As outrageous as the cost of health care can be in the United States, it's nothing compared to the markup on some prescription medicines.
While companies certainly have to recoup their research and development costs and earn a profit for investors — and the exclusive window before a generic version of a drug goes on sale is the optimal time to do so — those prices can sometimes get out of hand.
In 2015, you might recall, the price of Daraprim, which is used by AIDS and transplant patients, famously soared from $13.50 per pill to $750, which sparked an outrage. (As of last August, the price was down to $375 per pill, which hasn't done much to dissuade critics.) Last August the cost of a two-pack of EpiPens jumped to $600 (versus $90 a decade prior). That hike has resulted in a class-action lawsuit.
President Donald Trump has vowed to unveil a system that would dramatically reduce the price Americans pay for prescription drugs. So far, that has failed to materialize. Citi analyst Andrew Baum, though, wrote the administration's failure to get enough votes to pass the GOP's first pass at a health proposal "increases the legislative risk to pharma pricing."
Should some method to combat high drug prices materialize, regardless of origin, it would still likely not go into effect for some time, given expected resistance from pharmaceutical companies and the general slow pace of government.
For now, patients are stuck fighting their insurance companies to cover bills that can be jaw-droppingly expensive. GoodRx, which monitors the price of prescription drugs, has compiled a list of the most expensive ones on the market.
Prices listed are for a 30-day supply and do not factor in insurance or discount coupons. Both of those factors can make a big impact on the out-of-pocket price consumers pay, but vary wildly from person to person.
It's also important to note that what's reflected here are not the wholesale prices of these drugs, but rather prices taken from data gathered by GoodRx that is based on 'usual and customary' prices (aka retail prices) where pharmacies submitted four or more claims over a three-month period. (Extreme outlying claims were eliminated and not included, says Doug Hirsch, co-CEO of GoodRx.)
"To be clear, the prices we posted are from actual claims that were submitted by a pharmacy," says Hirsch. "This price is not necessarily reflective of the actual price paid but is the best indicator we have of a 'list' price. ... Drug manufacturers ... quote an average wholesale price, but they do not control the retail price that is submitted by the pharmacy."
Consumers, Hirsch acknowledges, could pay much less than the submitted retail price.
With that in mind, here's a look at the Top 10 from January 2017.
Correction: After this story went to press, GoodRx's revised its list of the most expensive prescriptions in the United States. Previously, GoodRx included Mytesi in error, when in fact this drug, distributed by Napo Pharmaceuticals, ranges in price from $617 to $638 per month. Mytesi is a diarrhea treatment that has been studied specifically for HIV patients. Napo provides people living with HIV/AIDS broad, affordable access to the drug.
Harvoni
Cost: $87,800
Who makes it: Gilead Sciences
What it does: This hepatitis C drug has actually seen its price increase substantially in recent months. It was ranked the second most expensive drug of 2016, with a 30-day supply running $74,000. At press time Harvoni was priced at $87,800 — an increase over 2016 by $13,800. The price jump could be due to its extremely high effectiveness rate (since patients no longer need treatment after finishing the 12- to 24-week supply. It also often doesn't need to be taken in combination with other drugs, and users require just a single pill per day, which has made it a popular choice among doctors.
Sovaldi
Cost: $73,800
Who makes it: Gilead Sciences
What it does: Another popular and effective hepatitis C treatment, also available as a once-daily pill, is Sovaldi. It is slightly older than Harvoni. First introduced in late 2013, Sovaldi was the first of the treatments for the disease that showed cure rates of close to 90 percent — substantially higher than previous options.
Epclusa
Cost: $73,300
Who makes it: Gilead Sciences
What it does: The third leg in Gilead's trilogy of hepatitis C treatments, this drug, which was approved in July 2016, boasts success rates of nearly 99 percent. It's quickly becoming the preferred option of many physicians and may be prescribed alone or, if patients have cirrhosis, with ribavirin.
Zepatier
Cost: $52,600
Who makes it: Merck
What it does: You might be sensing a theme here. Zepatier is another hepatitis C treatment, taken once a day for 12 weeks (like all of the preceding entries). Part of the reason there are so many options is because a large number of hepatitis C treatments were approved by the FDA over the past several years, says Elizabeth Davis of GoodRx. (As such, few have generic alternatives at this time.)
Bexarotene
Cost: $49,800
Who makes it: (generic)
What it does: Of all the expensive drugs on this list, there's only one that has been around long enough for generics to be possible. What's strange, though, is the generic version — bexarotene — is apparently more expensive than the name brand, Targretin, which didn't make the list. It comes in two forms: a gel or capsule. Both treat patients with certain types of T-cell lymphoma.
Daklinza
Cost: $49,400
Who makes it: Bristol-Myers Squibb
What it does: Another hepatitis C medication, Daklinza is unique in that it has the ability to treat a specific genotype that, until now, has been the hardest to cure. It's often taken in conjunction with Sovaldi, which makes the cost to the patient even more painful. The cocktail of those two drugs, however, has shown cure rates of 98 percent.
HP Acthar
Cost: $40,800
Who makes it: Mallinckrodt Pharmaceuticals
What it does: This antiinflammatory is used by multiple sclerosis patients and people with gout, among others. It's designed for people who can't handle the side effects that accompany high doses of corticosteroids or who have not seen results from those in the past.
Viekira Pak
Cost: $34,600
Who makes it: AbbVie
What it does: This hepatitis C treatment combines three tablets (taken at one time) and boasts a 95 percent cure rate. You'll take this a bit longer than the other, more expensive hep C treatments on this list, though — sometimes as long as 24 weeks.
