More and more, specialty drugs carrying eye-popping price tags are winning FDA approvals. While more are certainly on the way—look at Novartis' recent presentation that a gene therapy could be worth millions per patient—analysts at drug pricing website GoodRx have tallied up the most expensive pharmacy-dispensed drugs in the U.S. per month as of November. Readers may notice many of pharma's costliest drugs are absent from the rankings, as many of those are administered in a doctor's office or hospital. For its ranking, GoodRx instead focused on retail pharmaceuticals.
Some are marketed by small pharma companies such as Vyera Pharmaceuticals, while top biotechs and pharmaceutical companies market others. Some have seen controversy, while others are lesser known. Rare disease meds make up much of the list, while some treatments such as those for hepatitis C treat diseases that affect millions of people. Gilead, Shire and AbbVie each have multiple offerings. The drugs range from about $300,000 per year to more than $600,000 per year. For reference, several doctor- or hospital-administered meds such as BioMarin's rare disease med Brineura rank above pharmacy meds; that med costs $702,000 per year before discounts.
Many drugmakers offer patient assistance programs to help patients afford the meds, and the prices are listed before confidential rebates and discounts.
Nos. 1 through 5: From a price-hike poster child to a blockbuster-to-be
Topping the drug pricing rankings is Horizon’s Actimmune for malignant osteoporosis and chronic granulomatosis. The drug makes routine appearances on most-expensive lists, and has changed hands several times since its 2000 approval. Horizon hiked its price by 9.9% at the end of last year, according to Jefferies analysts. The drug now costs $52,322 per month, according to GoodRx.
Behind Actimmune comes the controversial Daraprim, a toxoplasmosis treatment formerly marketed by Martin Skhreli’s Turing Pharmaceuticals and now sold by Vyera Pharmaceuticals. Shkreli increased the drug’s price by 5,000% overnight and lit a drug pricing firestorm that's led to a now-constant drumbeat of pricing criticism. Now, lawmakers and others are threatening more action against pharma, and the increased scrutiny has hurt the industry's pricing power.
Since the notorious price increase, Shkreli has been sentenced to a prison term on fraud charges relating to his time at another biotech, Retrophin. Daraprim costs $45,000 per month, GoodRx reports.
Shire’s hereditary angioedema drugs Cinryze and Takhzyro take the No. 3 and No. 4 spots, respectively, carrying list prices of $44,140 per month. Cinryze is the older of the two meds; patients typically require 16 vials in a month.
Takhzyro, for its part, won approval in August and requires two vials per month. Each vial costs $22,070 before discounts, according to GoodRx. Jefferies analysts have predicted $1.8 billion in peak sales for the newer drug, making it among the blockbusters on the most-expensive rankings. The two brands are part of a rare disease lineup that attracted a $62 billion buyout offer from Takeda—a deal set to close in January.
Behind Shire’s two meds falls Chenodal, a drug to dissolve gallstones marketed by rare disease drugmaker Retrophin. On Shkreli’s watch, in 2014, the drug's price grew fivefold, GoodRx reports. And even though Chenodal is off patent, generic drugmakers can’t duplicate it, thanks to a "closed distribution system" that prevents them from obtaining samples needed for testing, according to the website.
The drug costs $42,570 per month, because patients typically take 90 tablets at $473 per tablet, GoodRx said. Some patients need up to 210 tablets per month, though, pushing their monthly price to nearly $100,000.
Nos. 6 through 10: Featuring a new Ionis drug and an in-the-news Mallinckrodt med
Outside of the top 5, Aegerion's Myalept costs $42,138 per month and treats leptin d...
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