This paper addresses how and why drug prices differ across countries. Studies of international variation in drug prices reach varied conclusions owing to methodological and data disparities. Price differences do exist across countries, with the United States footing the highest bill, but the differences are not nearly as large as they appear at first glance. The higher prices in the United States are concentrated among a subset of brand-name drugs and among those without insurance covering drugs. Some U.S. health plans obtain price concessions from manufacturers similar to those obtained by national governments. Price concessions occur whenever purchasers are willing to let price be a consideration in decisions about access and utilization. In low-income countries the vast majority are unwilling to pay for effective drugs simply because they are unable to pay. Low-income nations need more price discrimination--and vastly lower prices--if they are ever to afford the world's most effective medicines.

中文翻译：

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国际药品价格差异。

本文探讨了各国药品价格如何以及为何有所不同。由于方法和数据差异，对国际药品价格变化的研究得出了不同的结论。各国之间确实存在价格差异，而美国的价格差异最大，但差异并不像乍看起来那样大。在美国，较高的价格集中在部分品牌药和没有保险的药物中。一些美国卫生计划从制造商那里获得了价格优惠，类似于国家政府所获得的价格优惠。只要购买者愿意让价格成为获取和使用决策的考虑因素，就会发生价格优惠。在低收入国家，绝大多数人不愿意为有效药物付费，因为他们无力支付。低收入国家如果要负担世界上最有效的药品，就需要更多的价格歧视，而价格要低得多。