International patented medicine prices: how does Canada compare to the OECD? A descriptive analysis of list prices.

Background: Canada is known to have some of the highest patented medicine prices among high-income countries, yet few analyses have elucidated if prices are high across different subgroups of patented medicines. We conducted a comparative analysis of patented medicine list prices across the Organisation for Economic Co-operation and Development (OECD) member countries from the Canadian perspective. Methods: A cohort of prescription patented medicine markets, defined as unique molecule, dosage form and strength level combinations, that had positive sales and sales volume in 2023, was defined for each of the 34 included OECD countries using IQVIA MIDAS quarterly sales data. We estimated bilateral price ratios between an OECD comparator country and Canada in 2023, weighted according to Canadian sales volumes. Results: Overall, 1,722 markets in Canada were included and only a subset were present in comparator countries (range: 297-1,156). Canada had the 10th highest prices when accounting for purchasing power parity (PPP-USD). Canadian prices in the hospital sector were ranked 17th. Canada's price ranking for orphan patented medicines was relatively lower, regardless of whether they were biologics (16th) or not (13th). Prices were relatively higher in markets with no within-class competition (5th), markets in the top 50 by sales volume (6th), and markets older than 10 years (8th). Conclusion: In certain market segments, patented medicine list prices in Canada tended to be positioned closer to the median of the included comparator countries; however, policymakers should be concerned with comparatively high prices in markets with no within-class competition and high sales volume.