Which drugs might be hit by US Democrats’ pricing proposals?
US drug pricing is set to remain a hot topic ahead of next year’s elections. And now the Democrats have unveiled their plans to lower drug spending, via proposals put forward by House Speaker Nancy Pelosi yesterday. The most eye-catching was probably a scheme to allow the government to directly negotiate prices for drugs covered by Medicare, using overseas costs as a benchmark. The proposals call for direct negotiation for at least 25 drugs, rising to up to 250. It is still not clear which drugs might be included in the plans, which in any case are a long way from becoming reality. But a look at the most expensive drugs covered by Medicare Part D in 2017 – the most recent year for which data are available – suggests some potential contenders. And diabetes drug makers, which have already faced pricing squeezes, look to be right in the firing line.
| The 25 most expensive drugs covered by Medicare Part D in 2017 | ||||
|---|---|---|---|---|
| Product | Company | Disease area | Gross cost ($bn) | No. of patients treated |
| Revlimid | Celgene | Oncology | 3.3 | 37,000 |
| Eliquis | Bristol-Myers Squibb/Pfizer | Bleeding | 3.1 | 1.1m |
| Januvia | Merck & Co | Diabetes | 2.8 | 892,000 |
| Lantus Solostar | Sanofi | Diabetes | 2.6 | 1.1m |
| Xarelto | Johnson & Johnson/Bayer | Bleeding | 2.6 | 952,000 |
| Harvoni | Gilead | Liver disease | 2.6 | 32,000 |
| Lyrica | Pfizer | CNS | 2.5 | 875,000 |
| Advair Diskus | Glaxosmithkline | Respiratory | 2.4 | 1.1m |
| Humira Pen | Abbvie | Autoimmune disease | 2.0 | 52,000 |
| Spiriva | Boehringer Ingelheim | Respiratory | 1.7 | 717,000 |
| Lantus | Sanofi | Diabetes | 1.6 | 614,000 |
| Novolog Flexpen | Novo Nordisk | Diabetes | 1.5 | 546,000 |
| Symbicort | Astrazeneca | Respiratory | 1.5 | 995,000 |
| Copaxone | Teva | CNS | 1.5 | 26,000 |
| Sensipar | Amgen | Kidney disease | 1.4 | 154,000 |
| Levemir Flextouch | Novo Nordisk | Diabetes | 1.4 | 508,000 |
| Ibrance | Pfizer | Oncology | 1.4 | 20,000 |
| Imbruvica | Abbvie/Johnson & Johnson | Oncology | 1.4 | 19,000 |
| Renvela | Sanofi | Kidney disease | 1.3 | 184,000 |
| Enbrel Sureclick | Amgen | Autoimmune disease | 1.2 | 32,000 |
| Humalog Kwikpen U-100 | Lilly | Diabetes | 1.1 | 414,000 |
| Restasis | Allergan | Ophthalmology | 1.0 | 565,000 |
| Victoza 3-Pak | Novo Nordisk | Diabetes | 1.0 | 21,000 |
| Tecfidera | Biogen | CNS | 1.0 | 17,000 |
| Latuda | Sumitomo Dainippon Pharma | CNS | 1.0 | 112,000 |
| Total: $45bn | ||||
| Source: EvaluatePharma. | ||||
