Every month, it seems as if there is a new outrage over the ever-soaring cost of prescription drugs. But which drugs actually cost the most? Here are the 11 most expensive outpatient drugs, as of May 2018, based on list prices for a typical one-month prescription.
The 11 drugs on this list are all priced well over $25,000 for a monthly supply, and treat diseases rare diseases that afflict few people in the US.
Prices are based on the Wholesale Acquisition Cost (WAC), also referred to as a drug’s list price. This is the price the pharmaceutical company assigns as an official price to a drug, though actual costs to the patient may vary. While few people actually pay out of pocket for these drugs, as they are typically shielded by their health insurance, every year more people are on the hook for the price of their drug due to high deductible insurance plans and formulary changes. And high-priced drugs end up raising insurance rates and overall healthcare spending.
1. Actimmune – $52,321
Approved for osteopetrosis and chronic granulomatous disease, a rare disorder that causes the immune system to malfunction, Actimmune is manufactured by Horizon Pharma. Patients typically take Actimmune three times a week, and on average will go through about 12 single-use vials a month at $4,360 per vial.
2. Daraprim – $45,000
You might recall 2015 when Martin Shkreli sparked outrage for hiking the price of Daraprim from $13.50 per pill to about $750 per pill in a matter of days. While this caused a national conversation about drug prices and a class-action lawsuit, the price for Daraprim has still remained high – with the list price for a one month supply (60 tablets) coming out to $45,000.
Daraprim is commonly given to AIDS and transplant patients to prevent infection and is used to treat toxoplasmosis in otherwise healthy people. Unlike other drugs on this list, patients are rarely on Dariprim for more than a couple of months.
3. Cinryze – $44,140
Manufactured by Shire, the list price for a typical one month supply (16 vials) of Cinryze runs at $44,140. Cinryze is used to treat hereditary angioedema, a rare life-threatening genetic condition that causes swelling in various parts of the body including hands, face and throat.
4. Chenodal – $42,570
Chenodal, used to dissolve gallstones, is manufactured by Retrophin, which was founded by Martin Shkreli – the same person responsible for Daraprim’s price hike.
Back in 2014, while Shkreli was still CEO of Retrophin, prices for Chenodiol increased five-fold. What’s more, Chenodal is currently off patent, which means it is technically legal for affordable generics to be manufactured. However, Chenodal is protected under what is referred to as a “closed distribution system,” which prevents generic drug makers from purchasing a brand name drug.
While many patients take 90 tablets per month, some can take as many as 210 tablets per month, at a whopping $473 per tablet.
5. Myalept – $42,137
Myalept is an orphan drug used to treat leptin deficiency in patients with generalized lipodystrophy. Myalept is self-administered once-daily, and patients typically use 10 vials per month, at $4,213 per vial. Since Mylapet is the only option to control this rare condition there are no other cost-saving options available.
6. H.P. Acthar – $38,892
H.P. Acthar, also referred to as Acthar, is used to treat multiple conditions like Lupus, rheumatoid arthritis, multiple sclerosis, infantile spasms, ophthalmic conditions, psoriatic arthritis and more. It is manufactured by Mallinckrodt Pharmaceuticals and was approved back in 2010. Patients usually use one vial per month, which is priced at $38,892.
Just like many drugs on this list, Acthar has also seen its fair share of price hikes. Back in 2001, when Acthar was still manufactured by Sanofi, the list price for one vial ran at about $40. 17 years, and 1 new manufacturer later, the list price for one vial of Acthar runs at $38,892.
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7. Juxtapid – $36,992
Juxtapid is manufactured by Aegerion Pharmaceuticals to treat people with homozygous familial hypercholesterolemia, a gene mutation that leads to cardiovascular disease. Patients typically take 28 capsules of Juxtapid per month with a list price of $1,321 per capsule.
8. Firazyr – $32,468.40
Just like Cinryze mentioned above, Firazyr is manufactured by Shire for hereditary angioedema. However, unlike Cinryze, which is used to prevent swelling before an attack, Firazyr is used after an attack. Since patients suffer an average of two to four attacks per month, most fill one carton (3 syringes) of Fyrazar every month at a list price of $32,468.
9. Harvoni – $31,500
Harvoni is manufactured by Gilead and is the first once-daily combination drug used to treat Hepatitis C (HCV). Treatments for Hepatitis C are notoriously expensive, and the cost for Harvoni is no different. Patients typically take Harvoni for 12 weeks, and a one-month supply runs at $31,500 for 28 tablets – $1,125 per tablet.
10. Cuprimine – $31,426
Cuprimine is the oldest drug on this list and has been around since the 1970s. Manufactured by Valeant, Cuprimine removes copper build-up caused by Wilson’s Disease. Patients take one capsule of Cuprimine after every meal. With a list price of $261.89 per tablet, the cost of treatment quickly adds up.
Cuprimine’s price has been a hot-button issue and has even sparked debate in Congress and inspired an episode in a Netflix show Dirty Money.
11. Sovaldi – $28,000
Like Harvoni, Sovaldi is manufactured by Gilead to treat Hepatitis C. Patients take Sovaldi for 12 weeks; the fair price for a one month supply runs at $28,000.00 – $1,000 per tablet.
How did we get these prices?
We created a list of the most expensive drugs by list price, excluded drugs that are administered under the supervision of a healthcare provider and obtained typical fill quantities using our data and information from the drug manufacturer websites, to compare the monthly price of these drugs. Using the official manufacturer list price we calculated the total cost of a 1 month supply of a typical fill quantity. For drugs where there is a large effective dosing range, or where patient weight determines dosing, we select a conservative dosing quantity.