Top 20 Most Expensive Rx Drugs: New Ranking

A new Drug List compiled by the GoodRx Research Team shows which drugs are the most expensive in the U.S in 2021.

The research team of the GoodRx resource, which monitors the pricing policy of pharmaceutical manufacturers, has presented a new list of drugs with the highest list price in the United States.

A list of most expensive drugs in the USA (2021)

* List price is the price of a drug set by the manufacturer. Although few patients actually pay the list price since most Americans are protected to some degree by health insurance, the list price is still an informative indicator of how expensive a drug is.

It should be noted that the numbers in the list reflect the retail cost of a 30-day course of prescription drugs, the use of which does not require the participation of a medical specialist, and the patient can buy them at the pharmacy (albeit with a doctor’s prescription). That is, it did not include the notorious “most expensive drug in the world” from SMA Zolgensma or numerous cancer immunotherapy drugs: their use requires a visit to the clinic and the help of medical staff.

Leaderboard almost unchanged

While the prices of many of these expensive drugs have not changed since GoodRx researchers updated this list for the penultimate time, there are still some “variations” in the new edition. For example, the latest listing includes a new product, Qinlock, a drug for stromal tumors of the gastrointestinal tract, the only recently approved product added to the top luxury rating. The other newcomers to this list – Cerdelga and Korlym – entered the market earlier but never made it to the top 20.

GoodRx also noted that the manufacturer has increased the cost of the “regular” of this rating: the drug for multiple sclerosis Mavenclad has risen in price since 2020 by 6%. Many US patients cannot afford this expensive drug and even have to borrow money from banks. Those with a low credit score are not eligible for a bank loan. The only way out in these cases is a payday loan. Microfinance institutions approve 95% of loan applications and this is the secret of their popularity. It is very easy to meet the borrower’s requirements. For example, to get accepted for cash loans in GA, you only need to have a stable income and a government-issued ID. If accepted, you should expect to have the money in your bank account immediately.

In addition, the scandalous antiparasitic drug Daraprim took off from the list in connection with the entry into the American market of a cheaper generic drug, as well as the orphan drug Kynmaro and the antiviral Viekira XR.

“Tax” on orphan diseases and multiple sclerosis

If you look at the top ten in this ranking, it becomes clear that the most expensive drugs are mainly drugs developed for the treatment of rare diseases.

No. 1 on the list, an orphan drug intended for the treatment of a rare disease – generalized lipodystrophy. Today, Myalept is the only way to control this disease, there are no other drugs more readily available. Myalept last went up in January, from $64,859 to $71,306.

The second is the world-famous Mavenclad, which is used to treat recurrent forms of multiple sclerosis (MS). Patients receive two Mavenclad treatments 12 months apart, but still not everyone can afford this therapy. The manufacturer offers a co-pay card that can bring personal costs down to $0 per prescription, but this program is only for patients with commercial insurance.

A third drug, Ravicti, corrects a genetic disorder that causes the level of ammonia in the blood to rise. The average patient uses 11 vials of Ravicti in one month. The list price for one bottle of Ravicti is $5,031. The manufacturer launched the Horizon Patient Services program for uninsured and low-income patients, whereby they can get the drug for free.

No. 4, Actimmune, manufactured by Horizon Therapeutics, is used to treat a rare condition, chronic granulomatosis, and severe osteopetrosis. The Horizon Patient Services program works for those who cannot afford to pay for their treatment.

The fifth drug, Oxervate, is also indicated for the treatment of a rare disease, neurotrophic keratitis, a degenerative condition that causes the cornea to become desensitized. Patients typically take 28 vials of Oxervate over a 4-week period ($ 1,732 per vial). Fortunately, the manufacturer Dompe has developed several discount schemes, both for patients with commercial insurance and for vulnerable groups of the population.

Takhzyro is manufactured by Takeda and used to treat hereditary angioedema. To ease their financial burden, the Japanese company offers these patients a variety of OnePath Co-Pay co-payment schemes.

Juxtapid is designed to control lipids in people with homozygous familial hypercholesterolemia, another genetic disorder (although not so rare in the context of orphan diseases).

Cinryze is another Takeda drug for treating hereditary angioedema. Commercial patients can get it for as little as $0 through OnePath Co-Pay Assistance.

Chenodal (chenodeoxycholic acid), used for cholelithiasis, stands out somewhat on the list: it is made by Retrophin, which was founded by “Pharmabro” Martin Shkreli. Back in 2014, when Shkreli was CEO of Retrophin, the price of Chenodal jumped fivefold. Today, the drug has lost its patent protection, which usually means that other manufacturers can start making available generics. But Chenodal is protected by a so-called “closed distribution” system that prevents other pharmaceutical companies from starting to produce generics.

Finally, the tenth remedy, Gattex, is indicated for short bowel syndrome, a condition with malabsorption. Again, its manufacturer, Takeda, offers a variety of financial aid options for people in need.