The 5 most expensive drugs in the united states electricity production in china


The amount Americans spend on prescription drugs has nearly doubled since the 1990s, a 2017 government investigation found, meaning the United States spends the most of any high-income nation. List prices rose 6% over the past 12 months alone, according to the prescription website GoodRx. Medicare drug prices soared 10 times the rate of inflation.

Americans didn’t always spend the most. In the 1980s, several countries spent equally, but US spending grew faster in the 1990s, according to a 2017 analysis from the Commonwealth Fund. This was partially because several expensive specialty drugs came to market, and because drug companies that set the price in the United States, unlike in Europe, which has price controls.

Generic versions of these medications can lower costs, and they now make up 90% of dispensed prescriptions, according to the IQVIA Institute for Human Data Science. Typically, multiple generic options are needed for one drug before it gets cheaper, according to a study published Tuesday in the journal Health Affairs.

"I think patients are right to have serious concerns about pricing," said study author Stacie Dusetzina, an associate professor in Vanderbilt University’s Department of Health Policy and Ingram associate professor of cancer research. "And in many cases, insurance benefits aren’t generous if they have insurance, meaning patients often pay far too much out of pocket. In some cases, people wind up draining their savings or losing their homes."

"That’s a myth that is prevalent in the pharmaceutical industry that drugs are so expensive because companies are taking all that money and plowing it back into research and development to discover the new drugs of tomorrow. That’s not really true," said Dr. Jerry Avorn, a professor of medicine at Harvard Medical School .

"Since companies set prices to whatever the market will bear, then it is not really a surprise that most companies which are for-profit want to get their shareholders the maximum price," Dusetzina said. "That’s merely being a rational actor in this marketplace."

Plenty of patients with common health problems shudder about the costs of drugs, but the most expensive drugs typically treat rare diseases. A few cure hepatitis C, which afflicts 3.5 million Americans; those medications, though expensive, need to be taken for only a short amount of time.

Some drugs have hit close to the $1 million mark, including a gene therapy, Luxturna, that can restore sight to children with a rare retinal disease. Its price was set at $850,000. A drug to treat hemophilia B that’s making its way through the approval process, SPK-9001, could cost $1.5 million.

GoodRx, which tracks drug prices, ranked the most expensive drugs available on an outpatient basis, based on the wholesale acquisition cost that a typical patient in a typical case would typically use in a month. That’s not necessarily what you’d pay, as several steps can add expense before it gets to you, but it’s an example of how expensive drugs can be.

Chronic granulomatous disease is a rare genetic disorder that affects cells in the immune system and stops a body from fighting infections effectively. A person with this disease will typically get a serious bacterial or fungal infection every three to four years. About one in 200,000 to 250,000 people worldwide has it, according to the National Institutes of Health.

Matt Flesch, a spokesman for Horizon Pharma, the maker of Actimmune, said in a statement that the wholesale acquisition cost is "not an accurate reflection of cost," and that many variables and "complexities in coverage" can affect the price. Flesch said the average net price is $24,000 per month.

Actimmune is "used by fewer than 500 people living with two extremely rare, life-threatening diseases, and we have assistance in place so that where applicable patients are able to receive the medicine regardless of their ability to pay," Flesch said.

Daraprim is an antiparasitic used to treat toxoplasmosis, an infection caused by one of the most common parasites in the world. More than 60 million Americans may be infected with it, according to the Centers for Disease Control and Prevention, but people with healthy immune systems rarely have symptoms. Those with compromised immune systems and pregnant women can have serious reactions such as brain disease, blindness or miscarriage.

Curtis Jackson, a pharmaceutical investor to whom Vyera referred questions, said that it takes about a billion dollars to create a drug. Daraprim was created in 1952, he said, so the money it brings in now doesn’t pay for its development but is being used to create a new version.

Cinryze is a C1 inhibitor to prevent attacks in people with hereditary angioedema, a rare condition that occurs in one in 10,000 to one in 50,000 people. The attacks involve swelling of the skin, mucous membranes or both. They can affect a person’s upper respiratory and gastrointestinal tracts and can be fatal.

Drug maker Shire PLC said in a statement, "Shire is committed to responsibly pricing our products to reflect their value and to help support patient access. If the therapy provides a meaningful impact on the lives of patients, if it fulfills that high, unmet need, value is created, and we price our products commensurate with that value. This approach also enables us to continue to invest in developing innovative therapies for patients living with rare conditions."

Myalept is an injectable that helps people with leptin deficiency, a rare disorder; only a few dozen cases are reported in the medical literature, according to the National Institutes of Health. Leptin is an important hormone that helps control metabolic processes. People with generalized lipodystrophy have little or no fat tissue all over the body. The drug lowers triglycerides, blood sugar and A1C levels.