ifhp price report2010_comparativepricereport29112010

1

International Federation of

Health Plans

2010 Comparative Price Report

Medical and Hospital Fees by Country

2

The International Federation of Health Plans was founded in 1968 by a group of health plan industry leaders from a dozen countries. It is now the leading global network of the industry, with one hundred member companies in 30 countries.

Federation member plans meet regularly to share information about health care financing and health care delivery in their home countries.

COMPARATIVE COST REPORT

3

The attached comparative healthcare price report was presented at the iFHP Council meeting in November 2010 held in San Francisco, California, as part of a discussion of total health care cost differences between major countries.

COMPARATIVE COST REPORT

4

Scans and Imaging Fees:Angiogram (US$)

$153

$749$559$552$545

$287$245$187$134$117

$682

$2,160

$-

$500

$1,000

$1,500

$2,000

$2,500

Spain

Switzer

land

UK

Franc

e

Germ

any

Austra

liaChile

Argenti

na

New Zea

land

USA Fee R

ange

(95th percentile)

(Average)

USA Low USA Average USA 95th Percentile (Actual Payments)

5

Scans and Imaging Fees:CT Scan: Abdomen (US$)

$85 $117 $179 $187 $249$374 $411 $447 $487

$164$61

$536

$1,564

$0

$200$400

$600

$800$1,000

$1,200

$1,400$1,600

$1,800

Canada

Argenti

naSpa

in

Franc

eUK

Chile

Germ

any

Switzer

land

New Zea

land

Austra

lia

USA Fee R

ange

(95th percentile)

(Average)


6

Scans and Imaging Fees:

CT Scan: Head (US$)

$65 $117 $179 $187 $220 $227 $234 $287 $360

$82$60

$464

$1,430

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

Argenti

na

Canada

Spain

Franc

eUK

Chile

New Zea

land

Austra

lia

Germ

any

Switzer

land

USA Fee R

ange

(95th percentile)

(Average)


7


CT Scans: Pelvis (US$)

$117 $179 $187 $215 $302 $374 $386 $391

$142$98

$487

$1,404

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

Canada

Spain

Chile UK

Franc

e

New Zea

land

Germ

any

Austra

lia

Switzer

land

USA Fee R

ange

(95th percentile)

(Average)


8


MRI Scan (US$)

$187 $234 $304 $398 $439 $505 $603 $632$874

$509$86

$1,009

$2,590

$-

$500

$1,000

$1,500

$2,000

$2,500

$3,000

Argenti

naUK

Spain

Canada

Franc

e

Austra

liaChile

New Zea

land

Germ

any

Switzer

land

USA Fee R

ange

(95th percentile)

(Average)


9

Average Cost Per Hospital Day (US$)

Hospital Charges:

$340 $470 $543 $554 $617 $909 $1,183

$3,220

$1,595$319

$3,612

$14,306

$-

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

Argenti

na

Canada

Spain

Chile

Germ

any

Switzer

land

Franc

e

Austra

lia

New Zea

land

USA Fee R

ange

(95th percentile)

(Average)


10

Average Cost Per Hospital Stay (US$)

Hospital Charges:

$5,951$5,825$4,718$4,715$4,626$4,140$1,679

$7,707

$4,001$1,253

$14,427

$45,902

$-$5,000

$10,000$15,000$20,000$25,000$30,000$35,000$40,000$45,000$50,000

Argenti

na

Spain

Austra

lia

Switzer

land

Franc

e

Germ

any

New Zea

land

Chile

Canada

USA Fee R

ange

(95th percentile)

(Average)


11

Total Hospital and Physician Costs:Normal Delivery (US$)

$737$2,147 $2,266 $2,667 $2,792 $3,133 $3,485 $3,768

$4,592$6,379

$668

$8,435

$13,799

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

Nether

lands

Argenti

na

Germ

any

Spain

Canada UK

Chile

Switzer

land

Franc

e

Austra

lia

USA Fee R

ange

(95th percentile)

(Average)


12

C-Section (US$)

Total Hospital and Physician Costs:

$2,989 $4,376 $4,648 $5,192 $5,591

$9,012 $9,282

$959

$13,016

$21,989

$-

$5,000

$10,000

$15,000

$20,000

$25,000

Argent

ina

Spain

Franc

eUK

Switzer

land

Nether

lands

Austra

lia

USA Fee R

ange

(95th percentile)

(Average)


13


Appendectomy (US$)

$559$2,537 $2,570 $2,795 $3,285 $3,456 $3,810 $4,624 $5,406 $5,276 $6,526 $7,758

$13,123

$25,344

$-

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

Argenti

na

Spain

Switzer

land

Franc

e

Germ

any

UK

Canada

Nether

lands

Chile

New Zea

land

Austra

lia

USA Fee R

ange

(95th percentile)

(Average)


14

Hip Replacement (US$)


$2,968$6,683 $9,327 $9,637 $10,753 $12,629 $12,737 $15,041 $15,329 $15,860

$20,069 $21,247

$34,454

$75,369

$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

Argen

tina

Switzer

land

Spain UK

Canad

a

Franc

e

Nethe

rland

sChil

e

Germ

any

New Z

ealan

d

Austra

lia

USA Fee

Ran

ge

(95th percentile)

(Average)


15

Bypass Surgery (US$)


$4,959$11,618 $13,998 $15,802 $16,325 $19,180 $22,212

$27,237 $30,474 $32,934 $37,793

$59,770

$126,182

$-

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

Argenti

na

Switzer

land

UKSpa

in

Franc

e

Nether

lands

Canada

Germ

any

Austra

lia

New Zea

land

USA Fee R

ange

(95th percentile)

(Average)


16

Angioplasty (US$)


$1,641 $2,708 $5,223 $6,055 $6,709 $7,666 $8,003$12,581

$18,283

$29,055

$60,448

$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

Argenti

naChile

Switzer

land

Germ

any

Austra

lia

Franc

e

Spain

New Zea

land

USA Fee R

ange

(95th percentile)

(Average)


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Routine Office Visit (US$)

Physician Fees:

$8 $11 $15$24 $31 $39

$46 $47$61

$86

$156

$-

$20

$40

$60

$80

$100

$120

$140

$160

$180

Argen

tina

Spain

Germ

any

New Z

ealan

d

Franc

e

Canad

aChil

e

Austra

lia

USA Fee

Ran

ge

(95th percentile)

(Average)


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Normal Delivery (US$)

Physician Fees:

$129 $324$503

$776 $958$1,336

$2,380

$2,997

$4,848

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

Argentina Spain Canada Australia Chile France USA FeeRange

(95th percentile)

(Average)


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C-Section (US$)

Physician Fees:

$148 $422 $600$958

$1,336$1,581

$2,656

$3,505

$6,125

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

Argentina Spain Canada Chile France Australia USA FeeRange

(95th percentile)

(Average)


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Appendectomy (US$)

Physician Fees:

$119 $228 $271 $356

$753

$1,209$1,393 $1,450

$959

$647

$2,072

$-

$500

$1,000

$1,500

$2,000

$2,500

Argenti

na

Spain

Germ

any

Canada

Franc

e

Austra

liaChile

New Zea

land

USA Fee R

ange

(95th percentile)

(Average)


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Cataract Surgery (US$)

Physician Fees:

$120

$413 $464 $502 $560

$1,077 $1,158

$1,790

$632

$954

$2,210

$-

$500

$1,000

$1,500

$2,000

$2,500

Argenti

naSpa

in

Austra

lia

Canada

Germ

any

New Zea

land

Franc

eChile

USA Fee R

ange

(95th percentile)

(Average)


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Hip Replacement (US$)

Physician Fees:

$370$679 $815 $1,071

$1,962$2,588 $2,723 $2,748

$2,008

$2,834

$5,280

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

Argenti

na

Germ

any

Canada

Spain

Chile

New Zea

land

Franc

e

Austra

lia

USA Fee R

ange

(95th percentile)

(Average)


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Lipitor (US$)

Drug Prices:

(95th percentile)

$0.43

$30 $31 $31 $33 $38 $39

$72$78 $78

$129

$134

$0

$20

$40

$60

$80

$100

$120

$140

$160

Franc

e

Nether

lands

Canada

Spain

Austra

lia

Argenti

naUK

Chile

Switzer

land

Germ

any

USA Fee R

ange

USA Low USA 95th Percentile (Actual Payments)

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Nexium (US$)

Drug Prices:

$3$21 $30 $32 $33 $35 $49 $50

$69

$136$167

$186

$339

$-

$50

$100

$150

$200

$250

$300

$350

$400

Franc

e

Argen

tina UK

Canad

a

Austra

lia

Nethe

rland

sChi

le

Spain

Switzer

land

Germ

any

USA Fee

Ran

ge

(95th percentile)

(Average)


25

Plavix (US$)

Drug Prices:

$15$33

$46$55 $57 $59

$76 $80$98 $99

$148$152

$161

$-

$20

$40

$60

$80

$100

$120

$140

$160

$180

Franc

e

Austra

lia

Nethe

rland

s

Argen

tina UK

Switzer

land

Canad

aSpa

inChil

e

Germ

any

USA Fee

Ran

ge

(95th percentile)

(Average)


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Contact information

Tom Sackville, Chief Executive, the International Federation of Health Plans

Tom Sackville, Chief Executive of the International Federation of Health Plans was born in London and gained a degree in Modern History and Spanish Literature from Oxford University. He began his working life in financial services in New York, specializing in European and Latin American debt. In 1983 he was elected to the British Parliament, later serving as a Government Whip in the Thatcher administration and as a Minister in the Department of Health and the Home Office under John Major. He has served as Chief Executive of the iFHP since 1998.

Email: [email protected] cell: +44 7710 787 673

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List of Federation Member PlansArgentinaOmint Sa De ServiciosAustraliaAustralian Health Insurance AssociationAustralian Unity Health LimitedBUPA Australia LimitedGMHBA LimitedHBF Health Funds IncThe Hospitals Contribution Fund ofAustralia LimitedHealth PartnersMedibank PrivateNavy Health LimitedNIB Health Funds LimitedRT Health FundTeachers’ Federation Health LimitedTeachers’ Union HealthBelgiumMedicoverAssociation Internationale de la MutualiteNationaal Verbond van Socialistiche MutualiteitenUnion Nationale des Mutualities Libres (MLOZ)BotswanaBotswana Public Medical Aid SchemePULA Medical Aid FundCanadaAlberta Blue Cross PlanCanassurance Hospital Service AssociationGroup Medical ServicesManitoba Blue CrossMedavie Blue CrossPacific Blue CrossSaskatchewan Blue CrossChileBanmedicaColombiaAsociacion Colombiana de Empresas de Medicina IntegralDenmarkDanmark SygeforsikringDominican RepublicArs HumanoFranceMalakoff MedericGermanyMunich Health

GreeceInteramerican Life Insurance CompanyHong KongBUPA (Asia) LimitedHSBC Medical Insurance LimitedIndiaMAX BUPA Health Insurance LimitedIrelandVHI Healthcare LimitedItalyUnisaluteMauritiusAdministrators & Consultants LimitedNetherlandsAchmea HealthZorgverzkeraars NederlandNew ZealandSouthern Cross HealthcareHealth Fund Association of New ZealandUnimedNigeriaTotal Health Trust LimitedPeople's Republic of ChinaBUPA China Representative OfficeRomaniaMedihelp International Broker De Asigurare SRLSaudi ArabiaBUPA Middle EastSouth AfricaAgility Global Health SchemeBoard of Healthcare Funders of Southern AfricaBonitas Medical FundChartered Accountant (SA) Medical Aid FundDiscovery HealthLa-Health Medical SchemeMedihelpMedscheme HoldingsMetropolitan Health GroupNeil Harvey & AssociatesPolmedSizwe Medical FundTransmedUniversity of Natal

SpainCompañia de Seguros Adeslas SASanitas SASwitzerlandHelsana Versicherungen AGSanitasThailandBUPA Health Insurance (Thailand) LimitedTurkeyAcibadem Saglik ve Hayat Sigorta S.A.United KingdomAXA PPP HealthcareBUPAEurope Assistance HoldingsHealthways International LimitedSimplyhealth GroupWestern Provident AssociationWestfield Contributory Health SchemeUSAAetna IncAmerica's Health Insurance PlansBlue Cross & Blue Shield AssociationHIP Health Plan of New YorkKaiser Foundation Health Plan IncThe Trizetto GroupZimbabweCIMAS Medical Aid SocietyThe Medical Aid Society of Central Africa

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Source and Notes For Health Care Unit Price Comparisons

UK Based on NHS fee schedule

Australia Average hospital charges per day and stay : Based on Productivity Commission October 2009 report

Drugs : Reflects standard co-payments for patient

New Zealand Physician fees for office visits : not covered by private healthinsurance. 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 ofprocedures and thus the average prices are heavily determined according to the mix of procedures within.

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, Tahor

Germany 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

30


Netherlands Physician primary care fees (office visits) : No equivalent in Dutch health system. General Practitioner remuneration system is basedon 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% VAT

Switzerland 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

31


Spain Fee schedule is as of Oct 2010 and reflects the competitive feescharged by private providers.

Argentina Reflects a blend of fees for three health sub sectors; public health, social security and private weighed by corresponding coverage ofthe 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.

32


US data are from independent databases tracking payment levels by third party payers, and publicly reported sources. These reflectcommercially negotiated claims-based, fee-for-service paid charges between payers and providers / hospitals. For total hospital andphysician fees consists of physician, facility and other fees for the procedures that have been performed in inpatient settings. Thesefees vary widely by state, by specialty, by hospital and by payer

USA

Canada (Cont’d)

Average cost per hospital day : Includes only direct cost (no indirect 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, angiograms

ifhp price report2010_comparativepricereport29112010

Health & Medicine

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average cost

u usa lowusa average