 research by Rand that discovered, primarily based on 2018 figures, drug costs within the U.S. had been on common 2.56 instances the drug costs in 32 different Group for Financial Cooperation and Improvement international locations. These are principally high-income, developed nations. For brand-name medication, the hole was even greater: Individuals paid 3.44 instances the costs for these medication, on common. However the reverse was true for generic medication, for which Individuals paid simply 84% of what folks in different international locations studied paid. One exception: Turkey. U.S. drug costs had been practically eight instances these in Turkey general, and 10.5 instances these for brand-name medication.

Mulcahy, a co-author of the report, stated that though the ratio throughout all medication sometimes would not attain Sanders’ “10 instances” mark, “for some medication it will get shut, for those who have a look at the producer’s checklist value.”

The producer value, although, will not be essentially the most effective measure — particularly if the thought is to seize what shoppers are paying.

That is as a result of it would not mirror the rebates and different reductions negotiated by insurers and pharmacy profit managers that may decrease a drug’s retail value. Most individuals with medical health insurance are paying costs that embody these reductions. The Rand researchers used the producer value, although, as a result of the reductions are confidential and it is exhausting to quantify how they have an effect on internet costs, the report famous.

Different research have discovered smaller — although nonetheless important — gaps than Sanders cited. In 2021, the Authorities Accountability Workplace launched a comparative evaluation of the costs of 20 brand-name medication in the US, Canada, Australia, and France. The research, commissioned by Sanders himself, discovered that retail costs had been greater than 2 to 4 instances what they had been within the U.S.

One other evaluation, this one by the Peterson-KFF Well being System Tracker, in contrast the costs of seven brand-name medication within the U.S., Germany, the Netherlands, and the UK, and likewise discovered that some U.S. costs had been roughly 2 to 4 instances as excessive as these in different international locations. However for different medication the hole was smaller.

The medication tracked on this evaluation “are usually specialty medication and costly irrespective of the place you purchase them,” stated Cynthia Cox, director of the Peterson-KFF Well being System Tracker, who co-authored the evaluation.

As a result of the US would not straight regulate drug costs as many different international locations do, some costs listed below are costlier. In 2019, the US spent $1,126 per individual on pharmaceuticals, together with $963 by well being plans and $164 that individuals spent out-of-pocket, in line with a KFF evaluation of OECD information. Spending by comparable international locations was $552 per capita, together with $466 by well being plans and $88 in out-of-pocket spending by people.

Consultants added, although, that value is just one component that impacts general prescription drug spending.

“If we’re spending extra, a part of that could be as a result of we’re paying larger costs, however it additionally could be as a result of we’re utilizing extra medicine,” stated Cox.

After which there may be insulin

The place Sanders may discover assist for his assertion, in line with Mulcahy, is in insulin costs. A Rand research accomplished in 2020 for the Well being and Human Companies’ Workplace of the Assistant Secretary for Planning and Analysis in contrast 2018 insulin costs in the US with these in 32 different OECD international locations. Their findings: The typical U.S. producer value for the standard unit of insulin bought domestically was greater than 10 instances the worldwide value, $98.70 within the U.S. versus $8.81 within the OECD pattern.

Such statistics have triggered a considerably partisan rallying cry to deal with drug prices. The worth of insulin has been the topic of congressional hearings, together with one this month convened by Sanders.

In the meantime, capping insulin prices at $35 a month for Medicare recipients was a signature win for President Joe Biden within the Inflation Discount Act. Members of Congress, Sanders amongst them, need to slash insulin costs additional. In a press launch asserting a invoice he launched with Rep. Cori Bush (D-Mo.) that might prohibit producers from charging greater than $20 per vial of insulin, Sanders stated, “There isn’t any motive why Individuals ought to pay the best costs on this planet for insulin — in some instances, ten instances as a lot as folks in different international locations.”

Our ruling

When Sanders stated that Individuals “pay by far the best costs on this planet for pharmaceuticals,” he was on track. However his “10 instances extra” determine is off. Although that comparability could also be correct for some particular person medication or lessons of medicine — and he did mood his remark by saying “in some instances” — it exaggerates general variations in costs, that are usually larger right here however not 10 instances these in the remainder of the world.

A widely known exception is insulin: The worth within the U.S. has been proven to be 10 instances as excessive as in different international locations.

However even this willpower is sophisticated. Research that confirmed a tenfold unfold in costs for insulin medication referred to producer costs, which do not take reductions under consideration. However that is a deceptive comparability as a result of most individuals do not really pay producer costs.

Sanders’ assertion actually accommodates components of reality but in addition would not present all the required data or context. We charge it Half True.

This text was reprinted from with permission from the Henry J. Kaiser Household Basis. Kaiser Well being Information, an editorially unbiased information service, is a program of the Kaiser Household Basis, a nonpartisan well being care coverage analysis group unaffiliated with Kaiser Permanente.