Abstract
PurposeThe 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/approachLiterature review, economic theory, secondary data and bivariate regression were used to describe and evaluate US healthcare spending and pharmaceutical marketing.FindingsUS 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/valueThis 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.
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