Abstract
Purpose – The purpose of this paper is to consider the efficiency of US healthcare in an international
context. The paper emphasizes the concept of efficiency and explores implications for pharmaceutical
marketing.
Design/methodology/approach – Literature review, economic theory, secondary data and bivariate
regression were used to describe and evaluate US healthcare spending and pharmaceutical marketing.
Findings – US healthcare spending is inordinately high as a share of gross domestic product
within developed countries and this is associated with a relatively high share of private finance. But
public sector finance is displacing private payment and this trend is especially pronounced
for pharmaceuticals. Public finance combined with fiscal pressure can be expected to curb use of
pharmaceutical detailing and other forms of marketing. The limits of affordability are not well assessed
and socio-economic institutions to facilitate decisions about present and future costs have yet to evolve.
Originality/value – This paper provides a macro perspective for healthcare finance and the
marketing of pharmaceuticals. It pioneers analysis of economics and international healthcare systems
integrated with the foundations of demand for pharmaceutical marketing.
Keywords National health expenditures, Efficiency, Pharmaceuticals industry, Marketing, Advertising,
United States of America
Paper type Conceptual paper