Drugs in the United States can be expensive, whether you’re insured or uninsured. A number of the most expensive drugs on the market are referred to as “breakthrough therapies’’ which treat serious or life-threatening conditions.
According to the GoodRx tally, the most expensive pharmacy meds in the U.S. this year range from $71,306 per month for Amryt’s Myalept to $27,421 for Agios’ Tibsovo.
This article lists the most expensive drugs based on their yearly cost for a typical course of therapy.
Why Are These Drugs so Expensive?
Dr. Nouhavandi, Co-Founder and Co-CEO of online pharmacy HoneyBee Health, says the reason so many of these medications are so expensive is that their manufacturing processes are complex.
- Some of them are only one-time doses, and they don’t require repetitive dosing, so they’re convenient for patients to take.
- They usually treat unusual diseases that are not commonly seen, and they help patients recover from the conditions.
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Factors That Affect The Cost of Drugs
A large part of the high cost of some of today’s most advanced therapies is due to the complexity of the manufacturing process. However, many expensive drugs are repurposed generics.
The amount you spend on these drugs comes down to many factors.
- If you have insurance coverage for drugs.
- If the drug is on the health insurance formulary.
- Rebates and discounts from the manufacturer.
- Your prescription deductible and copay. If it’s a specialty drug, gene therapy, or biologic.
- You may be eligible for financial assistance from either the government (Medicaid, Medicare), discount coupons, or free samples from your doctor.
- Manufacturers’ prices and their interactions with pharmacy benefit managers (PBMs) will also be considered.
The true cost of any drug can be difficult to determine unless you go to the pharmacy or get a bill from them. There is a lack of transparency when it comes to how pharmaceutical companies price their products.
10 Most Expensive Drugs in the United States
Below are the 10 most expensive drugs in the U.S., including both pharmacies-dispensed drugs and healthcare practitioner-administered drugs. The vast majority of people don’t take most of these drugs – but their outsized costs can translate into higher insurance premiums.
1. Zolgensma
Price: $2,125,000
With its one-time cost of $2.1 million for a course of treatment, Zolgensma has remained the most expensive drug in the U.S. since its FDA approval in May 2019.
The drug Zolgensma is approved to treat spinal muscular atrophy, a rare childhood condition that can cause lung infections and muscle weakness if left untreated. The treatment is a one-time cure, and many children who have taken Zolgensma no longer show signs of the disease.
There are certain requirements patients must meet in order to qualify for coverage of Zolgensma, so gene therapy is not always covered by insurance companies. To entice insurers to cover the gene therapy, Novartis Gene Therapies has agreed to pay for Zolgensma in some cases.
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2. Zokinvy
Price: $1,032,480
The FDA approved Zokinvy in November 2020 for treating Hutchinson-Gilford progeria syndrome, and its cost is astronomical at over $1 million dollars per year. This is the only treatment approved for Hutchinson-Gilford progeria syndrome, a rare genetic disease that causes premature aging.
While dosage depends on body surface area, most patients take averaging 200 mg of Zokinvy per day, and with a price tag of $717 per 50-mg capsule, that comes to $86,040 per month. The Eiger OneCare Program can assist patients with insurance coverage and financial support options even though there is no copay card available for this drug.
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3. Danyelza
Price: $977,664
In November 2020, the FDA approved Danyelza for the treatment of pediatric and adult patients with neuroblastoma in the bone or bone marrow. It was approved under a faster approval program and is regarded as an orphan drug and a breakthrough therapy.
Nevertheless, Danyelza is not cheap. One vial costs $20,368 and a patient typically uses 48 vials a year, which means the annual cost comes to about $977,664. The manufacturer of Y-mAbs offers Y-mAbs Connect, a resource that helps patients deal with their insurance, as well as a patient assistance program.
4. Myalept
Price: $889,904
This is one of the only drugs that is dispensed from the pharmacy. Myalept is used to treat leptin deficiency in patients with generalized lipodystrophy, a condition in which fat is distributed abnormally in the body.
In the United States, Myalept costs $74,159 for a monthly supply of 14 vials. Patients use Myalept once a day and 14 vials per month on average, making the yearly cost $889,904. Because Myalept is the only available treatment for this rare illness, there are no other cost-saving options on the market.
Some patients can afford Myalept with the assistance programs offered by Aegerion Pharmaceuticals.
In order to reduce the amount of money you spend on hospital bills and drugs, you can obtain an insurance package from any of the 15 Largest Health Insurance Companies in the World.
5. Luxturna
Price: $850,000
With a price tag of $850,000 a year, Luxturna is the fifth-most expensive drug on the list. Luxturna is a gene therapy designed to treat an inherited condition called retinal dystrophy—a condition that can result in partial or complete blindness.
Patients can only receive one dose of Luxturna at a time, but the list price is incredibly steep, coming in at $425,000 per vial. As such, Luxturna cannot be purchased at a pharmacy as the medication must be administered by a physician directly into each eye. There should only be one dose of Luxturna required, but the list price is steep.
Spark Therapeutics Generation Patient Services can assist patients in navigating insurance coverage and connect them to other financial resources that can help them obtain this drug.
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6. Folotyn
Price: $817,865
A healthcare provider must administer Folotyn to patients, and the drug is given to them in the form of 135 vials yearly. It is approved to treat peripheral T-cell lymphoma, a rare blood cancer that can lead to death.
There are fewer than 9,500 cases of PTLC in the U.S. each year. Folotyn is classified as a cytotoxic antimetabolite (folate antagonist) and given intravenously when the disease progresses or when there are unacceptable side effects.
During April and July 2021, the manufacturer of Acrotech Biopharma increased the price for a vial by 1.9% and 1.5% respectively, making it $817,865.
For financial assistance information, contact the Folotyn STAR Copay Assistance Program at 888-537-8277.
7. Brineura
Price: $730,340
The medication Brineura treats a rare form of Batten disease called late infantile neuronal ceroid lipofuscinosis type 2 (CLN2). A disease is a group of rare conditions that affect the nervous system. For pediatric patients 3 years and older, Brineura helps treat the slow loss of walking ability. The list price of Brineura is $28,090 for a kit of two 150-mg vials.
The symptoms of Batten’s disease typically appear in the early years of life – between the ages of 2 and 4 – and include language delays, seizures, and difficulty coordinating movements.
It is recommended to take 300 mg every 2 weeks, which means a one-year cost of $730,340. Manufacturer BioMarin does offer patient support to patients with insurance as well as cash-paying patients through its copay assistance program.
You may want to see the 10 Highest Paid Pediatric Specialties in the World.
8. Blincyto
Price: $712,672
The eighth-most expensive drug on the list is Blincyto, which is manufactured by Amgen and is used to treat a rare form of acute lymphoblastic leukemia, a cancer of the blood and marrow. Blincyto can only be administered by a healthcare provider, and dosing is done in cycles. The first cycle, called the induction phase, is to reduce cancer cells. Cycles two through four, called consolidation phases, are meant to promote new healthy cells.
It is estimated that the average patient will use about 168 vials per year in each phase of the therapy. The current list price of each vial is $4,242.
9. Ravicti
Price: $695,970
A person with urea cycle disorders can suffer from confused states, coma, or even death if they do not receive treatment. Ravicti is used to treat these conditions, which cause high levels of ammonia in the blood.
Recently, Ravicti’s list price increased 4.8% to $5,273 for one bottle. Ravicti is dispensed in a pharmacy without requiring a healthcare practitioner to administer it. Patients typically receive 132 bottles annually.
Some patients may be able to save on Ravicti thanks to Horizon Therapeutics’ Horizon Cares Patient Assistance Program.
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10. Soliris
Price: $678,392
An infusion of Soliris is prescribed for adults experiencing paroxysmal nocturnal hemoglobinuria or atypical hemolytic uremic syndrome, conditions in which red blood cells are destroyed. Soliris comes with a high risk of infection. This is why the drug is included in a Risk Evaluation and Mitigation Strategy (REMS) program. Medications such as this have serious safety concerns and must be included in a REMS program.
The medication costs $678,392 per year and is administered by healthcare providers on a maintenance dose of 1200 mg every two weeks. Dosages may vary depending on the patient.
Soliris patients cannot receive a copay card, but the OneSource program from the manufacturer Alexion can assist them in navigating their health insurance policies.
Conclusion
Using data and information from the drug manufacturer websites, we identified the most expensive drugs in the United States as determined by their list prices, including drugs administered under the supervision of a healthcare provider.
The cost of prescription drugs can be quite high, especially for “breakthrough” therapies. However, individuals should take advantage of the different payment plans and reduced-cost schemes offered by the manufacturers.
Frequently Asked Questions On Most Expensive Drugs
Zolgensma is currently the most expensive drug in the U.S., with an estimated annual cost of $2,125,000.
In 2019, atorvastatin (marketed as Lipitor) was prescribed to 24.5 million U.S. citizens, or 7.5% of the population, as one of the statin medications used to prevent cardiovascular disease and treat abnormal lipid levels.
Every drug that’s proven to be safe is allowed to be put on the market in the United States, and the problems that causes are obvious, from high copays at the drugstore to people who can’t afford lifesaving medication.
In the US, the sales to volume weight ratio are significantly higher than in any other country, indicating that US drug prices are considerably higher than those in other countries.
U.S. consumers pay significantly more for drugs than consumers in similar countries, even when rebates are taken into account. Drug prices are nearly four times higher than average in the U.S.
References
- goodRx.com – 10 Most Expensive Drugs in the US, Period
- drugs.com – 10 of the Most Expensive Drugs in the US –
- talktomira.com – The 10 Most Expensive Drugs on the Market in 2022
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