An anti-cancer drug, Yervoy, that costs more than $43,000 per prescription, topped the list of the most expensive drugs sold in Oregon, according to a state report.
The second most expensive drug, Ocrevus, used to treat multiple sclerosis, was nearly as costly, priced at about $39,700 per prescription. But Humira, which targets rheumatoid arthritis and ulcerative colitis, again racked up the most sales: $81 million.
The just-released annual report by the Oregon Department of Consumer and Business Affairs is part of the state’s drug transparency program, established in 2018 to hold drug manufacturers accountable for prices. The industry has lined up against the program, filing lawsuits to try to overturn it.
No single manufacturer dominated the top 10 list.
Yervoy is produced by New York-based Bristol Myers Squibb, and Ocrevus is manufactured by Switzerland-based Roche Group. The third most expensive drug, Soliris, is made by Alexion Pharmaceuticals, based in Boston, Massachusetts. Soliris costs nearly $35,000 per prescription and is used for atypical hemolytic-uremic syndrome, a kidney disease. Among the top drugs in overall sales, Humira is produced by Illinois-based Abbvie. It sold about 17,400prescriptions in Oregon, costing an average of about $4,650 per prescription. A distant second in overall sales was Enbrel, produced by California-based Amgen, on which $33.7 million was spent statewide. Enbrel is used to treat psoriatic arthritis.
The data come from reports by insurers for commercial individual and small-group plans, which cover only a small portion of state residents. Prices paid for these and other drugs through large-group commercial plans, Medicaid or Medicare were not collected and may be different.
Here are the most expensive drugs listed in the state report:
Drug Cost Per Prescription Treatment Manufacturer Yervoy $43,525 cancer Bristol Myers Squibb, New Jersey Ocrevus $39,701 multiple sclerosis Roche Group, Switzerland Soliris $34,985 rare blood disorders Boston-based Alexion, Massachusetts Kalydeco $24,154 cystic fibrosis Vertex, Massachusetts Trikafta $23,362 cystic fibrosis Vertex Symdeko $22,513 cystic fibrosis Vertex Keytruda $15,613 cancer Merck & Co., New Jersey Revlimid $15,001 cancer Bristol Myers Squibb Xyrem $12,643 narcolepsy Jazz Pharmaceuticals, Ireland Mavyret $12,565 hepatitis Abbvie, Illinois
The state also collects some other pricing data from drug manufacturers – although the drug industry is suing the state in federal court to overturn two new disclosure-requirement laws. Those two laws do not actually regulate prices pharmaceutical companies can charge. Rather, they require disclosure when the companies raise prices above certain limits.Pharmaceutical prices have long been disputed in the United States. Many other countries, especially those with nationwide government-run health care systems, negotiate with drug producers, setting maximum prices the companies can charge. The United States doesn’t do that, leaving it up to insurers and drug companies to haggle. Critics of the U.S. system say it has led to sky-high prices compared to other countries. But the drug industry says it needs the leeway to be able to charge steeply for new drugs, in order to cover past research efforts and fund further research. U.S. laws give drug companies patents for up to 20 years from the time of patent application, before competitors can begin producing generic, lower-cost competitor drugs. So, to maximize revenues, drug companies heavily market new, government-approved drugs during the patent-protected period.
High drug prices are one element blamed for the ever-escalating cost of health care. But officials and other observers also cite insurance industry and hospital system profits, salaries for health system executives, rising compensation for the health care industry workforce, an aging population, and the cost of equipment and facilities.
A 2019 report said that hospitals account for 33% of health care costs, followed by physician and clinical spending at 20%, with drugs accounting for 10%.
“The data (in the annual report) from our insurers is an important piece to understanding which prescription drugs have the biggest effect on our health care costs; we appreciate their willingness to share this information,” said Andrew Stolfi, insurance commissioner and director of the Department of Consumer and Business Services. “The more data we receive the better informed all of us are.”
The state also encourages consumers to report price increases. On Dec. 16, the agency is holding a virtual public hearing - https://dcbs.az1.qualtrics.com/jfe/form/SV_6tcDQrRAuBaG7vD - on prescription drug prices. The agency will use the hearing to provide testimony to state legislators.
Some Oregon lawmakers have repeatedly expressed alarm at high drug prices, but the Legislature has shied away from the tricky and controversial step of trying to cap or otherwise regulate prices.
Instead, in 2018, the Legislature passed House Bill 4005, which requires drug companies to submit reports on drugs that had a wholesale price increase of more than 10% for a one-month supply that cost at least $100. In 2019, the Legislature passed House Bill 2658, which requires drug manufacturers to report price increases to the state at least 60 days before they take effect. Lawmakers hope the so-called transparency will deter drug makers from raising prices so quickly.
The pharmaceutical industry strongly opposed both measures, which are intended to curb expensive drug prices for consumers. The Pharmaceutical Researchers and Manufacturers of America, an industry trade group, lobbied strongly against the measures. That didn’t work. In December 2019, the industry trade organization, known as PhRMA, sued the state in federal court over the drug transparency laws, as it has in California and Nevada. The lawsuit, which alleges the state law puts trade secrets at risk of disclosure, is pending.
Current federal law bans the federal government from negotiating drug prices for Medicare, a big slice of the health care market. Legislation allowing Medicare to negotiate with pharmaceutical companies is stalled in Congress.
You can reach Christian Wihtol at [email protected].
