ICER identifies new crop of 'unsupported' drug price rises

News
Marek Studzinski

The Institute for Clinical and Economic Review (ICER) has published its annual report on "unsupported" price increases for medicines that it says have added around $815 million to US drug spending.

The new list (PDF) highlights 10 drugs that saw substantial price increases in the last year, including five – from Gilead Sciences, Johnson & Johnson, Novartis, Exelixis, and Pfizer – that it claims have no evidence to warrant the hikes.

The five drugs singled out for the dubious accolade are Gilead's HIV blockbuster Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide), J&J's blood cancer therapy Darzalex (daratumumab), and Novartis Entresto (sacubitril/valsartan) for heart failure, alongside Exelixis' cancer therapy Cabometyx (cabozantinib) and Pfizer's Xeljanz (tofacitinib) for inflammatory diseases.

The worst offender was Gilead, according to ICER, which raised the wholesale acquisition cost (WAC) of Biktarvy by 5.9%, adding $359 million to the nation's medicines bill. Darzalex came in at number two – its second time on the list – with a 7.6% increase in its WAC that added $190 million to spending.

"We continue to see list price increases that are far above the rate of inflation for many of the costliest drugs," commented Foluso Agboola, head of research at the health technology assessment (HTA) organisation.

However, she added that since it started exposing price increases in this way in 2019, "we have noticed a decrease in the number of drugs that have significant price hikes without any new clinical evidence."

Another five drugs were deemed to have had substantial price rises with new clinical evidence, including MSD's Keytruda (pembrolizumab), AstraZeneca's Imfinzi (durvalumab), and Bristol-Myers Squibb's Opdivo (nivolumab) – all cancer immunotherapies – as well as AZ's targeted cancer therapy Tagrisso (osimertinib) and Amgen's Prolia (denosumab) for osteoporosis.

ICER emphasised that putting products in this latter category "should not be interpreted to mean that the new evidence justifies the level of price increase."

Keytruda headed the five drugs with new evidence with a 4.1% increase in WAC that added $364 million to US drug spending.

The figures will likely feature in deliberations among US lawmakers about strategies to control medicine price increases, although President-elect Donald Trump has not yet articulated his policy plans in this area. That includes, for example, whether he will continue allowing Medicare the power to negotiate drug prices introduced under President Biden's Inflation Reduction Act.

Photo by Marek Studzinski on Unsplash