The Price of Health: Americans Pay a Hefty Bill for Drugs

Americans pay some of the highest prices in the world for prescription drugs, often several times more than patients in Canada or Europe. Data from PharmacyChecker, a trusted source for comparing international drug prices, reveal huge disparities in prices for essential medications between the United States and abroad.

For example, one of the most striking gaps is seen for Spiriva Respimat inhalers, used in the treatment of chronic pulmonary diseases. One inhaler costs over $120 in the United States, compared to only about $1 in Canada and other countries worldwide (as of January 2026). Meanwhile, other common essential medicines like Januvia (type 2 diabetes), Bystolic (hypertension) and Renvela (chronic kidney disease), are on average three times more expensive in the U.S. than in Canada. For the anticoagulant Xarelto, used to treat and prevent blood clots, there is even a fivefold difference in pricing between the two countries. These disparities are not outliers: PharmacyChecker's database shows that U.S. patients pay generally 2 to 10 times more for the same medications than their counterparts in Canada or Europe.

A lack of price regulation in the U.S. market (i.e. no drug price caps), longer patent protection and exclusivity, as well as the American healthcare system's reliance on higher pricing, are some of the main reasons for these disparities. Trump regularly accuses European countries and Canada of "brutal" tactics to suppress drug prices and, in May 2025, announced his intention to curb U.S. drug costs by signing an executive order aimed at aligning U.S. prices with the lowest prices paid abroad (aka the "Most Favored Nation" policy). However, the White House policy currently faces legal and industry resistance. Pharmaceutical giants argue that lowering prices could stifle innovation, while critics note that previous attempts failed due to lobbying and legal challenges.