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Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
Ifhp price report2010_comparativepricereport29112010
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Ifhp price report2010_comparativepricereport29112010

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  • 1. International Federation of Health Plans 2010 Comparative Price ReportMedical and Hospital Fees by Country 1
  • 2. COMPARATIVE COST REPORTThe International Federation of Health Plans wasfounded in 1968 by a group of health plan industryleaders from a dozen countries. It is now the leadingglobal network of the industry, with one hundredmember companies in 30 countries.Federation member plans meet regularly to shareinformation about health care financing and healthcare delivery in their home countries. 2
  • 3. COMPARATIVE COST REPORTThe attached comparative healthcare price report waspresented at the iFHP Council meeting in November2010 held in San Francisco, California, as part of adiscussion of total health care cost differencesbetween major countries. 3
  • 4. Scans and Imaging Fees: Angiogram (US$) (95th percentile)$2,500 $2,160$2,000$1,500$1,000 $749 $682 (Average) $545 $552 $559 $500 $245 $287 $117 $134 $187 $153 $- d ge y a nd n ce le UK lia an an ai in i an an la Ch ra Sp nt al m er st Fr ge R Ze er Au it z e Ar G Sw Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 4
  • 5. Scans and Imaging Fees: CT Scan: Abdomen (US$) (95th percentile)$1,800 $1,564$1,600$1,400$1,200$1,000 $800 $536 (Average) $600 $447 $487 $411 $400 $374 $187 $249 $200 $85 $117 $179 $164 $61 $0 d da n y a ce ge nd UK le lia an an ai in i an na Ch la ra an Sp nt al m er st Fr Ca ge R Ze er Au it z e Ar G Sw Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 5
  • 6. Scans and Imaging Fees: CT Scan: Head (US$) (95th percentile)$1,600 $1,430$1,400$1,200$1,000 $800 $600 $464 (Average) $400 $360 $220 $227 $234 $287 $179 $187 $200 $60 $65 $117 $82 $0 d ge da y a nd n ce le lia UK an an ai in i an na la an Ch ra Sp nt al m er st Fr Ca ge R Ze er Au it z e Ar G Sw Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 6
  • 7. Scans and Imaging Fees: CT Scans: Pelvis (US$) (95th percentile)$1,600 $1,404$1,400$1,200$1,000 $800 $600 $487 (Average) $374 $386 $391 $400 $302 $187 $215 $200 $98 $117 $179 $142 $0 d da ge y n ce nd le UK lia an an ai i an na Ch la ra an Sp al m er st Fr Ca R Ze er Au it z e G Sw Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 7
  • 8. Scans and Imaging Fees: MRI Scan (US$) (95th percentile)$3,000 $2,590$2,500$2,000$1,500 $1,009 (Average)$1,000 $874 $603 $632 $439 $505 $509 $500 $304 $398 $86 $187 $234 $- d ge da y a n ce nd le UK lia an an ai in i an na Ch la an ra Sp nt al m er st Fr Ca ge R Ze er Au it z e Ar G Sw Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 8
  • 9. Hospital Charges: Average Cost Per Hospital Day (US$) (95th percentile)$16,000 $14,306$14,000$12,000$10,000 $8,000 $6,000 $3,220 $3,612 (Average) $4,000 $2,000 $340 $470 $543 $554 $617 $909 $1,183 $1,595 $319 $- d ge da y a nd n ce le lia an an ai in i an na an la Ch ra Sp nt al m er st Fr R Ca ge Ze er Au it z e Ar G Fe Sw w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 9
  • 10. Hospital Charges: Average Cost Per Hospital Stay (US$) (95th percentile)$50,000 $45,902$45,000$40,000$35,000$30,000$25,000$20,000 $14,427 (Average)$15,000$10,000 $7,707 $4,140 $4,626 $4,715 $4,718 $5,825 $5,951 $5,000 $1,253 $1,679 $4,001 $- d ge da y a n nd ce le lia an an ai in i an na an la Ch ra Sp nt al m er st Fr Ca R ge Ze er Au it z e Ar G Sw Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 10
  • 11. Total Hospital and Physician Costs: Normal Delivery (US$) (95th percentile)$16,000 $13,799$14,000$12,000$10,000 $8,435 (Average) $8,000 $6,379 $6,000 $4,592 $3,768 $4,000 $2,667 $2,792 $3,133 $3,485 $2,147 $2,266 $2,000 $737 $668 $0 ge da s a y n nd ce le UK lia an nd ai in i an na an la Ch ra Sp nt m la er st Fr Ca ge R er er Au it z e Ar th G Sw Fe Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 11
  • 12. Total Hospital and Physician Costs: C-Section (US$) (95th percentile)$25,000 $21,989$20,000$15,000 $13,016 (Average)$10,000 $9,012 $9,282 $5,192 $5,591 $5,000 $4,376 $4,648 $2,989 $959 $- ge s a nd in ce lia K nd tin U pa an an la tra rla en er S R Fr us he tz rg e A wi A Fe et S N A S U USA Low USA Average USA 95th Percentile (Actual Payments) 12
  • 13. Total Hospital and Physician Costs: Appendectomy (US$) (95th percentile)$30,000 $25,344$25,000$20,000$15,000 $13,123 (Average)$10,000 $6,526 $7,758 $4,624 $5,406 $5,276 $5,000 $2,537 $2,570 $2,795 $3,285 $3,456 $3,810 $559 $- d ge da y s a nd n ce le lia UK an an nd ai in i an na an la Ch ra Sp nt al m la er st Fr Ca R ge Ze er er Au it z e Ar th G Sw Fe w Ne Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 13
  • 14. Total Hospital and Physician Costs: Hip Replacement (US$) (95th percentile)$80,000 $75,369$70,000$60,000$50,000$40,000 $34,454 (Average)$30,000 $20,069 $21,247$20,000 $12,629 $12,737 $15,041 $15,329 $15,860 $6,683 $9,327 $9,637 $10,753$10,000 $2,968 $- UK nd d ile s in y lia da e a ce nd n an ng tin a Ch rla tr a la na an Sp la en m Ra a tze s Fr Ca Ze er er Au g th e G Ar i Sw Fe w Ne Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 14
  • 15. Total Hospital and Physician Costs: Bypass Surgery (US$)$140,000 (95th percentile) $126,182$120,000$100,000 $80,000 $60,000 $59,770 (Average) $40,000 $32,934 $37,793 $30,474 $27,237 $22,212 $19,180 $20,000 $15,802 $16,325 $11,618 $13,998 $4,959 $- d ge s da y a nd n ce lia UK an an nd ai in an na an la ra Sp nt al m la er st Fr R Ca ge Ze er er Au it z e Ar th G Fe Sw w Ne Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 15
  • 16. Total Hospital and Physician Costs: Angioplasty (US$) (95th percentile)$70,000 $60,448$60,000$50,000$40,000$30,000 $29,055 (Average)$20,000 $18,283 $12,581 $6,055 $6,709 $7,666 $8,003$10,000 $2,708 $5,223 $1,641 $- d ge y a nd ce n le lia an an ai in i an an la Ch ra Sp nt al m er st Fr ge R Ze er Au itz e Ar G Fe Sw w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 16
  • 17. Physician Fees: Routine Office Visit (US$) (95th percentile)$180 $156$160$140$120$100 $86 (Average) $80 $61 $60 $46 $47 $31 $39 $40 $24 $11 $15 $20 $8$- d le in ge y lia a a ce n an ad ti n hi a la ra an an Sp C en m an a st R Fr Ze er Au g C e G Ar Fe ew SA N U USA Low USA Average USA 95th Percentile (Actual Payments) 17
  • 18. Physician Fees: Normal Delivery (US$)$6,000 (95th percentile)$5,000 $4,848$4,000 $2,997$3,000 (Average) $2,380$2,000 $1,336 $776 $958$1,000 $503 $129 $324 $- Argentina Spain Canada Australia Chile France USA Fee Range USA Low USA Average USA 95th Percentile (Actual Payments) 18
  • 19. Physician Fees: C-Section (US$) (95th percentile)$7,000 $6,125$6,000$5,000$4,000 $3,505 (Average)$3,000 $2,656$2,000 $1,581 $1,336 $958$1,000 $422 $600 $148 $- Argentina Spain Canada Chile France Australia USA Fee Range USA Low USA Average USA 95th Percentile (Actual Payments) 19
  • 20. Physician Fees: Appendectomy (US$) (95th percentile)$2,500 $2,072$2,000 $1,393 $1,450$1,500 $1,209$1,000 $959 (Average) $753 $647 $500 $271 $356 $119 $228 $- d ge da y a n ce le lia an an ai in i an na an Ch ra Sp nt al m st Fr Ca ge R Ze er Au e Ar G Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 20
  • 21. Physician Fees: Cataract Surgery (US$) (95th percentile)$2,500 $2,210$2,000 $1,790$1,500 $1,077 $1,158 $954 (Average)$1,000 $502 $560 $632 $413 $464 $500 $120 $- d da n y a ce ge le lia an an ai tin i an na Ch ra an Sp al m n st Fr Ca ge R Ze er Au e Ar G Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 21
  • 22. Physician Fees: Hip Replacement (US$) (95th percentile)$6,000 $5,280$5,000$4,000 $2,723 $2,748 $2,834 (Average)$3,000 $2,588 $1,962 $2,008$2,000 $1,071$1,000 $679 $815 $370 $- d ge da y a n ce le lia an an ai in i an na an Ch ra Sp nt al m st Fr Ca ge R Ze er Au e Ar G Fe w Ne A US USA Low USA Average USA 95th Percentile (Actual Payments) 22
  • 23. Drug Prices: Lipitor (US$) (95th percentile)$160$140 $134$120 $129$100 $78 $78$80 $72$60 $31 $33 $38 $39$40 $30 $31$20 $0.43 $0 da ge y s n a ce nd ile UK lia an nd ai in an na Ch la ra an Sp nt m la er st Fr Ca ge R er er Au it z e Ar th G Sw Fe Ne A US USA Low USA 95th Percentile (Actual Payments) 23
  • 24. Drug Prices: Nexium (US$)$400 (95th percentile) $339$350$300$250$200 $186 (Average) $136$150 $167$100 $69 $49 $50 $50 $21 $30 $32 $33 $35 $3$- K d s le in y ge lia a a ce n nd U an ad tin hi a la tr a an an Sp C rla en m an er R s Fr er he i tz Au g C e G Ar Sw Fe et N SA U USA Low USA Average USA 95th Percentile (Actual Payments) 24
  • 25. Drug Prices: Plavix (US$) (95th percentile)$180 $161$160 $152 (Average)$140 $148$120 $98 $99$100 $76 $80 $80 $55 $57 $59 $60 $46 $40 $33 $20 $15$- K d le in s y lia a e a ce U n nd an ad ng tin hi a la ra an Sp C rla en m an Ra er st Fr er he i tz Au g C e G Ar Sw et Fe N A US USA Low USA Average USA 95th Percentile (Actual Payments) 25
  • 26. Contact informationTom Sackville, Chief Executive, the International Federation ofHealth PlansTom Sackville, Chief Executive of the International Federation of HealthPlans was born in London and gained a degree in Modern History andSpanish Literature from Oxford University. He began his working life infinancial services in New York, specializing in European and LatinAmerican debt. In 1983 he was elected to the British Parliament, laterserving as a Government Whip in the Thatcher administration and as aMinister in the Department of Health and the Home Office under JohnMajor. He has served as Chief Executive of the iFHP since 1998.Email: tom@ifhp.comUK cell: +44 7710 787 673 26
  • 27. List of Federation Member PlansArgentina GreeceOmint Sa De Servicios Interamerican Life Insurance CompanyAustralia Hong KongAustralian Health Insurance Association BUPA (Asia) LimitedAustralian Unity Health Limited HSBC Medical Insurance LimitedBUPA Australia Limited IndiaGMHBA Limited MAX BUPA Health Insurance LimitedHBF Health Funds Inc IrelandThe Hospitals Contribution Fund of VHI Healthcare LimitedAustralia Limited Spain ItalyHealth Partners Compañia de Seguros Adeslas SA UnisaluteMedibank Private Sanitas SA MauritiusNavy Health Limited Switzerland Administrators & Consultants LimitedNIB Health Funds Limited Helsana Versicherungen AG NetherlandsRT Health Fund Sanitas Achmea HealthTeachers’ Federation Health Limited Thailand Zorgverzkeraars NederlandTeachers’ Union Health BUPA Health Insurance (Thailand) Limited New ZealandBelgium Turkey Southern Cross HealthcareMedicover Acibadem Saglik ve Hayat Sigorta S.A. Health Fund Association of New ZealandAssociation Internationale de la Mutualite United Kingdom UnimedNationaal Verbond van Socialistiche Mutualiteiten AXA PPP Healthcare NigeriaUnion Nationale des Mutualities Libres (MLOZ) BUPA Total Health Trust LimitedBotswana Europe Assistance Holdings Peoples Republic of ChinaBotswana Public Medical Aid Scheme Healthways International Limited BUPA China Representative OfficePULA Medical Aid Fund Simplyhealth Group RomaniaCanada Western Provident Association Medihelp International Broker De Asigurare SRLAlberta Blue Cross Plan Westfield Contributory Health Scheme Saudi ArabiaCanassurance Hospital Service Association USA BUPA Middle EastGroup Medical Services Aetna Inc South AfricaManitoba Blue Cross Americas Health Insurance Plans Agility Global Health SchemeMedavie Blue Cross Blue Cross & Blue Shield Association Board of Healthcare Funders of Southern AfricaPacific Blue Cross HIP Health Plan of New York Bonitas Medical FundSaskatchewan Blue Cross Kaiser Foundation Health Plan Inc Chartered Accountant (SA) Medical Aid FundChile The Trizetto Group Discovery HealthBanmedica Zimbabwe La-Health Medical SchemeColombia CIMAS Medical Aid Society MedihelpAsociacion Colombiana de Empresas de Medicina Integral The Medical Aid Society of Central Africa Medscheme HoldingsDenmark Metropolitan Health GroupDanmark Sygeforsikring Neil Harvey & AssociatesDominican Republic PolmedArs Humano Sizwe Medical FundFrance TransmedMalakoff Mederic University of NatalGermanyMunich Health 27
  • 28. Source and Notes For Health Care Unit Price ComparisonsUK Based on NHS fee scheduleAustralia Average hospital charges per day and stay : Based on Productivity Commission October 2009 report Drugs : Reflects standard co-payments for patientNew Zealand Physician fees for office visits : not covered by private health insurance. government subsidy for General Practitioner visits (primary care capitation). Subsidies will vary depending on the eligibility of the patient. This calculated fee relates to the average cost not covered by the subsidy. Physician fees for normal delivery and c-sections : not covered by private health insurance. fully funded by the government Average hospital charges per day and per stay : Include all surgical procedures funded under private insurance. Cover a wide range of procedures and thus the average prices are heavily determined according to the mix of procedures within. 28
  • 29. Source and Notes For Health Care Unit Price Comparisons (Cont’d)France Drugs : Reflect prices negotiated by hospitals including a 2.1% tax. These prices that are generally much lower than drugs available in primary care settings and pharmacies Drugs - Lipitor : Reflects the prices for the generic substitute, TahorGermany Based on current Medical Fee Schedule (GOA) and represents the average costs per treatment Total (Hospital and Physician) Cataract surgery fees : Excluded due to limited and non-comparable data definitions Normal delivery physician fees : Reflects only the incremental private insurance fees paid to physicians above the annually negotiated medical fees which consists of fees per time period and per medical procedure. e.g., only incremental physician charges above the bundled DRG payment for specific procedures which consists of both total physician and hospital cost Drugs : Reflect commercially available prices. No public fees available. Public co-payment schemes also vary greatly 29
  • 30. Source and Notes For Health Care Unit Price Comparisons (Cont’d)Netherlands Physician primary care fees (office visits) : No equivalent in Dutch health system. General Practitioner remuneration system is based on a fixed fee per patient plus an additional 9 Euro consult fee. Total (Hospital and Physician) fees : Estimated based on DBC (diagnose treatment combinations) which are negotiated mixed bundled payments model on per patient / diagnosis basis. Components are not separated Drugs : Reflect the standard public charges for patient. Excludes 6% VATSwitzerland All fees except for physician inpatient fees are based on public fee schedule Physician inpatient fees (Normal Delivery, C-Section, Appendectomy, Cataract Surgery, Hip Replacement) : Based on private charges billed by hospitals for medical services. Physician specific component is not separated 30
  • 31. Source and Notes For Health Care Unit Price Comparisons (Cont’d)Spain Fee schedule is as of Oct 2010 and reflects the competitive fees charged by private providers.Argentina Reflects a blend of fees for three health sub sectors; public health, social security and private weighed by corresponding coverage of the total population - 50%, 38% and 12% respectively.Canada Hospital and Total (Hospital and Physician) fees : reflect 2009/10 relative hospital cost, based using fiscal 2009/10 acute care discharge data from the Canada Institute for Health Information (CIHI) Discharge Abstract Database and a relative dollar value of $5,422 (fiscal 2008/09 - New Brunswick provincial average) for 1 RIW (resource intensity weights) or cost per weighted case (CPWC) as provided by CIHI. 31
  • 32. Source and Notes For Health Care Unit Price Comparisons (Cont’d)Canada Average cost per hospital day : Includes only direct cost (no indirect(Cont’d) or overhead cost) Average cost per hospital admission : Based on acute hospitals only and includes newborns Drugs : Reflects one month supply (30 days) covering base ingredient costs excluding mark-up and dispensing fees. Given that Nexium is not included in the New Brunswick Formulary, the comparable product, Losec, was used Cost-based fees are not captured at a detailed level for various procedures including c-sections, angiogramsUSA US data are from independent databases tracking payment levels by third party payers, and publicly reported sources. These reflect commercially negotiated claims-based, fee-for-service paid charges between payers and providers / hospitals. For total hospital and physician fees consists of physician, facility and other fees for the procedures that have been performed in inpatient settings. These fees vary widely by state, by specialty, by hospital and by payer 32

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