ICER Report: Price Hikes for Eight Drugs Lead to $1.3 Billion Increase in U.S. Healthcare Costs

December 12, 2023

The Institute for Clinical and Economic Review (ICER) reported that price increases for eight drugs led to a nearly $1.3 billion surge in U.S. healthcare spending in the last year without new evidence of added health benefits. AbbVie’s Humira, a rheumatoid arthritis medication, was the main contributor, with a 2% price hike resulting in an additional $386 million in spending. Other significant contributors to the increase were Johnson & Johnson’s Darzalex, Pfizer’s Ibrance, and Amgen’s Prolia, each adding over $100 million in spending due to unsupported price rises.

This report, ICER’s fifth annual review, now examines 250 drugs, expanded from 100 in its first edition. ICER, funded by non-profit foundations and an insurer, identified these drugs based on the most significant U.S. sales and only included those with price hikes exceeding inflation by more than two percentage points.

The analysis involved determining if price increases were supported by substantial clinical improvements in the last two years. Eight of the ten drugs on the final list needed more clinical evidence to justify their price hikes. Notably, Novartis’ Entresto and Incyte’s Jakafi did have supporting evidence.

Amgen’s Nplate, Prolia, and Xgeva were also highlighted for contributing to increased spending, with Nplate’s 7% price rise costing an additional $17 million. While Darzalex was on both ICER’s main and Medicare-specific lists, its Medicare price increases were justified by a 2020 study.

The National Pharmaceutical Council criticized the report, calling it flawed and stating that the pricing data was unreliable. They argued that ICER overlooked significant peer-reviewed evidence and used an insufficient evaluation timeframe. They cautioned that such reports could lead to misguided policies and restrict patient access to necessary treatments.

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[Source: BioPharma Dive, December 12th, 2023]

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