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The laudable UK initiative to drive the costs of drugs down to affordable assumes that there is consistency in drug pricing between producer and recipient countries and that price is a barrier to their use.1
When generics are included in pricing studies and compared with the price per gram of active ingredient, Japan and Switzerland are more expensive than the United States. When price per standard unit (a rough measure of dose, which differs across countries) is compared, Canada, Germany, Switzerland, and Sweden are more expensive than the US. And many governments subsidise research and development of their pharmaceutical and vaccine industries, making international comparisons difficult.2
Other factors contribute to a drug's price when it finally reaches a patient. Some governments procure medicines efficiently but charge markedly higher prices to patients.3
Yet the problem remains more profound than simply a matter of prices: the fragility of health systems. The UK would help the developing world more by disseminating best practices for disease management through the principle of rational choices between therapeutic alternatives which promise the most advantageous economic value relative to clinical outcome.
Competing interests: None declared.