MFN · a standing page · as at 2026-09-21

What Australia will pay for a year of life is now a number other systems reference.

The United States now prices some of its medicines against other countries, and which of its instruments reference Australia depends on the basket: in the nineteen the Medicare models would use, out of the eight the Medicaid model uses. This page states the baskets, reads the Australian record for what it actually shows, which is a file of decisions with the cost per year of healthy life stated in a minority of them and redacted in most, and counts how much of that record belongs to the firms that have signed a US deal.

Three instruments, three baskets

A medicine can be inside one basket and outside another. Australia is in the nineteen that GLOBE and GUARD would reference and is not one of the eight that GENEROUS references. Saying "Australia is in the basket" as one fact is a mistake this page exists to stop. The second distinction matters as much for Australia: GENEROUS references net prices, and the Medicare models default to list prices. Australia's list price is public and its net price is not.

Instrument	Programme	Status	Basket	Australia	Benchmark
GENEROUS	Medicaid	Voluntary; a five-year model dated from 1 January 2026. As at September 2026 it is still being set up and the sign-up deadlines have been pushed back (NPR); no discount has yet been paid under it. Internal CMS email, reported September 2026: participants are to be exempt from GLOBE and GUARD	Eight: UK, France, Italy, Germany, Canada, Japan, Switzerland, Denmark	out	Second-lowest net price the manufacturer reports, adjusted for GDP per head at purchasing power parity
GLOBE	Medicare Part B	Still proposed (23 December 2025); mandatory if finalised; proposed to run 1 October 2026 to 30 September 2031. No final rule published; under OMB review since June 2026. About a quarter of Medicare fee-for-service	Nineteen OECD markets	in	The greater of two figures: the lowest list price in the nineteen that CMS can find, and, if the manufacturer volunteers its net prices, the average of those. Both adjusted for GDP per head at purchasing power parity. Volunteering net data can only raise the benchmark
GUARD	Medicare Part D	Still proposed (23 December 2025); mandatory if finalised; proposed from January 2027. No final rule published	The same nineteen	in	As GLOBE
Voluntary deals	All channels, by company	26 manufacturers, "89% of the branded drug market" (White House), as at 31 August 2026. The agreements are unpublished; asked by NPR, none of the first seventeen would confirm that all of its medicines would be discounted	"Comparable developed nations": not a published list	unstated	Deal terms, not a public formula

Status as at 21 September 2026. This table is the one hand-maintained part of the page and is rewritten when an instrument moves. The consequence of the reported exemption for Australia: the two instruments that would reference an Australian price are the two a GENEROUS participant would sit outside. This page does not follow the day-to-day of US policy; it reads the Australian side.

The baskets

Each country the US instruments reference, drawn as itself, one row per instrument class, west to east within the row; the shapes are not to a common scale. A different committee, a different population and a different price in every tile, so this is a map of who is in which basket and nothing else; tap, hover or tab to a tile for the pricing mechanism and whether its public price is a list price or a net one.

Tap, hover or tab to a tile: its basket, its pricing mechanism, and whether the public price is a list price or a net one.

The list-or-net distinction is most of the story: the eight are referenced on net prices that sponsors report; the nineteen on the prices available to CMS, and Australia's effective prices sit behind special pricing arrangements nobody publishes.

Every referenced market, and how its price is made

Market	Eight	Nineteen	Pricing mechanism	Public price is	Note
Canada	yes	yes	PMPRB ceilings, pCPA negotiation, CDA review	list public; pCPA net hidden	In both baskets; sector task force since March 2026
Denmark	yes	yes	Medicines Council	public	In both
France	yes	yes	HAS, CEPS negotiation	list public; rebates hidden	In both
Germany	yes	yes	AMNOG negotiated price after year one	negotiated, public	In both
Italy	yes	yes	AIFA negotiation	list public; rebates hidden	In both
Japan	yes	yes	NHI price list, biennial cuts	public	In both
Switzerland	yes	yes	FOPH price, external reference	public	In both
United Kingdom	yes	yes	NICE threshold, VPAG clawback	list public; VPAG rebate	In both
Australia	—	yes	PBAC, PBS, special pricing arrangements	list (DPMQ) public; effective hidden	In the nineteen, out of the eight
Austria	—	yes	HVB reimbursement code	public	Nineteen only
Belgium	—	yes	CTG-CRM	list public	Nineteen only
Czech Republic	—	yes	SUKL	public	Nineteen only
Ireland	—	yes	NCPE, HSE negotiation	list public; rebates hidden	Nineteen only
Israel	—	yes	health basket committee	public	Nineteen only
Netherlands	—	yes	ZIN, sluice negotiation	list public; net hidden	Nineteen only
Norway	—	yes	national list	public	Nineteen only
South Korea	—	yes	HIRA, NHIS negotiation	public	Nineteen only
Spain	—	yes	CIPM, national	list public	Nineteen only
Sweden	—	yes	TLV value-based pricing	public	Nineteen only
New Zealand	—	—	PHARMAC budget tender	public	Not referenced by any US instrument

A different committee, a different population and a different price in every row. This is a map of mechanisms, not a league table, and it deliberately carries no prices and no thresholds.

The barometer: Australia's price for a year of life

The PBAC does not publish a threshold. It publishes decisions, and each Public Summary Document states, or redacts, the cost per quality-adjusted life year the sponsor asked the committee to accept. Counted across every decision since 2015, band by band, the record shows how often the committee said yes at each stated figure, and how few decisions state one at all.

One honesty line before the chart. This is not the price MFN imports. The US instruments reference a country's list or net price for a medicine; the bands below are a stated dollars-per-QALY figure, often a threshold-seeking ask, and the effective Australian price sits behind special pricing arrangements the public does not see. The chart shows what the committee has been willing to accept. It cannot name the price anyone is paying.

recommended not recommended deferred, withdrawn, other · the figure above each bar is recommended as a share of recommended plus not recommended · decisions with a Public Summary Document, 2015 to date; the same slices the WTP Explorer reads

80%

of modelled decisions since 2015, meaning those with a stated or a redacted ICER, redact it entirely (478 of 594). Those were recommended 51% of the time. The share that is redacted is the number to watch each cycle.

828

decisions since 2015 asked for no incremental price at all: cost-minimisation, dominant, or cost-neutral against what is already listed. That is the largest single category in the record, and it is where a referenced price is most literally a reference to another price.

66%

of submissions stating $50,000 to $75,000 per QALY were recommended (n = 54), against 56% at $75,000 to $100,000 (n = 17) and 20% at $150,000 to $200,000 (n = 8: 1 yes, 4 no). The slope is the pattern; the small bands are small. Most of the yeses above $50,000 came with a risk-sharing arrangement, which is where the real price hides.

What this is not: a threshold the committee has ever stated, or a price. It is the pattern of what it accepted, at the cost per QALY sponsors were willing to put in writing. A redacted ICER is a decision made at a price the public cannot see, and the share of those is the number to watch each cycle.

What the Australian record shows

Australia is the country the instrument table is about: referenced by the mandatory Medicare models, not by the voluntary Medicaid one. Its public price is not its real price, so the honest sentence is this: we do not see net special-pricing-arrangement prices, and cannot say what price MFN would import from Australia. What we can see is the committee's behaviour and what happens after a yes.

218

medicines recommended by the PBAC and not yet listed, as at 2026-09-08. Who holds the next step for each is on the Access Board.

10.3%

of 2025 decisions were deferred, against 8.5% across 2015 to 2024: the highest share since 2017, and 1.21× the base rate.

64%

of 2025 decisions were recommended, in line with the 57% base rate. The committee is not saying no more often; it is saying not yet.

recommended deferred not recommended noted, withdrawn, other deferral share (right scale) · 2026 is two meetings, not a year

One year of higher deferrals is consistent with MFN and also with a committee asking for more evidence. The number that would settle it is time from recommendation to listing, which is not yet in this record and is the next thing to add.

The firms that have signed, in the Australian record

The US obligations attach to firms: the White House fact sheets name Medicaid prices, TrumpRx, and most-favoured-nation pricing on new medicines, and the agreements themselves are unpublished. If a firm were to change how it launches in Australia because of them, it would show here first, as fewer submissions, more withdrawals, or recommendations left unlisted. 26 manufacturers have signed. This is how much of the Australian record is theirs.

58%

of Public Summary Documents since 2020 were for a submission by one of the 26 (567 of 982).

106 of 218

medicines recommended by the PBAC and not yet listed are theirs, as at 2026-09-08. Each is on the Access Board.

7 of 17

items on the next published agenda are theirs (November 2026 PBAC Meeting; agenda read 2026-08-03).

57%

2020

92 of 162

55%

2021

89 of 161

61%

2022

94 of 155

68%

2023

98 of 145

56%

2024

87 of 156

52%

2025

81 of 156

55%

2026

26 of 47

Share of each year's Public Summary Documents that were for a signatory firm, by PBAC meeting year. The first deal was signed on 30 September 2025. A submission is lodged four to five months before its meeting and its document is published months after, so 2026 is incomplete and the first meetings that could show a change are only now being published.

No change can be read from this yet. 2025 is the lowest full year in the series at 52%, against 55% to 68% in the years before it, and almost all submissions to 2025 meetings were lodged before the first deal was signed. The share moved by as much between earlier years, before MFN existed. The count is here so that it can be read again each cycle, not because it has found something.

Manufacturer	Signed	Documents since 2020	Recommended, not yet listed	On the next agenda
AbbVie	by April 2026	31	5	1
Amgen	by April 2026	23	9	—
AstraZeneca	by April 2026	74	8	2
Boehringer Ingelheim	by April 2026	12	—	2
Bristol Myers Squibb	by April 2026	41	5	—
Eli Lilly	by April 2026	23	7	—
EMD Serono (Merck KGaA)	by April 2026	11	2	—
Genentech (Roche)	by April 2026	26	1	—
Gilead	by April 2026	12	3	—
GSK	by April 2026	30	8	—
Johnson & Johnson	by April 2026	38	12	—
Merck & Co (MSD)	by April 2026	36	4	1
Novartis	by April 2026	51	8	—
Novo Nordisk	by April 2026	9	4	—
Pfizer	by April 2026	42	7	—
Regeneron	by April 2026	—	—	—
Sanofi	by April 2026	27	7	—
Alcon	31 August 2026	4	1	—
Astellas	31 August 2026	15	5	1
BeOne Medicines	31 August 2026	8	1	—
BridgeBio	31 August 2026	—	—	—
CSL	31 August 2026	17	—	—
Kyowa Kirin	31 August 2026	6	1	—
Sun Pharma	31 August 2026	10	2	—
Teva	31 August 2026	11	3	—
UCB	31 August 2026	13	3	—

In signing order, then alphabetical: a register, not a ranking. Counts are by the Australian sponsor of record, mapped to today's parent: Alexion to AstraZeneca, Celgene to Bristol Myers Squibb, Allergan to AbbVie, Seqirus and Vifor to CSL, BeiGene to BeOne, ViiV to GSK. Sandoz is not counted with Novartis. A signatory whose medicines are sponsored here by a partner or a distributor shows a dash: Regeneron and BridgeBio have no Australian sponsor of record, and BridgeBio's acoramidis is on the November 2026 agenda under its distributor. A jointly sponsored submission counts once for each firm and once in the totals. The first seventeen are the recipients of the July 2025 pricing letters; the nine are named in the White House fact sheet of 31 August 2026.

What this page is not

Not a price league table, not a daily wire, not a ranking of firms, not medical advice, and not a trading note. A first-pass event study of PBAC outcomes against share prices, with approximate event dates, found nothing consistent in mid or large caps (mean abnormal return +1.9% and −0.1%, hit rates near a coin toss); the small caps, where a move would matter, were not priced. What moves is policy, and the instrument table above is the policy. The global read belongs to the people who do it daily; we hold the Australian file.

script.report provides factual analysis of public documents and general information about reimbursement policy. It does not provide financial product advice, does not hold an Australian Financial Services Licence, and nothing here is a recommendation to buy or sell any security.