The Cost of Care: America’s Most Expensive Prescription Drugs Revealed

In light of the recent executive order aimed at lowering prescription drug prices, many Americans are turning their attention to the current costs of medications and the savings that could be realized. The order, announced by President Donald Trump, introduces the concept of “most favored nations drug pricing.” This policy means that Americans would pay the lowest price for a drug that is available in other developed countries.

According to Trump, some prescription drug prices could be reduced by as much as 90%. However, the journey to lower prices is not straightforward. Katy Dubinsky, a New York pharmacist and CEO of Vitalize, emphasizes that while the move is commendable, it won’t result in immediate reductions. The government agencies must first create the necessary rules, a process that may take time.

The focus now shifts to the most expensive prescription drugs in the United States. Understanding these medications can shed light on the broader context of drug pricing in America.

Understanding the Most Expensive Prescription Drugs by Price

Dubinsky outlines the five most costly prescription drugs based on their price. These medications often come with a high financial burden but are critical in treating severe and rare health conditions.

1. Lenmeldy (atidarsagene autotemcel) by Orchard Therapeutics – $4.25 Million

Lenmeldy targets metachromatic leukodystrophy, a rare genetic disorder that affects the nervous system. Administered only once, this treatment aims to slow the disease’s progression in young children.

2. Hemgenix (etranacogene dezaparvovec-drlb) by CSL Behring – $3.5 Million

Hemgenix is a groundbreaking therapy for individuals suffering from hemophilia B, allowing the body to produce its own clotting factor with a single treatment.

3. Elevidys (delandistrogene moxeparvovec-rokl) by Sarepta Therapeutics – $3.2 Million

This prescription is designed for young boys with Duchenne muscular dystrophy, a condition that significantly weakens muscle strength over time.

4. Skysona (elivaldogene autotemcel) by Bluebird Bio – $3 Million

Skysona treats cerebral adrenoleukodystrophy, a severe brain disorder in boys, aiming to mitigate damage before symptoms escalate.

5. Zynteglo (betibeglogene autotemcel) by Bluebird Bio – $2.8 Million

For patients with beta-thalassemia, Zynteglo is a form of gene therapy that aims to reduce the frequency of blood transfusions by enabling the production of healthy red blood cells.

Examining Drug Sales Volume

John Stanford, executive director of Incubate, emphasizes that often, the most expensive drugs are measured by sales volume rather than sheer list price. When the governing bodies analyze expenditure, they focus on drugs that generate significant revenue, which frequently impacts how policies are shaped.

1. Keytruda (pembrolizumab) by Merck – $25 Billion in 2023 Revenue

This immunotherapy drug is effective in treating various cancers, such as melanoma and lung cancer, and serves as a pivotal medication in Merck’s portfolio as it expands its cancer therapies.

2. Eliquis (apixaban) by Bristol Myers Squibb and Pfizer – $18.95 Billion

Often described as an anchor drug, Eliquis is used to prevent and treat blood clots, making it a crucial medication within the portfolios of both BMS and Pfizer.

3. Ozempic (semaglutide) by Novo Nordisk – $13.93 Billion

Initially prescribed for type 2 diabetes, Ozempic has gained popularity for its secondary effect of aiding weight loss, helping to fuel Novo Nordisk’s exploration of its broader applications.

4. Humira (adalimumab) by AbbVie – $14.4 Billion in U.S. 2023 Revenue

As one of the highest-grossing drugs in history, Humira remains a treatment option for rheumatoid arthritis and other inflammatory diseases, having generated significant revenue during its exclusivity period.

5. Biktarvy by Gilead – $11.85 Billion

Biktarvy is a leading HIV treatment that also plays a crucial role in Gilead’s strategy to expand into cancer research, underlining its importance in the pharmaceutical market.

Challenges and Future Considerations

Dr. Jacob Glanville, CEO of Centivax, argues that while the executive order may bring changes, it likely won’t affect the pricing of vaccines or most generic drugs, which typically cost less than a dollar each. He suggests that the focus should be on newer brand-name drugs still under intellectual property protection, as well as antibody and gene therapies that carry high treatment costs.

Glanville points out that while these therapies can be extremely expensive, they are often the most effective options for treating serious conditions. The pharmaceutical industry fears that lowering drug prices could result in reduced investment in research and development, stifling innovation for future treatments.

Moreover, balancing patient affordability with the need for continued medical breakthroughs presents a complex challenge. If medication prices are capped, stakeholders may need to explore ways to cut costs related to clinical trials and manufacturing, ensuring that developments in the pharmaceutical field remain sustainable.

Addressing the Healthcare Landscape

In a broader context, the rising costs of medical care in the United States create significant hardship for patients. Experts agree that the interplay of high medication prices, insurance complexities, and overall healthcare expenses must be strategically addressed to create a more equitable system.

Ultimately, while the executive order represents a step toward addressing prescription drug pricing, it is essential to continue the conversation surrounding health equity and the financial sustainability of innovative treatments.

Reporting contribution from Greg Norman of Fox News Digital.