International Online Pharmacies Offer Relief as Medicare Prices Remain Sky-High
Another missed opportunity for the U.S. government to do right by patients struggling to afford medicines. Recent findings published in JAMA highlight an all-too-familiar disparity: despite Medicare's recent price negotiations under the Inflation Reduction Act (IRA), Americans will continue to pay significantly more for prescription drugs than their counterparts in other high-income countries. The study revealed that the prices of all but one of the first 10 drugs negotiated under the IRA, though lower than their previous U.S. net prices, still remain substantially higher compared to peer nations like France, Germany, and the UK. This disparity underscores the potential for broader savings opportunities that remain untapped, as well as a continued need for affordable access to medicine through international online pharmacies to promote adherence to prescribed drug therapies.
Related: PharmacyChecker Recognized by JAMA as Key Resource for Finding Reputable Online Pharmacies
Medicare’s price negotiations reduced costs by 8% to 42% across selected drugs, with prices for most falling near statutory ceiling limits. For instance, the price of sitagliptin (Januvia), used for type 2 diabetes, decreased by 42%, and etanercept (Enbrel) for rheumatoid arthritis saw a 34% reduction. However, these reductions, set to take effect in 2026, still fall short compared to drug prices in other countries. U.S. prices for brand-name drugs, overall, remain uncompetitive internationally. For instance, while Medicare's negotiated price of ustekinumab (Stelara) for inflammatory bowel disease stands at $4,695 for a 30-day supply—a 40% reduction—patients in France pay $1,219.92, nearly a quarter of the U.S. cost.
Related: Medicare Negotiated Drug Prices 4.7 Times Higher Than NHS Negotiated Prices
U.S. vs. Global Peers Drug Price Comparisons
In all cases but one (insulin aspart, due to a voluntary price reduction by the manufacturer), U.S. drug prices remain significantly higher than those in peer nations. According to the JAMA study, Medicare-negotiated prices are two to four times higher than average prices in Australia, Canada, France, Germany, Switzerland, and the United Kingdom.
| Drug | Initial Net Price (U.S.) | Negotiated Price (U.S.) | Australia | Canada | France | Germany | Switzerland | United Kingdom |
| Ustekinumab (Stelara) | $7,859.88 | $4,695.00 | $1,341.56 | $1,813.12 | $1,219.92 | $2,503.99 | $1,729.97 | $1,291.68 |
| Etanercept (Enbrel) | $3,571.61 | $2,355.00 | $754.42 | $1,135.39 | $646.48 | $974.25 | $1,176.51 | $851.93 |
| Sacubitril/valsartan (Entresto) | $458.40 | $295.00 | $138.89 | $181.91 | $156.61 | $150.36 | $145.12 | $117.91 |
| Ibrutinib (Imbruvica) | $385.71 | $257.37 | $71.22 | $77.33 | $82.39 | $164.79 | $172.39 | $148.22 |
| Apixaban (Eliquis) | $309.00 | $231.00 | $57.13 | $80.37 | $63.84 | $68.66 | $82.23 | $68.59 |
| Rivaroxaban (Xarelto) | $261.30 | $197.00 | $51.22 | $70.71 | $58.68 | $86.38 | $86.41 | $65.00 |
| Empagliflozin (Jardiance) | $251.70 | $197.00 | $33.48 | $67.05 | $38.31 | $50.60 | $50.93 | $47.16 |
| Sitagliptin (Janumet) | $195.60 | $113.00 | $30.51 | $75.83 | $26.43 | $35.90 | $43.61 | $42.90 |
| Dapagliflozin (Farxiga) | $193.80 | $178.50 | $33.50 | $64.89 | $38.63 | $41.88 | $48.92 | $47.13 |
| Insulin aspart | $12.95 per 100 IU | $8.96 per 100 IU | $5.44 | $9.87 | $6.93 | $11.09 | $9.57 | $7.38 |
Source: Date from Wouters OJ, Sullivan SD, Cousin EM, Gabriel N, Papanicolas I, Hernandez I. "Drug Prices Negotiated by Medicare vs US Net Prices and Prices in Other Countries." JAMA. Published online December 2, 2024. https://doi.org/10.1001/jama.2024.22582; Drug names are hyperlinked to drug price comparison pages on PharmacyChecker.com, which compare drug costs across accredited international online pharmacies with discount coupon prices offered at United States pharmacies.
The Role of International Online Pharmacies
Established in 2003, PharmacyChecker is considered a pioneer in verifying the safety of international online pharmacies through our International Pharmacy Verification Program. PharmacyChecker drug price comparisons provide critical information for those U.S. consumers who are unable to afford domestic drug prices. Research consistently shows that accredited pharmacies in countries with robust regulatory systems offer medications that are affordable and comparable in quality to those sold in the U.S.
PharmacyChecker-accredited international online pharmacies frequently offer affordable alternatives. For instance, a 30-day supply of Janumet from an accredited international pharmacy may cost as little as $50, compared to Medicare's negotiated price of $113 and the original U.S. price of $195.60. This difference highlights the broader accessibility gap in the American healthcare system when it comes to patented brand-name products without approved generic competition. Generally, generic drug prices are affordable domestically. Below, PharmacyChecker provides the lowest listed brand name price according to drug price comparisons published on our website. These comparisons include international online pharmacy prices and drug discount coupon prices available at local U.S. pharmacies – including well-known chains and independent pharmacies.
Lowest Obtainable Retail Price for Popular Brand Name Drugs
| Drug (Brand name) | Lowest Brand Price According to PharmacyChecker.com Comparisons |
| Ustekinumab (Stelara) | $1,942.65* |
| Etanercept (Enbrel) | $1,734.57* |
| Sacubitril/valsartan (Entresto) | $1.39 per tablet^ |
| Ibrutinib (Imbruvica) | $101.85 per capsule^ |
| Apixaban (Eliquis) | $0.70 per tablet^ |
| Rivaroxaban (Xarelto) | $1.08 per tablet^ |
| Empagliflozin (Jardiance) | $0.97 per tablet^ |
| Sitagliptin (Janumet) | $0.33 per tablet^ |
| Dapagliflozin (Farxiga) | $0.93 per tablet^ |
| Insulin Aspart | $66.57 per vial |
| * This is a sample U.S. pharmacy discount coupon price. No international mail order prices available. ^ This is the brand name price; generic prices available according to PharmacyChecker.com drug price comparisons. |
All international online pharmacy prices are those of online pharmacies that are accredited and monitored in the PharmacyChecker International Pharmacy Verification Program. Accredited online pharmacies partner with dispensing pharmacies located in Canada, Australia, India, Mauritius, New Zealand, Turkey, the UK, and the United States. Most pharmacies ship worldwide.
Moving Toward Patient-Centric Solutions
The U.S. must take bold steps to bridge the affordability gap. Until then, international online pharmacies remain an essential resource for millions of Americans struggling to afford life-saving medications. The current Medicare negotiations are a step forward but remain insufficient to address the financial strain many patients face. Even with necessary adjustments, systemic barriers—such as patent protections and opaque pricing systems—limit how much Medicare can reduce prices.
PharmacyChecker continues to advocate for policies that prioritize patient safety and affordability, leveraging its expertise to ensure that consumers have access to trusted resources. As drug pricing debates evolve, utilizing information provided by organizations like PharmacyChecker and NeedyMeds can help bridge the gap between what is legislatively feasible and what patients need today.
In a world where life-saving medications are too often out of reach, safe and affordable international options serve as a vital lifeline for millions of Americans.
