Bernie Sanders on healthcare: what the evidence says · JRE #1330
“How is it possible that we pay ten times more for insulin in this country and for other drugs than the one in Canada or countries around the world?”
What the evidence says
Sanders claimed the United States pays roughly ten times more than Canada and other countries for insulin and for prescription drugs broadly. For insulin specifically, this figure is in the right range for list/gross prices: a RAND analysis using 2022 data found U.S. gross insulin prices averaged 9.71 times those in 33 comparison OECD countries, and roughly six times Canada's prices specifically, though after accounting for manufacturer rebates the U.S.-versus-comparison-country gap narrows to about 2.3 times. For prescription drugs overall, the ratio is considerably smaller than tenfold: the same RAND research found U.S. prices averaged 2.78 times those in 33 other countries across all drugs, with brand-name drugs at 4.22 times and unbranded generic drugs, which make up the large majority of U.S. prescriptions by volume, actually priced lower in the U.S. than in comparison countries. The claim is well-supported for insulin's gross list-price ratio but overstates the situation when generalized to 'other drugs' as a whole, where the average gap is closer to threefold than tenfold.