A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia

Background. A major contributor to increased healthcare spending in the United States is drug pricing, as US drug prices are nearly 3× higher than those in other countries. This cross-sectional study aimed to investigate current global price differences in liver transplant medications and provide po...

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Main Authors: Leah Yao, MD, Xiaohan Ying, MD, Arun B. Jesudian, MD, Robert S. Brown, Jr, MD, Stephen E. Congly, MD
Format: Article
Language:English
Published: Wolters Kluwer 2025-06-01
Series:Transplantation Direct
Online Access:http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001805
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author Leah Yao, MD
Xiaohan Ying, MD
Arun B. Jesudian, MD
Robert S. Brown, Jr, MD
Stephen E. Congly, MD
author_facet Leah Yao, MD
Xiaohan Ying, MD
Arun B. Jesudian, MD
Robert S. Brown, Jr, MD
Stephen E. Congly, MD
author_sort Leah Yao, MD
collection DOAJ
description Background. A major contributor to increased healthcare spending in the United States is drug pricing, as US drug prices are nearly 3× higher than those in other countries. This cross-sectional study aimed to investigate current global price differences in liver transplant medications and provide potential cost savings for Medicare Part D if international reference pricing was adopted. Methods. Publicly available drug formularies for Canada, the United Kingdom, Japan, France, Germany, Italy, and Australia were used to collect 2024 prices for 8 commonly used liver transplant medications (mycophenolate mofetil, mycophenolate sodium, sirolimus, tacrolimus, Advagraf, Envarsus, everolimus, and cyclosporine). US prices were obtained from UptoDate’s 2024 listed representative average wholesale prices and Medicare Part D’s drug prices from 2022. Results. The average US wholesale price and Medicare spend for originator liver transplant medications were 4.1× and 6.8×, respectively, the average originator prices in G7 countries and Australia. Adopting the average global originator drug price per dose may lead to an estimated $26 141 463 in cost savings per year to Medicare. The average US wholesale price and Medicare spend for generic liver transplant medications were 2.76× and 3.75×, respectively, the global average generic prices. Adopting the average global generic drug price per dose may lead to an estimated $363 538 474 in cost savings per year to Medicare. Conclusions. This study demonstrates the significantly greater financial burden that liver transplant patients in the United States face compared with liver transplant patients in 7 other major industrial countries. Future adoption of international reference pricing may help bridge this pricing disparity.
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spelling doaj-art-fd76ed7e08cf4fc49ec6fd97578cfa1e2025-08-20T03:12:23ZengWolters KluwerTransplantation Direct2373-87312025-06-01116e180510.1097/TXD.0000000000001805202506000-00005A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and AustraliaLeah Yao, MD0Xiaohan Ying, MD1Arun B. Jesudian, MD2Robert S. Brown, Jr, MD3Stephen E. Congly, MD41 Department of Medicine, New York-Presbyterian/Weill Cornell Medical Center, New York, NY.1 Department of Medicine, New York-Presbyterian/Weill Cornell Medical Center, New York, NY.2 Department of Medicine and Gastroenterology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY.2 Department of Medicine and Gastroenterology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY.3 Department of Medicine and Gastroenterology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.Background. A major contributor to increased healthcare spending in the United States is drug pricing, as US drug prices are nearly 3× higher than those in other countries. This cross-sectional study aimed to investigate current global price differences in liver transplant medications and provide potential cost savings for Medicare Part D if international reference pricing was adopted. Methods. Publicly available drug formularies for Canada, the United Kingdom, Japan, France, Germany, Italy, and Australia were used to collect 2024 prices for 8 commonly used liver transplant medications (mycophenolate mofetil, mycophenolate sodium, sirolimus, tacrolimus, Advagraf, Envarsus, everolimus, and cyclosporine). US prices were obtained from UptoDate’s 2024 listed representative average wholesale prices and Medicare Part D’s drug prices from 2022. Results. The average US wholesale price and Medicare spend for originator liver transplant medications were 4.1× and 6.8×, respectively, the average originator prices in G7 countries and Australia. Adopting the average global originator drug price per dose may lead to an estimated $26 141 463 in cost savings per year to Medicare. The average US wholesale price and Medicare spend for generic liver transplant medications were 2.76× and 3.75×, respectively, the global average generic prices. Adopting the average global generic drug price per dose may lead to an estimated $363 538 474 in cost savings per year to Medicare. Conclusions. This study demonstrates the significantly greater financial burden that liver transplant patients in the United States face compared with liver transplant patients in 7 other major industrial countries. Future adoption of international reference pricing may help bridge this pricing disparity.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001805
spellingShingle Leah Yao, MD
Xiaohan Ying, MD
Arun B. Jesudian, MD
Robert S. Brown, Jr, MD
Stephen E. Congly, MD
A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia
Transplantation Direct
title A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia
title_full A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia
title_fullStr A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia
title_full_unstemmed A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia
title_short A Global Comparison of Liver Transplant Drug Pricing: US Versus Other G7 Countries and Australia
title_sort global comparison of liver transplant drug pricing us versus other g7 countries and australia
url http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001805
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