Unjustified price increases for seven drugs in 2019 cost US healthcare $1.2 billion, CT can remedy this

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According to a report released today, in 2019 the US health system spent an extra $1.2 billion on price increases for seven drugs that were not supported by clinical evidence. Enbrel led this year’s list costing Americans $403 million extra for an 8.9% net price increase, after accounting for rebates. The Unsupported Price Increase report is published annually by the Institute for Clinical and Economic Review. ICER is an independent nonprofit think tank, and the US leader in fair, value-based pricing for drugs and other healthcare services.

ICER examined the top ten drugs with the largest US total sales and with a price increases over twice the rate of general inflation in 2019. ICER then assessed each drug on the list for “new evidence of a substantial improvement in net health benefit” that could justify the price increase. Only three of the ten had good, new clinical evidence to support the price increase. It is important to note that ICER did not comment on whether the new evidence was sufficient to justify the amount of the price increase. ICER estimated the extra cost to the US health system in 2019 for the price increases of each of the other seven drugs.

Unjustified drug price increases in 2018 and 2019 cost Americans $6.3 billion. In good news, the top seven unjustified drug price increases cost the US health system about $4 billion less in 2019 than in 2018. Humira had the highest unjustified price increase among all drugs. Humira and Tecfidera had unjustified large price increases in both 2018 and 2019.

Drug2018 – 2019 2017 – 2018 
 Net price percent changeResulting increase in US drug spending (in millions)Net price percent changeResulting increase in US drug spending (in millions)
Invega Sustenna/Trinza10.7%$203  
Rituxan  23.6%$806
Lyrica  22.2%$688
Truvada  23.1%$550
Neulasta  13.4%$489
Cialis  32.5%$403
Total $1,166 $5,106

In response to state policymaker requests, ICER also included 2019 insulin list price increases in their report. They found that among list prices for the top ten insulin products, five increased in price, most by far more than the rate of medical inflation, while prices for four were level, and one declined from 2018. List prices are especially important for consumers facing financial toxicity who do not benefit from rebates, including people without coverage or with high deductibles.

Massachusetts and Washington policymakers plan to tax 80% of unjustified drug price increases to lower drug costs and control premiums. Connecticut could use the ICER report to reduce drug costs for households, businesses, and government.