The Most Expensive Drugs of 2016

Sovaldi tops the list

Prescription drug prices have gotten out of control for many Americans and many insurers, with some medications costing as much as premium sports cars, according to health-care investments analyst Keith Speights, writing for The Motley Fool. Speights recently reviewed the five most expensive drugs of 2016.

Sovaldi (sofosbuvir, Gilead Sciences) topped the list, costing approximately $75,600 for a 30-day regimen. It is something of a “miracle drug” for patients with hepatitis C virus (HCV) infection, showing a 90% cure rate for genotypes 1, 2, and 4, and an 84% cure rate for genotype 3. The drug was launched in December 2013 and generated sales of nearly $10.3 billion in 2014. The following year, however, Gilead’s earnings from the drug dropped by half with the introduction of its follow-up product, Harvoni (ledipasvir/sofosbuvir).

Harvoni was 2016’s second most-expensive medication, costing $74,000 for a 30-day supply. On the plus side, the drug provides cure rates even higher than those of Sovaldi, and it doesn’t need to be taken in combination with another therapy. Harvoni racked up sales of nearly $13.9 billion in 2015 thanks to heavy initial uptake. During the first nine months of 2016, however, sales for the drug fell nearly 30% compared with the prior year. Speights offers a simple explanation for the drop: many patients were cured and no longer needed treatment.

Cinryze (C1 esterase inhibitor [human], Shire Pharmaceuticals) was number 3 on Speights’ list of big-ticket treatments. An injectable drug, it is used to help prevent pain and swelling in patients with hereditary angioedema. A 30-day supply costs $72,100. Sales during the first six months of 2016 topped $337 million.

The fourth most-expensive medication of 2016 was H.P. Acthar gel, first approved in the 1950s. The repository corticotropin injection product is currently marketed by Mallinckrodt for 10 indications, including arthritis, multiple sclerosis, and bowel inflammation. Costing $51,600 for a 30-day supply, it is the most expensive drug on a per-patient basis for Medicare. Mallinckrodt made $1.16 billion from H.P. Acthar in its last fiscal year.

The fifth and final high-priced drug on Speights’ list was Daklinza (daclatasvir, Bristol-Myers Squibb), which––like Sovaldi and Harvoni––is indicated for patients with HCV infection. A 30-day supply costs $50,700. The FDA approved Daklinza in 2015, but only for use in combination with Sovaldi for patients with genotype-3 HCV infection.

An article posted on the BioSpace website adds Exondys 51 (eteplirsen, Sarepta Therapeutics) to Speights’ list. The controversial muscular dystrophy drug costs approximately $300,000 for a year’s treatment. One insurance company, Anthem, has chosen not to pay for the drug, arguing that it is “investigational and not medically necessary.” Humana agreed to cover it, but only for a six-month treatment if the drug was covered by initial approval. Moreover, Humana will cover the second six months only if the patient remains ambulatory. 

Sources: The Motley Fool; December 19, 2016; and BioSpace; December 19, 2016.