The news: Drug prices for 25 top-selling brand-name medicines increased an average of 81% after their US launch, even as prices for the same drugs fell an average of 13% in 19 other high-income countries, according to a new AARP report. Its analysis focused on the costliest drugs covered by Medicare.

• The widest price divergence was Amgen’s Enbrel, with its US list price increasing 873% versus an average 27% drop in the other countries.
• Amgen's Repatha was the only drug in the study whose US list price decreased, dropping 46%. Across the other countries, its price dropped an average of 11%.

For context, US drugmakers face few limits on post-drug launch pricing, while many other high-income countries use price controls and other regulations to lower drug prices over time.

Why it matters: Despite years of federal efforts to reduce prescription drug costs, the gap between US drug prices and those in other developed countries remains substantial, suggesting policies have yet to meaningfully narrow the divide. Price regulation efforts such as Medicare drug price negotiations under the Inflation Reduction Act and the Trump administration's most-favored-nation individual deals with drugmakers are intended to lower US drug prices. But the AARP study found mixed results among drugs on the IRA negotiation lists: Six saw price declines between 2024 and 2026, while six others increased, suggesting the broader effect on drug pricing beyond Medicare remains uneven.

More Americans than ever are now worried about prescription drug costs. Nearly 6 in 10 US adults (59%) said they are concerned about being able to afford prescription medications for themselves or their families, according to a March KFF survey. That’s the highest share since KFF began tracking the measure in 2018.

Implications for pharma companies: Most-favored nation agreements could lower prices for some drugs, but achieving parity with other developed markets is unlikely. While some countries like the UK have agreed to modest price increases, others, such as Germany, are considering additional price cuts, making an international benchmark difficult to sustain. Because the individual drugmaker agreements with this administration expire after three years, any drug price reductions may prove temporary, limiting the long-term affordability benefits for consumers.

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