Thursday, April 2, 2009

A Quick comparison of Canada and the US

IMS Health released the numbers last week for both Canada and the US .   It is interesting to compare some of the results as it gives a bit of insight into the differences between the two countries.   Firstly the US market as a whole is $291 B while Canada is $21.4 B.  So nothing startling there, Canada  is equivalent  7.3 % of US  Market.   
But we know that there are major differences in pricing between the US and Canada.  For example , US Brand pricing is the highest in the world and Canada is less due to our Price regulations.  The US has some of the lowest generic prices as seen with the Walmart introduction of $4 and $10 prescriptions which has lead most other retailers to follow suit.   In Canada, we have some of the highest generic prices in the world as there is little competition and a MAC pricing across the country.  So it is difficult to compare on $.  So lets look at Prescriptions.   ( I'll concentrate on statins here) 
If we look at Top 15 Drugs dispensed in the US you see 66.7 Million Prescriptions for Simvastatin (Primarily generic, trade name Zocor) and 57.9 Million Prescriptions for Lipitor.  Now compare this to The Top 20 Drugs Dispensed in Canada Table 6  .  Simvastatin is nowhere on that list, Lipitor has 14.8 Million Prescriptions and Crestor is there with 6 Million prescriptions.  My understanding is that Simvastatin has drastically declined in prescriptions in Canada while it has grown 39% in the US!   If you just look at Lipitor alone, as it is the only one with the high level data for both countries,  Canada is equivalent to 25% of the US usage. Think about that for a minute..... Canada is equivalent to 7.3 % of the total US Market in terms of dollars  but on a prescription basis for the #1 product in the world, Canada is equivalent to 25% of the prescriptions!!!!!  Obviously , Crestor has to have an even higher percentage and Simvastatin a really low number.     
So , some of the questions we need to ask are,  
  1. Are all of these Americans at significantly greater risk than Canadians? 
  2. Why is there such a difference? 
  3. Why do Canadian governments and Industry not take advantage of the price reductions?
  4. Can we learn from what is happening in the US ?
  5. Are there ways the Canadian health Care system can save $?
  6. etc. etc. etc
I've concentrated on Statins here but , we could have discussed other classes of drugs as well.  Perhaps my next post will be on the PolyPill .  You can read about it  here at the Lancet... 
Could save lives and money! 

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