Furthermore, 7 of these 9 drugs were found by the Institute of Clinical and Economic Review (ICER) to be lacking sufficient clinical evidence to support such price increases. Not only did adalimumab top the list of best-selling drugs last year, but the anti-inflammatory medication ranked first in terms of the most substantial price hikes from 2016 to 2018.
Of the drugs listed, the ICER indicated that lenalidomide and dimethyl fumarate were the only 2 with new clinical evidence. However, the report noted that “this is not a determination that the new evidence necessarily justified these prices increases.”
Below are the top 9 drug price hikes based on wholesale acquisition cost (WAC) increase, net price increase, and overall estimated increase in drug spend.
1. Adalimumab (Humira)
WAC increase: 19.1%
Net Price increase: 15.9%
Drug spending increase: $1.86 billion
Indicated for: Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, adult and pediatric Crohn disease, ulcerative colitis, plaque psoriasis, adult and adolescent hidradenitis suppurativa, and adult and pediatric non-infectious uveitis.
2. Rituxan (rituximab)
WAC increase: 17%
Net Price increase: 23.6%
Drug spending increase: $806 million
Indicated for: non-Hodgkin lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, pemphigus vulgaris, granulomatosis with polyangiitis, and microscopic polyangiitis.
3. Pregabalin (Lyrica)
WAC increase: 28.3%
Net Price increase: 22.2%
Drug spending increase: $688 million
Indicated for: Neuropathic pain associated with diabetic peripheral neuropathy, neuropathic pain associated with spinal cord injury postherpetic neuralgia, adjunctive therapy for partial-onset seizures in patients 1 month of age and older, and fibromyalgia.
4. Elvitegravir, Cobicistat, Emtricitabine, Tenofovir (EVG/COBI/FTC/TAF) (Genvoya)
WAC increase: 14.3%
Net Price increase: 21.7%
Drug spending increase: $651 million
Indicated for: HIV in antiretroviral (ART)-naïve adults and pediatric patients aged 12 years and older and to replace the current ART regimen in virologically suppressed patients.
5. Emtricitabine/Tenofovir Disoproxil Fumarate (Truvada)
WAC increase: 14.3%
Net Price increase: 23.1%
Drug spending increase: $550 million
Indicated for: to be used in combination with other antiretroviral agents for the treatment of HIV-infected adults and childred aged 12 yeas and older and for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV in adulst and adolescents at high risk.
5. Pegfilgrastim (Neulasta)
WAC increase: 14.6%
Net Price increase: 13.4%
Drug spending increase: $489 million
Indicated for: decrease the incidence of infection as manifested by febrile neutropenia in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia and to increase survival in patients acutely exposed to myelosuppressive doses of radiation.
6. Tadalafil (Cialis)
WAC increase: 26.2%
Net Price increase: 32.5%
Drug spending increase: $403 million
Indicated for: erectile dysfunction and benign prostatic hyperplasia
7. Dimethyl Fumarate (Tecfidera)
WAC increase: 16.7%
Net Price increase: 9.8%
Drug spending increase: $313 million
Indicated for: relapsing forms of Multiple Sclerosis
8. Lenalidomide (Revlimid)
WAC increase: 25.8%
According to the report, ICER received public comment that lenalidomide experienced “important price increases,” but due to uncertainties in the volume of unit sales, they were unable to accurately determine the change in drug spending.
Indicated for: myelodysplastic syndromes, mantle cell lymphoma that has relapsed or progressed after 2 prior therapies, and multiple myeloma.
Institute for Clinical and Economic Review. Unsupported Price Increase Report. October 8, 2019. https://icer-review.org/wp-content/uploads/2019/01/ICER_UPI_Final_Report_and_Assessment_100819_Final.pdf. Accessed October 9, 2019.