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International Federation of Health Plans 2012 Comparative Price Report
 

International Federation of Health Plans 2012 Comparative Price Report

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    International Federation of Health Plans 2012 Comparative Price Report International Federation of Health Plans 2012 Comparative Price Report Presentation Transcript

    • International Federation of Health Plans 2012 Comparative Price Report Variation in Medical and Hospital Prices by Country
    • International Federation of Health PlansThe International Federation of Health Plans was founded in 1968 by a small group of healthplan industry leaders. It is now the leading global network in the industry, with more than onehundred member companies from twenty-five countries.Federation member plans meet regularly to share information about health care financing andhealth care delivery in their home countries. 2
    • 2012 Survey OverviewThis year’s survey includes new prescription drug prices in response to increased interest in this area from plansin many countries. We have also added three new non-drug items to our survey: hip prosthesis, kneereplacement, and colonoscopy.Prices for each country are submitted by participating federation member plans, and are drawn from differentsectors: • Prices for Canada, New Zealand, Switzerland, and the United Kingdom are from the public sector, with data provided by one health plan in each country. • Prices for Australia, Chile, the Netherlands, Spain, and South Africa are from the private sector and represent prices paid by one private health plan in each country. • Prices for France and Argentina are a blend of public and private sector prices with the data provided by one health plan in each country. • Prices for the United States are calculated from a database with over 100 million paid claims that reflect prices negotiated between thousands of providers and almost a hundred health plans.Comparisons across different countries are complicated by differences in sectors, fee schedules, and systems. Inaddition, for some countries a single plan’s prices are real for that plan but may not be representative of pricespaid by other plans in that market. The U.S. numbers are based on an aggregate of over a 100 million paid claimsacross multiple payers. 3
    • 2012 Scanning and Imaging: Angiogram $2,430 $914 $378 $218 $235 $264 $125 $173 $35 Canada Spain Switzerland South Af rica France Chile United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 4
    • 2012 Scanning and Imaging: CT Scan, Abdomen $1,737 $630 $437 $472 $349 $267 $234 $243 $175 $183 $103 $118 $124 Argentina Spain Canada United France Chile Netherlands New Switzerland South Af rica United Kingdom Zealand States USA 25th Percentile Average Price USA 95th Percentile($ USD) 5
    • 2012 Scanning and Imaging: CT Scan, Head $1,672 $566 $300 $310 $328 $252 $175 $183 $192 $119 $124 $138 $82 Argentina Spain Canada United France Chile Netherlands South Af rica New Switzerland United Kingdom Zealand States USA 25th Percentile Average Price USA 95th Percentile($ USD) 6
    • 2012 Scanning and Imaging: CT Scan, Pelvis $1,565 $567 $386 $328 $349 $257 $166 $175 $183 $217 $117 $124 $66 Argentina Spain Canada Chile United France Netherlands Switzerland New South Af rica United Kingdom Zealand States USA 25th Percentile Average Price USA 95th Percentile($ USD) 7
    • 2012 Scanning and Imaging: MRI $2,871 $1,072 $1,121 $928 $502 $554 $522 $319 $335 $363 $230 $118 Argentina Spain Netherlands United France Chile New Zealand Switzerland South Af rica United States Kingdom USA 25th Percentile Average Price USA 95th Percentile($ USD) 8
    • 2012 Cost Per Hospital Day $12,537 $4,287 $1,472 $1,514 $731 $853 $964 $979 $429 $476 $665 Argentina Spain South Af rica Netherlands France Chile New Zealand Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 9
    • 2012 Total Hospital and Physician Cost: Appendectomy $29,426 $13,851 $8,156 $5,392 $5,467 $4,221 $4,498 $4,463 $4,782 $3,381 $3,408 $2,245 $953 Argentina Spain South Af rica United Chile Netherlands France Switzerland New Australia United Kingdom Zealand States USA 25th Percentile Average Price USA 95th Percentile($ USD) 10
    • 2012 Total Hospital and Physician Cost: Normal Delivery $16,653 $9,775 $6,846 $7,262 $4,039 $3,541 $2,669 $2,992 $2,386 $2,641 $2,035 $2,265 $1,188 Argentina South Af rica Spain New Netherlands United Chile France Switzerland Australia United Zealand Kingdom States USA 25th Percentile Average Price USA 95th Percentile($ USD) 11
    • 2012 Total Hospital and Physician Cost: C-Section $26,305 $15,041 $10,566 $10,545 $6,441 $5,186 $5,328 $4,435 $4,717 $3,097 $3,378 $3,449 $1,541 Argentina Spain Chile South Af rica United New Switzerland Netherlands France Australia United Kingdom Zealand States USA 25th Percentile Average Price USA 95th Percentile($ USD) 12
    • 2012 Total Hospital and Physician Cost: Cataract Surgery $8,143 $3,738 $2,829 $2,566 $2,205 $2,418 $1,938 $2,079 $1,867 $1,534 $1,139 $564 Argentina United Netherlands Spain France New Zealand South Af rica Switzerland Chile United States Kingdom USA 25th Percentile Average Price USA 95th Percentile($ USD) 13
    • 2012 Total Hospital and Physician Cost: Knee Replacement Surgery $52,451 $25,637 $22,421 $14,849 $16,473 $13,466 $11,954 $7,827 $7,833 $3,192 Argentina Spain United Kingdom Switzerland South Af rica New Zealand Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 14
    • 2012 Total Hospital and Physician Cost: Hip Replacement $87,987 $40,364 $27,810 $25,061 $14,390 $15,403 $11,889 $13,409 $9,574 $10,927 $11,187 $7,731 $3,365 Argentina Spain Switzerland France Netherlands United Chile New South Af rica Australia United Kingdom Zealand States USA 25th Percentile Average Price USA 95th Percentile($ USD) 15
    • 2012 Total Hospital and Physician Cost: Bypass Surgery $150,515 $73,420 $43,230 $46,547 $37,044 $26,432 $22,844 $17,437 $17,729 $12,401 $14,061 $14,117 $8,882 Argentina Chile Netherlands United Spain Switzerland France New South Af rica Australia United Kingdom Zealand States USA 25th Percentile Average Price USA 95th Percentile($ USD) 16
    • 2012 Total Hospital and Physician Cost: Angioplasty $61,649 $28,182 $16,533 $13,475 $14,366 $8,911 $9,446 $6,332 $7,010 $7,564 $5,295 $2,851 Argentina Switzerland Netherlands New Zealand France Australia Spain South Af rica United United States Kingdom USA 25th Percentile Average Price USA 95th Percentile($ USD) 17
    • 2012 Physician Fees: Routine Office Visit $176 $95 $68 $38 $30 $30 $25 $10 $11 Argentina Spain South Af rica France Canada Chile United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 18
    • 2012 Physician Fees: Normal Delivery $5,407 $3,096 $2,397 $1,837 $890 $536 $583 $292 $329 $116 $163 South Af rica Argentina Netherlands Spain Canada France Chile Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 19
    • 2012 Physician Fees: C-Section $6,593 $3,676 $2,688 $2,118 $1,084 $838 $938 $606 $428 $193 $216 Argentina South Af rica Spain Canada Netherlands France Chile Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 20
    • 2012 Physician Fees: Cataract Surgery $1,839 $1,311 $1,048 $922 $699 $651 $420 $426 $332 $286 $157 Argentina Netherlands South Af rica Spain France Canada Chile Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 21
    • 2012 Physician Fees: Appendectomy $2,044 $1,001 $776 $782 $724 $674 $539 $408 $231 $148 $157 Argentina South Af rica Spain Canada Netherlands Chile France Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 22
    • 2012 Physician Fees: Hip Replacement $5,196 $2,883 $2,888 $1,992 $1,983 $1,288 $1,088 $697 $748 $761 $461 Argentina Canada Netherlands South Af rica Spain France Chile Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 23
    • 2012 Drugs: CelebrexCelebrex is commonly prescribed for pain. $258 $162 $163 $140 $126 $128 $116 $88 $59 $53 Canada Argentina South Af rica United Kingdom France Switzerland Spain United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 24
    • 2012 Drugs: VytorinVytorin is commonly prescribed for high cholesterol. $131 $123 $120 $80 $70 $68 $55 $31 Argentina New Zealand United Kingdom Switzerland Spain United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 25
    • 2012 Drugs: CymbaltaCymbalta is commonly prescribed for depression, anxiety, and fibromyalgia. $317 $176 $149 $113 $77 $84 $70 $57 $47 $48 France United Kingdom South Af rica Spain Switzerland Argentina Canada United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 26
    • 2012 Drugs: NasonexNasonex is commonly prescribed for nasal allergies. $115 $108 $105 $39 $29 $21 $22 $23 $17 $12 United Kingdom France Spain Argentina South Af rica Canada Switzerland United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 27
    • 2012 Drugs: LipitorLipitor is commonly prescribed for high cholesterol. $145 $124 $100 $60 $48 $43 $39 $11 $13 $6 New Zealand South Af rica Spain Argentina United Kingdom France Chile United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 28
    • 2012 Drugs: NexiumNexium is commonly prescribed for acid reflux. $373 $202 $187 $71 $72 $37 $41 $30 $32 $18 $21 Spain Argentina France United South Af rica Chile Switzerland Netherlands United States Kingdom USA 25th Percentile Average Price USA 95th Percentile($ USD) 29
    • 2012 Diagnostics: Colonoscopy $2,627 $1,185 $864 $893 $655 $536 $413 Argentina Switzerland New Zealand United Kingdom United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 30
    • 2012 Devices: Hip Prosthesis $27,497 $12,222 $10,763 $6,895 $3,579 $1,556 $2,682 $1,516 Argentina Chile Spain South Africa Australia United States USA 25th Percentile Average Price USA 95th Percentile($ USD) 31
    • 2010 Health Spending as Percent of GDP 17.6% 11.4% 11.4% 11.6% 10.1% 9.6% 9.6% 9.1% 9.5% 8.0% OECD Average Chile Australia Spain United New Zealand Canada Switzerland France United States KingdomSource: OECD Health Spending 2012. Data represents 2010 or most recent year. 32
    • Country Sources and NotesArgentina Prices are a weighted average from the public system, the social security system, and a private health plan.Australia Prices are private sector prices paid by a private health plan.Canada Prices are public sector prices for the province of Nova Scotia.Chile Prices are private sector prices paid by a private health plan.France Prices are a blend of public and private system prices.Netherlands Prices are private sector prices paid by a private health plan, and incorporate the new DRG system implemented in 2012.New Zealand Prices are public sector prices based on the fee schedule for one large District Health Board, as well as other national tariff pricing lists.South Africa Prices are private sector prices paid by a private health plan.Spain Prices are private sector prices paid by a private health plan.Switzerland Prices are public sector prices. 33
    • Country Sources and NotesUnited States Prices are calculated from commercial claims data from the Truven (formerly Thomson Reuters) MarketScan Research databases. The MarketScan databases capture person-specific clinical utilization, expenditures, and enrollment from a selection of large employers, health plans, and government and public organizations. The annual medical databases include private sector health data from approximately 100 payers. Claims data was compiled by Deloitte Consulting LLP on behalf of Kaiser Permanente Health Plan. Any opinions or conclusions expressed herein regarding the data are not those of Deloitte Consulting LLP. Because a broad range of prices were available, the national 25th percentile (low), average, and 95th percentile were calculated. Prices represent allowed charges, which are the negotiated rates for which providers receive payment. Allowed charges include both patient cost sharing and health plan payment. Cataract surgery price represents the price for outpatient procedures. The angioplasty and appendectomy prices reflect a blend of inpatient and outpatient prices based on relative utilization in each setting. The patent for Lipitor expired on November 30, 2011. This has an impact on the drug’s unit cost, and data show a rapid drop in volume and a gradual reduction in price for the branded version of this drug throughout 2012. The price in this report was calculated based on the same process as the other drug benchmarks, but incorporated an adjustment factor to reflect the impact on price of patent expiration. Prices may decline further over time, and the utilization of the drugs may also continue to decline as generic substitutes gain market share.United Kingdom Prices are public sector prices from the National Health Service (NHS) and the British National Formulary drug price listings. 34
    • List of Federation Member PlansArgentina Germany SpainOmint Sa De Servicios AXA Krankenversicherung AG Compañia de Seguros Adeslas SAAustralia Munich Health Sanitas SAAustralian Health Service Alliance Greece SwitzerlandAustralian Health Insurance Association Limited Interamerican Life Insurance Company Helsana Versicherungen AGAustralian Unity Health Limited Hong Kong Sanitas KrankenversicherungBUPA Australia Limited AXA General Insurance Hong Kong Limited ThailandGMHBA Limited BUPA (Asia) Limited BUPA Health Insurance (Thailand) LimitedHBF Health Funds IncHospitals Contribution Fund of Australia, Limited India United KingdomHealth-Partners MAX BUPA Health Insurance Limited Aria Assistance GroupMedibank Private Ireland AXA PPP HealthcareNavy Health Limited VHI Healthcare Limited BUPANIB Health Funds Limited InterGlobal Insurance Company Italy Simplyhealth GroupPolice Health Unisalute Western Provident Association LimitedRT Health FundTeachers’ Federation Health Limited Mexico Westfield Contributory Health SchemeTeachers’ Union Health AXA Seguros SA de CV USABelgium Aetna Inc NetherlandsMedicover Americas Health Insurance Plans Achmea HealthNationaal Verbond van Socialistiche Mutualiteiten Blue Cross & Blue Shield Association New Zealand Emblem Foundation Health PlanUnion Nationale des Mutualities Libres (MLOZ) Health Funds Association of New Zealand Kaiser Foundation Health Plan IncCanada Southern Cross Healthcare RW2 EnterpriseAlberta Blue Cross Plan Union Medical Benefits Society, Limited The Trizetto GroupCanassurance Hospital Service Association Tufts Health Plan NigeriaGroup Medical Services UnitedHealth Group Total Health Trust LimitedManitoba Blue CrossMedavie Blue Cross Poland ZimbabwePacific Blue Cross Signal Iduna Polska Tusa Association of the Healthcare Funders of ZimbabweSaskatchewan Blue Cross Cimas Medical Aid Society Saudi Arabia The Medical Aid Society of Central AfricaChile BUPA Middle East Premier Service Medical Aid SocietyBanmedica South AfricaChina Board of Healthcare Funders of Southern AfricaBUPA China Representative Office Bonitas Medical Fund Chartered Accountants (SA) Medical Aid FundDenmark Discovery Health Medical SchemeDanmark Sygeforsikring La-Health Medical SchemeDanica Pension Forretningsudvikling MedihelpForenede Gruppeliv A/S Medscheme HoldingsDominican Republic Metropolitan Health GroupArs Humano PolmedFrance TransmedMalakoff Mederic 35