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International Federation of Health Plans
2012 Comparative Price Report
Variation in Medical and Hospital Prices by Country International Federation of Health Plans The International Federation of Health Plans was founded in 1968 by a small group of health plan industry leaders. It is now the leading global network in the industry, with more than one hundred member companies from twenty-five countries. Federation member plans meet regularly to share information about health care financing and health care delivery in their home countries. This year’s survey includes new prescription drug prices in response to increased interest in this area from plans in many countries. We have also added three new non-drug items to our survey: hip prosthesis, knee Prices for each country are submitted by participating federation member plans, and are drawn from different Prices for Canada, New Zealand, Switzerland, and the United Kingdom are from the public sector, with data provided by one health plan in each country. Prices for Australia, Chile, the Netherlands, Spain, and South Africa are from the private sector and represent prices paid by one private health plan in each country. Prices for France and Argentina are a blend of public and private sector prices with the data provided by Prices for the United States are calculated from a database with over 100 million paid claims that reflect prices negotiated between thousands of providers and almost a hundred health plans. Comparisons across different countries are complicated by differences in sectors, fee schedules, and systems. In addition, for some countries a single plan’s prices are real for that plan but may not be representative of prices paid by other plans in that market. The U.S. numbers are based on an aggregate of over a 100 million paid claims 2012 Scanning and Imaging: CT Scan, Abdomen 2012 Scanning and Imaging: CT Scan, Head 2012 Scanning and Imaging: CT Scan, Pelvis New Zealand Switzerland South Af rica United States 2012 Total Hospital and Physician Cost: Appendectomy 2012 Total Hospital and Physician Cost: Normal Delivery 2012 Total Hospital and Physician Cost: C-Section 2012 Total Hospital and Physician Cost: Cataract Surgery 2012 Total Hospital and Physician Cost: Knee Replacement Surgery 2012 Total Hospital and Physician Cost: Hip Replacement 2012 Total Hospital and Physician Cost: Bypass Surgery 2012 Total Hospital and Physician Cost: Angioplasty 2012 Physician Fees: Routine Office Visit Celebrex is commonly prescribed for pain. Vytorin is commonly prescribed for high cholesterol. Cymbalta is commonly prescribed for depression, anxiety, and fibromyalgia. Nasonex is commonly prescribed for nasal allergies. Lipitor is commonly prescribed for high cholesterol. Nexium is commonly prescribed for acid reflux. Source: OECD Health Spending 2012. Data represents 2010 or most recent year. Argentina
Prices are a weighted average from the public system, the social security system, and a private health plan. Australia
Prices are private sector prices paid by a private health plan. Prices are public sector prices for the province of Nova Scotia. Prices are private sector prices paid by a private health plan. Prices are a blend of public and private system prices. Netherlands
Prices are private sector prices paid by a private health plan, and incorporate the new DRG system implemented in 2012. New Zealand
Prices are public sector prices based on the fee schedule for one large District Health Board, as well as other national tariff pricing lists. South Africa
Prices are private sector prices paid by a private health plan. Prices are private sector prices paid by a private health plan. Switzerland
United States
Prices are calculated from commercial claims data from the Truven (formerly Thomson Reuters) MarketScan Research databases. The MarketScan databases capture person-specific clinical utilization, expenditures, and enrollment from a selection of large employers, health plans, and government and public organizations. The annual medical databases include private sector health data from approximately 100 payers. Claims data was compiled by Deloitte Consulting LLP on behalf of Kaiser Permanente Health Plan. Any opinions or conclusions expressed herein regarding the data are not those of Deloitte Consulting LLP. Because a broad range of prices were available, the national 25th percentile (low), average, and 95th percentile were calculated. Prices represent allowed charges, which are the negotiated rates for which providers receive payment. Allowed charges include both patient cost sharing and health plan payment. Cataract surgery price represents the price for outpatient procedures. The angioplasty and appendectomy prices reflect a blend of inpatient and outpatient prices based on relative utilization in each setting. The patent for Lipitor expired on November 30, 2011. This has an impact on the drug’s unit cost, and data show a rapid drop in volume and a gradual reduction in price for the branded version of this drug throughout 2012. The price in this report was calculated based on the same process as the other drug benchmarks, but incorporated an adjustment factor to reflect the impact on price of patent expiration. Prices may decline further over time, and the utilization of the drugs may also continue to decline as generic substitutes gain market share. United Kingdom
Prices are public sector prices from the National Health Service (NHS) and the British National Formulary drug price listings. Argentina
Australia
Switzerland
Australian Health Insurance Association Limited Hong Kong
Thailand
BUPA Health Insurance (Thailand) Limited HBF Health Funds Inc Hospitals Contribution Fund of Australia, Limited United Kingdom
Netherlands
Nationaal Verbond van Socialistiche Mutualiteiten Blue Cross & Blue Shield Association New Zealand
Union Nationale des Mutualities Libres (MLOZ) Canassurance Hospital Service Association Zimbabwe
Association of the Healthcare Funders of Zimbabwe Saudi Arabia
The Medical Aid Society of Central Africa South Africa
Board of Healthcare Funders of Southern Africa Bonitas Medical Fund Chartered Accountants (SA) Medical Aid Fund Dominican Republic

Source: http://obamacarefacts.com/2012-Comparative-Price-Report.pdf

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