ICER identifies a new set of “unsupported” drug price increases

The Institute for Clinical and Economic Review (ICER) has released its annual report on “unsupported” drug price increases, which it says have increased drug spending in the US by around $815 million.

The new list (PDF) highlights 10 drugs that have seen significant price increases in the last year, including five – from Gilead Sciences, Johnson & Johnson, Novartis, Exelixis and Pfizer – for which there is reportedly no evidence supporting the justify increases.

The five drugs chosen for the dubious award 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, and cancer therapy Exelixis Cabometyx (cabozantinib ) and Pfizer Xeljanz (Tofacitinib) for inflammatory diseases.

The worst offender, according to ICER, was Gilead, which increased Biktarvy’s wholesale cost (WAC) by 5.9%, adding $359 million to the country’s drug bill. Darzalex came in second – for the second time on the list – with a 7.6% increase in its WAC, increasing expenses by $190 million.

“For many of the most expensive drugs, we continue to see list price increases well above inflation,” commented Foluso Agboola, research director at Health Technology Assessment (HTA).

However, she added that since we began disclosing price increases in this way in 2019, “we have seen a decrease in the number of medicines that experienced significant price increases without any new clinical evidence.”

Another five drugs saw significant price increases based on 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 Tagrisso’s targeted cancer therapy ( Osimertinib) and Amgens Prolia (denosumab) for osteoporosis.

ICER emphasized that the classification of products in this latter category “should not be interpreted as meaning that the new evidence justifies the magnitude of the price increase.”

Keytruda led the five drugs with new findings with a 4.1% increase in WAC, increasing U.S. drug spending by $364 million.

The figures will likely inform U.S. lawmakers’ deliberations on strategies to curb drug price increases, although President-elect Donald Trump has not yet outlined his policy plans in this area. That includes, for example, whether he will continue to give Medicare the authority to negotiate drug prices established as part of President Biden’s Inflation Reduction Act.

Photo by Marek Studzinski To Unsplash