I hope my fellow Lizards won’t mind a bit of shameless self promotion. The topic of how different countries pay for medicines (and how those decisions impact patients) has been the focus of my professional life for the last few years. After a lot of hard graft, I received my doctorate in August.

There are a few points I’d like to make. First, there are always tradeoffs, but the outcomes are very much a result of the choices a country makes. My home country of New Zealand, for instance, has nationwide pharmaceutical coverage, low patient co-payments (typically NZ $5 per three month supply of medicines, with a cap of $100 per family per year), and good control of national pharmaceutical spending. The trade-off is that we have fewer and older publicly funded medicines than a lot of other countries.

If we take the asthma medicines mentioned in the NYT article as an example, any NZ resident who needed them would get them for the minimum co-payment. However, if a breakthrough new drug became available in the US, it could be a decade before we funded it. (We also don’t have a much of a private insurance market for pharmaceuticals, though people do have private insurance for hospital and specialist costs if they want an alternative to the public system). Essentially, if you want something that’s not on the publicly funded list, you would pay the full price yourself.

The other point I’d like to make is that my advisors and I searched long and hard for a US comparator to the systems that existed in New Zealand, Australia and the UK. In the end, the closest match we found was the Department of Veterans Affairs National Formulary. Even then, the thesis examiners asked me to italicise all tables referring to the US, to highlight the fact that the US system was very, very different from any of the others.