Comparing International Generic Drug Prices: A 2025 Unit-Cost Analysis Using U.S.

Comparing International Generic Drug Prices: A 2025 Unit-Cost Analysis Using U.S. Cost-Plus Benchmarks

Author credit: Junmo Jeon, PharmD Candidate 2026, Duquesne University

Introduction

Generic drug prices can vary widely across countries, even for identical active ingredients. This analysis compares the unit costs of six generic medications across six countries: the United States, South Korea, Brazil, India, Germany, and Canada, as of June 18, 2025. All prices were converted to U.S. dollars using current exchange rates to ensure fair comparison.

The medications selected for this analysis were chosen to reflect a mix of commonly prescribed generic drugs and less frequently used, higher-cost generics. This balance allows for comparison across both routine and specialty care settings. While the selection was not driven by a strict scientific methodology, it was designed to capture a range of therapeutic categories and market behaviors. Medications analyzed included:

• Metformin HCl 500 mg (diabetes)
• Rosuvastatin 20 mg (cholesterol)
• Sertraline 50 mg (depression)
• Teriflunomide 14 mg (multiple sclerosis)
• Abiraterone 250 mg (prostate cancer)
• Levetiracetam 500 mg (epilepsy)

Note: In South Korea, abiraterone is only available in a 500 mg strength, which may affect unit price comparisons.

Prices reflect the lowest available consumer costs for generic formulations found on publicly accessible pharmacy websites. Original brand-name products were excluded where possible, though branding conventions vary — particularly in markets like South Korea, where generics are often sold under unique brand names.

NOTE: This chart shows how U.S. prices — based on a cost-plus pharmacy model — compare to those in Canada, Germany, India, Brazil, and South Korea. For reference, a country listed at 300% pays three times more than the U.S. cost-plus price; a country at 50% pays half as much. The dashed line marks the U.S. baseline (100%) using a cost-plus pharmacy model (acquisition cost + dispensing fee).

For the United States, this analysis uses the cost-plus member pricing from an independent pharmacy model as a benchmark. This differs from typical U.S. retail prices, which are often shaped by insurance coverage, manufacturer rebates, and pharmacy benefit managers (PBMs). Using cost-plus pricing allows for a more consistent and transparent comparison with other countries’ consumer-facing prices, which generally don’t involve third-party reimbursement complexities.

Key Takeaways

• U.S. cost-plus prices are often the lowest — even compared to countries like India, Brazil, and Germany.
• Some countries show extreme outliers, like South Korea’s high price for teriflunomide or Brazil’s for abiraterone, likely due to market or regulatory differences.
• Generic drug prices vary widely across countries, underscoring the need for transparency in pricing and global comparisons.

Why Prices Differ

Several factors help explain this variation:

• Patent Status & Generics: Drugs like abiraterone and teriflunomide may still be under patent or recently off-patent in some countries, limiting the availability of cheaper generics.
• National Health Coverage: In countries like South Korea or Germany, reimbursement and insurance affect what is paid out of pocket — but may not reflect the drug cost.
• Market Size and Manufacturer Competition: The U.S. and India often have intense price competition among generics (e.g., rosuvastatin, sertraline), contributing to lower unit prices.
• Import/Export Restrictions: Some markets depend on imported drugs, which can raise costs.

Conclusion

This analysis underscores how dramatically generic drug prices can vary — even for identical medications and dosages. While pricing reflects complex factors like insurance coverage, government subsidies, and packaging, several trends emerged:

• The U.S. cost-plus model offered the lowest per-unit price for four of the six drugs studied.
• India consistently offered low prices, although often in smaller package sizes (e.g., strips of 10).
• South Korea and Canada tended to have the highest per-unit prices, particularly for specialty therapies.
• Outlier cases, such as teriflunomide in South Korea, suggest the impact of national policies and market dynamics.

While drug pricing is multifaceted and also impacted by insurance coverage, subsidies, and access, the data shows that the U.S. generic drug supply is, in many cases, competitively priced or even leading in affordability. Understanding these trends can help patients, policymakers, and prescribers alike when considering both international benchmarks and local drug access strategies.

Sources (Accessed June 18, 2025)

Academic Reference

1. Top 100 Drugs.” RxTechExam, 13 Sept. 2024, rxtechexam.com/top-100-drugs/

Medication Price Sources by Country

2. United States — https://price.blueberrypharmacy.com | EZRIRx: https://app.ezrirx.com/

3. Canada — Canada Pharmacy: https://www.canadapharmacy.com/

4. India — NetMeds: https://www.netmeds.com/

5. Germany — Medizinfuchs: https://www.medizinfuchs.de/

6. Brazil — Panvel Pharmacy: https://www.panvel.com/

7. South Korea — Health.kr Drug Search: https://www.health.kr/searchDrug/search_detail.asp | HMP Mall: https://www.hmpmall.co.kr/