International Drug Prices Get Cheaper as U.S. Prices Keep Climbing
Americans should not have to wait for lower prescription drug prices
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Launch prices of a brand drugs in the U.S. compared to other high-income nations are often shocking enough. According to a recent AARP Public Policy Institute analysis, however, the story only gets worse after they’ve hit the market. While U.S. prices continue to climb, prices for those same medicines marketed by the same companies fall in other high-income countries.
Image Source: AARP
An important, albeit bleak, conclusion.
For decades now, the same life-threatening trend is documented and repackaged: researchers publish new analyses and politicians promise reform. But what are patients to do in the meantime?
If an American was worried about affording a refill of one of these meds this month, we asked, how much could they save if they chose to compare prices at accredited international online pharmacies?
What we found
Of the drugs analyzed by AARP, PharmacyChecker identified 15 for which current prices were available from accredited international mail-order pharmacies in selected high-income countries (Australia, Canada, New Zealand, and the United Kingdom).
We compared cash pay prices across current U.S. pharmacy coupon offerings with prices available through PharmacyChecker-accredited international online pharmacies.
We found that Americans can save an average of 66.13% today by purchasing many of these same medicines through accredited international online pharmacies.
Thirteen of the 15 drugs cost more than twice as much in the United States as the lowest available international price.
Take a look at the price comparison below.
Brand Drug Retail Prices in the US vs. International Mail Order from Canada, Australia, UK, New Zealand, 2026
| Drug (also marketed as) | Manufacturer | US Price Change Since Market Entry | Non-US Price Change Since Market Entry | US Pharmacy Coupon | Lowest International Mail Order Price (Tier 1) | Source Country | Savings |
| Linzess (Constella outside North America) | AbbVie | 33% | -6% | $707.07 | $335.00 | United Kingdom | 52.62% |
| Rinvoq | AbbVie | 44% | -15% | $6,334.33 | $1,430.00 | New Zealand | 77.42% |
| Enbrel | Amgen (Pfizer outside US and Canada) | 873% | -27% | $2,053.15 | $639.43 | Canada | 68.86% |
| Xtandi | Astellas Pharma | 106% | -7% | $13,597.92 | $3,942.40 | Canada | 71.01% |
| Calquence | AstraZeneca | 16% | -6% | $14,562.80 | $8,633.52 | Canada | 40.72% |
| Tagrisso | AstraZeneca | 42% | -10% | $18,278.46 | $11,037.45 | Australia | 39.61% |
| Jardiance | Boehringer Ingelheim | 16% | -9% | $1,008.90 | $282.00 | Australia | 72.05% |
| Eliquis | Bristol Myers Squibb | 38% | -42% | $1,000.80 | $387.00 | Canada | 61.33% |
| Trulicity | Eli Lilly | 106% | -16% | $495.74 | $73.75 | Canada | 85.12% |
| Breo Ellipta | GSK | 52% | -17% | $165.36 | $50.40 | Australia | 69.52% |
| Trelegy Ellipta | GSK | 32% | -10% | $1,006.12 | $390.00 | United Kingdom | 61.24% |
| Jakafi (Jakavi outside the US) | Incyte (licensed to Novartis outside the US) | 160% | -9% | $16,246.72 | $3,000.00 | Australia | 81.53% |
| Erleada | Johnson & Johnson (Janssen) | 44% | -16% | $15,048.00 | $4,219.10 | Canada | 71.96% |
| Januvia | Merck (MSD outside US and Canada) | 126% | -40% | $685.44 | $176.00 | Australia | 74.32% |
| Ibrance | Pfizer | 37% | -25% | $13,209.65 | $4,680.00 | New Zealand | 64.57% |
| Average Savings | 66.13% | ||||||
| US and Non-US Price Changes as reported by AARP. Savings are calculated using the lowest available international mail order price among the United Kingdom, Australia, New Zealand, and Canada dispensing pharmacies that partner with PharmacyChecker-accredited international online pharmacies compared with U.S. pharmacy discount coupon prices on PharmacyChecker.com. | |||||||
Your money or your life
As our chart above also shows, the same global pharmaceutical companies sell the same medicines in the United States and other wealthy countries. Yet Americans routinely pay dramatically more. If the manufacturer is the same, why does Januvia cost $176 in Australia but $685 in the United States? Why does Trulicity cost $74 in Canada but nearly $500 in the United States?
Prescription drug prices in the U.S. are so high that they are dramatically out of step with what ordinary people actually earn. Take Humira, Abbvie's flagship arthritis and autoimmune drug: a year's supply in the U.S. ran upwards of $77,000 in 2024, compared with roughly $25,000 to $30,000 in countries like the UK and Canada.
A Peterson-KFF Health System Tracker analysis found that Abbvie’s Humira, used to treat various forms of arthritis and other inflammatory conditions, is 423% more expensive in the U.S. than in the UK, and 186% more expensive than in Germany. Those numbers are monstrous no matter where you stand, but hell opens up when you weigh those prices against the fact that the median U.S. household earned $83,730 in 2024, meaning a single year of Humira can eat up nearly an entire household's income should they not qualify for patient assistance.
Shall I state the obvious? A single medication shouldn't be capable of consuming nearly an entire household's annual income.
There is nothing inevitable about these price differences. Other wealthy countries negotiate prices, periodically review them, and use their purchasing power to keep costs from continually climbing. The United States generally does not (perhaps because our regulators and the regulated look like one man’s left hand shaking his right). Manufacturers largely determine what the U.S. market will bear, then raise prices, as AARP shows, over time.
In the U.S., it’s your money or your life. And if you think that’s a claim rooted in hyperbole, ask Shanon and William Schmidtknecht, whose son died in 2024 because he couldn't afford a sudden price increase on his asthma medication, or Rose Walters, whose fiancé died after not being able to afford his insulin.
When a medicine becomes unaffordable, patients don't stop needing it. They stop taking it.
Are American patients truly captive to the pricing whims of pharma execs?
PharmacyChecker was conceived in 2002 for that very reason. The founders realized millions of people were headed online to find the most affordable way to access their medication, but without the necessary guidance to protect their health. There are bogus, even dangerous, products aplenty on the internet. The health space, in particular, is ripe for scamming, especially amid frenzies over the latest treatments – years ago, it was Viagra. In 2020, it was ivermectin and hydroxychloroquine. Today, it’s GLP-1s.
PharmacyChecker’s International Pharmacy Verification Program is designed to identify and monitor those international mail order pharmacies that meet high standards of pharmacy practice, helping patients distinguish legitimate pharmacies from dangerous ones. JAMA, a peer-reviewed medical journal published by the American Medical Association, recommends that patients and clinicians “use PharmacyChecker to compare prices at trusted online pharmacies” as a strategy in responding to high prescription drug costs. PharmacyChecker’s verification program and drug price comparisons have also been referenced by leading media outlets, including AARP Magazine and PBS.
We publish a sample list of international online pharmacies that meet the high safety standards of the the IPVP here: Accredited International Online Pharmacies
The PharmacyChecker Network spans dispensing pharmacies and wholesalers located in Canada, the United States, Turkey, India, Mauritius, Australia, New Zealand, the United Arab Emirates, and the United Kingdom.
Read about Rogue Pharmacy Websites here.
Our bottom line
No single country consistently has the lowest prescription drug prices in the world, but one country reigns when it comes to the highest: our these United States of America.
AARP showed how prices climb here while they fall in comparable countries. PharmacyChecker shows how international online pharmacies, vetted and monitored, can help Americans today.
Americans shouldn't have to wait for lower drug prices. Until meaningful reform arrives, patients deserve information about safe, transparent ways to access the medications they need at prices they can afford.
