Peterson-KFF puts US tirzepatide at three times the Netherlands price

A month's supply of Mounjaro (tirzepatide) carried a list price of $1,023 in the United States in mid-2023, compared with $444 in the Netherlands and $319 in Japan, according to an August 17, 2023 analysis from the Peterson-KFF Health System Tracker ^[1]. That gap made the U.S. price roughly two to three times higher than in the two peer countries studied for this drug ^[1].

The analysis, based on web searches of list prices as of August 15, 2023, and currency conversions using June 30, 2023 exchange rates, also compared prices for semaglutide products ^[1]. Ozempic cost $936 for a month's supply in the U.S., more than five times the $169 price in Japan and about ten times the price in Sweden, the United Kingdom, Australia, and France ^[1]. Wegovy, semaglutide's weight-loss version, listed at $1,349 in the U.S. against $328 in Germany and $296 in the Netherlands ^[1]. Rybelsus, the oral semaglutide tablet, was priced at $936 in the U.S., more than four times the Netherlands price of $203 ^[1].

The researchers noted that Mounjaro prices could only be found in three countries — the U.S., Japan, and the Netherlands — because pricing data was unavailable elsewhere, including Austria and Belgium ^[1]. In the United Kingdom, Mounjaro was not yet recommended by the National Institute for Health and Care Excellence at the time, due to insufficient evidence on effectiveness and cost-effectiveness ^[1]. Wegovy also was not available in Australia and some other countries because of shortages affecting people who use semaglutide for diabetes ^[1].

The analysis pointed out that list prices are not the same as what is actually paid, since manufacturers offer insurer rebates and patient coupons ^[1]. As an example, privately insured Wegovy patients could get manufacturer coupons of $225 per 28-day supply for up to a year if their plan covered the drug, or $500 per 28-day supply if it did not ^[1]. Private insurers and employers may also negotiate lower net prices than the public list prices ^[1].

Why it matters for patients

The price comparison matters because it shows how much more the U.S. list price system charges for the same drugs sold in other wealthy countries ^[1]. The U.S. also has by far the highest obesity rate among the peer nations studied — 33.5% of U.S. adults, compared with a comparable-country average of 17.1% — meaning higher American prices combined with more potential patients could translate into a larger effect on national health spending than in other countries ^[1].

How much any individual patient actually pays depends on insurance coverage, which varies widely. Medicare is not allowed to cover weight-loss drugs under current law, and Medicaid coverage differs by state ^[1]. Peer countries also have variable coverage rules, so a lower list price abroad does not automatically mean patients there pay less out of pocket ^[1]. KFF polling cited in the analysis found about half of U.S. adults said they were interested in taking prescription weight-loss drugs, but that interest fell when a drug was not covered by insurance or when patients learned that weight might return after stopping the medication ^[1].

The analysis also flagged unresolved questions: it is not yet known whether patients would need to take these drugs indefinitely, or in combination with other treatments, and long-term health effects are still being studied ^[1].

What happens next

The Peterson-KFF analysis is dated to August 17, 2023, and reflects prices and exchange rates as of mid-2023 ^[1]. The sources provided here do not include updated price comparisons since that date, so how the gap has changed since then is not established by this material.