Affordable, quality health care. For everyone.

Prescription Drug Accessibility and Affordability in the United States and Abroad


Australia, Canada, Germany, Netherlands, New Zealand, United Kingdom


This issue brief contrasts prescription drug access, affordability, and costs in the United States with six other high-income countries, drawing from Commonwealth Fund survey data of patient experiences as well as international spending and pricing data. The analysis reveals that Americans, particularly the relatively young and healthy, are more likely to use prescription drugs than are residents of Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom, but they also experience more financial barriers in accessing medications and spend more out-of-pocket for prescriptions. In the U.S., there are also larger income-related inequities in pharmaceutical use. Despite access barriers and disparities, spending per person in the U.S. is far higher, likely the result of paying higher prices for similar medications and using a more expensive mix of drugs. The authors say that value-based benefit designs, reference pricing, and group purchasing could reduce financial barriers and keep down pharmaceutical spending.


Publication Details

Publication Date: June 1, 2010
Author: Steven Morgan, Jae Kennedy, Ph.D.

S. Morgan and J. Kennedy, Prescription Drug Accessibility and Affordability in the United States and Abroad, The Commonwealth Fund, June 2010.


Steven Morgan
2001-02 Canadian Harkness Associate
Canadian Institutes for Health Research post-doctoral fellow in Health Economics