Which Health Conditions Have Seen the Biggest Drug Price Spikes Over the Past 5 Years?
According to a GoodRx analysis, the price for all drugs, brand and generic, has increased by 32% since 2014. This steep increase comes as no surprise, but a deeper look at price trends for some common conditions tells a more intricate story.
As it turns out, prices for drugs that treat certain conditions are rising faster than others. Specifically, prices for drugs that treat rheumatoid arthritis and anaphylaxis have increased by over 90% since 2014, while prices for depression and anxiety medications have dropped by 18%.
While the media continues to ring alarm bells over rising drug prices, it seems as if some Americans may be feeling these sharp increases more than others.
Price Change by Condition, 2014-2019
| Condition | Price change |
|---|---|
| Anaphylaxis | +96% |
| Rheumatoid arthritis | +92% |
| Diabetes | +58% |
| HIV | +42% |
| Asthma | +35% |
| Birth control | +18% |
| ADHD | +12% |
| Erectile dysfunction | +7% |
| Migraine | +5% |
| High cholesterol | +5% |
| Depression and anxiety | -18% |
| All drugs | +32% |
These numbers are even more staggering when you consider the rate of inflation. If drug prices were rising in line with the rate of inflation, we would only see an increase of 9.69% since 2014. Instead, we are seeing increases of nearly 100% in some cases.
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The following are some popular conditions that saw substantial changes in list price over the past 5 years. For an in-depth review of all conditions reviewed in this research, and a deep-dive into the methodology, read our white-paper here.
Rheumatoid arthritis
The average list price for rheumatoid arthritis medications has increased by 92% since 2014, and it may continue to climb.
Four popular brand drugs seem to be contributing to this steep rise in prices. Since 2014, list prices for Enbrel, Humira, and Xeljanz have all increased by over 100%, and the list price for Duexis has increased by 266%.
If these price increases weren’t enough, keep in mind that both Humira and Enbrel are biologic drugs that are made out of living cells. This means that they will likely never get affordable generics, as it is nearly impossible to make an exact replica of a biologic drug.
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Anaphylaxis
The average list price for anaphylaxis medications, like EpiPen and Adrenaclick, has increased by 96% since 2014, far surpassing the rate of increase in the average list price of all drugs (32%).
This increase may not shock many, considering the EpiPen controversy that occurred 2 years ago. Back in August 2016, many patients who filled their EpiPen or EpiPen JR prescriptions experienced sticker shock at the pharmacy. Those paying the cash price for EpiPen were hit with a bill for a whopping $600 or more for a pack of 2 auto-injectors. It soon came out that manufacturer Mylan had increased prices for EpiPen and EpiPen JR by 400% from 2011 to 2016.
In an effort to curb the high cost of anaphylaxis drugs, manufacturers and pharmacies have taken steps to release more affordable alternatives. Both Teva and Mylan released generic versions of EpiPen, and CVS slashed prices for the EpiPen alternative, Adrenaclick. These efforts are reflected in the list price trend—price increases for anaphylaxis medications halted in the middle of 2016 but have not dropped.
Erectile dysfunction
The average list price for erectile dysfunction (ED) drugs, which includes Viagra and Cialis, increased the fastest compared to the average drug list price for any other condition, at least up until 2018. In fact, in 2018, the average list price of erectile dysfunction medications was almost 150% more expensive than it was in 2014.
But after rising in lockstep multiple times per year, the average list price for erectile dysfunction medications dropped drastically and is now only 7% more expensive than it was 5 years ago.
So, what accounts for this drop in average list price? Three new generics. Since December 2017, the most popular erectile dysfunction medications, Viagra, Cialis, and Levitra, went generic, and prices for those generics have dropped off. In fact, since its approval, generic Viagra (sildenafil) has seen a 74% decline in list price.
While ED medications are more affordable than ever, you may notice from the graph above that the average list price still hasn’t returned to where it was in 2014. This is mainly due to brand-name ED drugs continuing to get more expensive: List prices for Viagra and Cialis have increased by 165% and 119%, respectively, since 2015.
Diabetes
Prices for diabetes medications are also on the rise. Since 2014, the average list price for diabetes medications has increased by 58%.
What’s driving this increase? A couple of things.
First off, the list price for one drug, Glumetza, has increased by nearly 1,000% since 2014. While this is a large increase, the cheaper, generic version of Glumetza, metformin ER, is more commonly prescribed.
From the chart above, you’ll see that the price for Glumetza skyrocketed in mid-2015 right before its generic, metformin ER, was released. This isn’t a coincidence. It’s a common pricing tactic manufacturers use to keep the prices of generics high, while still touting that generics are a bargain compared to the brands.
Secondly, according to previous research on diabetes medications, prices for non-insulin medications are far outpacing prices for insulins and are likely a large contributor to the increase in the overall list price of diabetes medications. Non-insulin medications like Victoza and Januvia have increased in list price by 72% and 59%, respectively, since 2014.
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Co-contributors: Jeroen van Meijgaard, PhD, Diane Li, and Clement B. Feyt, MPH
Methodology:
This analysis is based on the GoodRx List Price Index, a model created by GoodRx researchers. The index takes into account published list prices as set by drug manufacturers and dispensed in community retail pharmacies.
While few people actually pay the full list price of a drug, it is a powerful indicator of drug pricing trends because it informs other prices, like the cash price or copay that people pay in pharmacies. What’s more, high-priced drugs end up raising insurance rates and overall healthcare spending, which trickles down to patients in the end.
The list price index is used to track the evolution of the price of prescription drugs in the United States. It is calculated daily, taking into account day-to-day changes in list prices and quarterly changes in the prescription drug mix. The list price index starts on December 31, 2013, using the Q4 2013 drug mix and published list prices on December 31, 2013 and ends on August 31, 2019. The index is based on the prescription drug mix as dispensed, so price changes in high-volume and high-cost drugs will have more impact on the index than low-volume and low-cost drugs.
The GoodRx List Price Index uses a nationally representative sample of prescription fills from each quarter to estimate the drug mix across all community retail pharmacies for that time period. The drug mix is used to calculate the average price change of all drugs and is updated every quarter.
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