Prescription drug prices have gotten out of control for many Americans and many insurers. Some drugs cost as much as premium sports cars. Here are the five most expensive prescription drugs in 2016 as compiled by prescription drug comparison website GoodRx -- and which companies are profiting from them.
The price tag for hepatitis C virus (HCV) drug Sovaldi is a whopping $75,600 for a 30-day supply. Sovaldi's developer, Gilead Sciences (NASDAQ:GILD), launched the drug in December 2013. The HCV drug went on to generate sales of nearly $10.3 billion in 2014, although sales slipped in 2015 to "only" $5.3 billion after Gilead's follow-up product, Harvoni, was introduced.
Sovaldi's popularity stemmed from its great efficacy. The drug cured upwards of 90% of patients with HCV genotypes 1, 2, and 4 and 84% of patients with HCV genotype 3 in clinical studies. Because of these high cure rates previously unseen among hepatitis C patients, Sovaldi was a game-changer in treatment of the disease.
It's not surprising that the second most expensive drug is Sovaldi's successor, Harvoni. Harvoni cost $74,000 for a 30-day supply according to GoodRx's data. Gilead Sciences launched the HCV therapy in the fourth quarter of 2014. Harvoni went on to rack up sales of nearly $13.9 billion in 2015. Harvoni's astounding financial performance was the result of cure rates even higher than those for Sovaldi. The drug also didn't need to be taken in combination with another therapy.
However, in some ways, Harvoni's success came too quickly and too intensely for Gilead. During the first nine months of 2016, sales for the HCV drug fell nearly 30% compared to the prior year period. A key challenge was that the sickest patients began using the drug immediately after it became available. Many were cured and no longer needed treatment.
Cinryze, an injectable drug used to help prevent swelling and pain in patients with hereditary angioedema (HAE), cost $72,100 for a 30-day supply. The drug first won U.S. regulatory approval in 2008. Its original developer, Lev Pharmaceuticals, was bought by ViroPharma that same year. ViroPharma was subsequently acquired by Shire Pharmaceuticals (NASDAQ: SHPG) in 2013.
Although HAE is a rare genetic disorder that affects no more than one in 10,000 people, Cinryze has been a big moneymaker for Shire. Sales for the drug in 2014 totaled $503 million and rose in 2015 to $618 million.Cinryze is on track to have an even better year in 2016: Sales during the first six months topped $337 million.
4. H.P. Acthar
H.P. Acthar is perhaps the most controversial member of the list of the five most expensive drugs in 2016. The drug, which first won FDA approval back in the 1950s, comes with a price tag of $51,600 for a 30-day supply. H.P. Acthar is also the most expensive drug on a per-patient basis for Medicare.
The controversy about H.P. Acthar stems both from its price and its efficacy. Mallinckrodt (NYSE:MNK) markets the drug as a treatment for 10 indications. H.P. Acthar is approved for 19 indications. Some payers have balked at reimbursing the drug for any indication other than infantile spasms. Despite these headwinds, Mallinckrodt made $1.16 billion from H.P. Acthar in its last fiscal year.
Like Sovaldi and Harvoni, Daklinza treats HCV. And like the other two drugs, Daklinza is also quite expensive, with a 30-day supply costing $50,700. Bristol-Myers Squibb (NYSE:BMY) gained U.S. approval for the drug in 2015.
Did Bristol's win with Daklinza negatively impact Gilead? Not at all. The U.S. Food and Drug Administration (FDA) approved the drug only in combination with Sovaldi in treating HCV genotype 3. While Bristol made $1.3 billion with Daklinza in 2015, Gilead was also making money with every sale.
Price versus value
There's no doubt that all of these drugs are very expensive. However, Gilead and Bristol-Myers Squibb would point to the healthcare costs that their HCV drugs save and maintain that the high price tags represent a good value overall. Shire and Mallinckrodt would probably make the case that their drugs offer treatment alternatives for patients than other therapies.
This argument about price versus value will continue into 2017 and beyond. And it's likely that the price tags for the most expensive drugs next year will be even higher, regardless of which drugs make the list.