DOSE OF REALITY: BIG PHARMA’S PRICES FOR COSTLIEST 2025 MEDICATIONS OUTPACE FAIR PRICE ESTIMATES BASED ON CLINICAL VALUE
Highest Priced Brand Name Treatments Showcase Big Pharma’s Rising Launch Prices, Disconnect from Cost-Effectiveness Benchmarks
A new report from Fierce Pharma details the most expensive prescription drugs in the United States in 2025. The list, dominated by multimillion-dollar gene therapies, provides an opportunity to review the growing gap between Big Pharma’s out-of-control prices, especially on newly launched brand name products, and their clinical value for patients.
Many of the highest priced treatments on the list have been evaluated for cost‑effectiveness relative to clinical benefit by the Institute for Clinical and Economic Review (ICER), which issues a health‑benefit price benchmark (HBPB) to reflect a drug’s fair value. Time and again, Big Pharma’s list prices soar far beyond these benchmarks for a fair price.
For example, Big Pharma giant Novartis placed a $2.32 million price tag on rare disease gene therapy Zolgensma. ICER’s health-benefit price benchmark estimates a fair price for the treatment would fall between $310,000 and $900,000. At launch, Zolgensma was the most expensive treatment in the world, netting more than $1.2 billion in 2024 sales for Novartis.
Additional examples of the disparities between Big Pharma’s prices and estimates for a fair price among the highest price treatments this year include:
- Lenmeldy ($4.2M Price vs. $2.3M Estimate for Fair Price)
- Hemgenix ($3.5M Price vs. $2.9M Estimate for Fair Price)
- Lyfgenia ($3.1M Price vs. $1.3M Estimate for Fair Price)
- Roctavian ($2.9M Price vs. $1.9M Estimate for Fair Price)
- Zynteglo ($2.8M Price vs. $2.1M Estimate for Fair Price)
- Casgevy ($2.2M Price vs. $1.3M Estimate for Fair Price)
Lenmeldy, Hemgenix and Roctavian all entered the market in 2023 with launch prices outpacing their fair price estimates.
Get a Dose of Reality on Big Pharma’s increasingly out-of-control launch prices, and egregious prices unjustified by clinical benefit below.
OUT-OF-CONTROL LAUNCH PRICES
According to a Reuters analysis, launch prices for prescription drugs first entering the market in the United States have more than doubled since 2021. Big Pharma has been setting increasingly out-of-control launch prices on new medications when they face no competition in the market and have the greatest possible remaining periods of exclusivity — routinely extended through abuse of the U.S. patent system. Of the 45 medicines surveyed in 2024, the median annual list price was more than $370,000 compared to a median launch price of $300,000 in 2023 and $222,000 in 2022.
A study published in JAMA Network found the median launch price for 30 drugs was $180,000 in 2021. That study, conducted by researchers affiliated with Harvard University and Brigham and Women’s Hospital, found that for 14 years, “from 2008 to 2021, launch prices for new drugs increased by 20 percent per year.” Big Pharma’s egregious pricing practices, including setting out-of-control launch prices on new products and anti-competitive tactics, impose an unsustainable burden on American patients, taxpayers and the U.S. health care system.
UNJUSTIFIED PRICE HIKES
ICER’s Unsupported Price Increase Report from December 2024 examines substantial price hikes on prescription drugs without new clinical evidence or improvements to justify the increases. Several pharmaceutical giants were on this year’s list of top offenders, including Gilead Sciences, Johnson & Johnson, and Novartis. The report offers the latest reminder that Big Pharma’s price hikes are about boosting profits, not true innovation.
Here are some takeaways from ICER’s most recent analysis:
- Gilead Sciences’ HIV drug Biktarvy — a case study in Big Pharma’s patent abuse — topped the list, costing taxpayers an additional $359 million after the company increased the drug’s price 5.9 percent in 2023.
- Johnson & Johnson raised the price of multiple myeloma treatment Darzalex by 7.6 percent in 2023, costing American patients an additional $190 million.
- Big Pharma giant Novartis increased the price of its heart treatment Entresto by 6.2 percent, resulting in $108 million in additional spending.
- Amgen raised the price of osteoporosis medication Prolia by 7.6 percent, causing spending to rise $140 million in 2022.
- Amgen also increased the price of bone marrow stimulant Nplate by 6.8 percent, totaling an additional $17 million in spending.
BIG PHARMA’S UNJUSTIFIED PRICE HIKES COST AMERICAN TAXPAYERS $805 MILLION
An analysis conducted by ICER found Big Pharma hiked prices on seven of the top 10 most popular drugs in 2021, with no accompanying increase in clinical value — increasing overall drug spending in the U.S. by $805 million. The price of the costliest drug, Horizon Therapeutics’ gout treatment Krystexxa, increased by 12 percent, raising out-of-pocket spending by $3,210 on average per patient. Prices for the second and third most widely used drugs among Medicare Part B beneficiaries, Seagen’s cancer drug Adcetris and Ipsen’s injection Somatuline Depot, were both hiked by $1,000 per patient.
Read the full report from Fierce Pharma HERE.
Read more on Big Pharma’s out-of-control launch prices HERE.
Read more on how Big Pharma’s innovation arguments don’t hold up to scrutiny HERE.
Learn more about market-based solutions to hold Big Pharma accountable and lower drug prices HERE.
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