It doesn't matter where you are in the world, local healthcare providers want to hold down costs. So France and Italy directly regulate pharmaceutical prices, Germany and Italy control reimbursement, while in the UK, the Pharmaceutical Price Regulation Scheme (PPRS) controls profits.*Of the major countries, only the US allows an unfettered free market. The received wisdom is that countries that directly and strictly regulate reimbursement have lower pharmaceutical prices than the UK and the US. Indeed, US Presidential candidate Al Gore is understood to favour Federal pharmaceutical price controls. However, a new report from the UK Office of Health Economics (OHE) questions the value of making decisions about domestic reimbursement strategies based on international price comparisons - an increasingly favoured pastime among politicians - as well as the assumption that generic competition invariably drives down pharmaceutical costs.1