Chapter 2.2 Medicine Prices in the United States and Canada

The United States and Canada are unique in their reliance on a mixed public–private system of drug insurance. Prices paid are among the highest globally, with US prices higher than Canadian prices. In this chapter, we review the reimbursement policies of the public and private plans in both countries and the role of national price regulator in Canada. We also focus on the role of intermediaries. In the United States, these include pharmacy benefit managers that secure discounts for large-scale private drug plans. In Canada, this includes health technology assessment agencies that provide evidence on value for money for new drugs.