The Relative Costs of Anesthesia Drugs in New Zealand Versus the United States

To the Editor: Two United States Congressional reviews recently documented how drug companies typically charge more for drugs in the United States (US) compared with Canada and the United Kingdom [1,2]. The Pharmaceutical Manufacturing Association's chairman-elect is on record as stating that these differences are real, adding, "But you cannot fuel the research engine that discovers and develops new drugs on the profits that you make in countries outside the US" [3]. These reviews did not compare anesthesia drug prices. This communication outlines significant anesthesia drug price differences between New Zealand (NZ) and the US Table 1. Some drugs, however, are similar in price Table 2. The data represent July 1994 and compare costs in one of NZ's largest hospitals (Auckland Hospital, Auckland, NZ) with Harborview Medical Center (Seattle, WA), which purchases drugs through a multiinstitutional, interstate purchasing group. These tables show that this US hospital pays a premium for newer, more expensive drugs. NZ pays more for generic drugs.Table 1: Relative costs of anesthesia drugs: United States (US) Price as Percentage of New Zealand (NZ) PriceTable 2: Drugs which have a cost difference less than one United States dollar per patient doseOne caveat applies: cost comparisons will change with exchange rate fluctuations. (The US/NZ exchange rate moved in a 4% band over the last 3 yr.) It is reasonable to ask why there are such international differences in anesthesia drug prices. Questioning will encourage US debate about appropriate drug costs to the consumer. Hospitals and anesthesiologists, on behalf of their patients, need accurate drug pricing details which consider underlying factors, in order to intelligently confront economic restrictions ahead. Jeremy O. Cooper, MB, ChB, FANZCA Department of Anesthesiology, University of Washington School of Medicine, Seattle, WA 98195