This paper compares and contrasts outpatient pharmaceutical policies for the elderly in seven OECD nations: Australia, Canada, Germany, Japan, New Zealand, the United Kingdom, and the United States. Each country is facing an increasing financial burden due to rapidly growing numbers of elderly citizens, in number and as a percentage of population, and rising drug costs. As a result, they are struggling to balance varying levels of commitment to providing drugs for the elderly with the need to contain costs. Although each country's healthcare system is unique, the methods that each country is using to control rising pharmaceutical costs are similar. Many countries are gravitating toward the use of last-dollar rather than first-dollar coverage. All provide inpatient pharmaceutical coverage.