Prescription drug accessibility and affordability in the United States and abroad

Issue Brief (Commonw Fund). 2010 Jun:89:1-12.


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 types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Australia
  • Canada
  • Chronic Disease
  • Developed Countries
  • Drug Costs
  • Drug Utilization / economics
  • Drug Utilization / statistics & numerical data*
  • Europe
  • Financing, Personal
  • Formularies as Topic
  • Health Care Surveys
  • Health Expenditures / statistics & numerical data
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Health Status
  • Healthcare Disparities
  • Humans
  • Income
  • Medication Therapy Management / economics
  • Middle Aged
  • Prescription Drugs / economics*
  • Prescription Drugs / therapeutic use
  • United States


  • Prescription Drugs