Humira leads ICER’s latest list of ‘unsupported’ price hikes

Price hikes for eight drugs increased U.S. healthcare spending by nearly $1.3 billion last year despite a lack of new evidence supporting their health benefits, according to a new report published Monday by the Institute for Clinical and Economic Review. 

The report, a yearly look at price increases “unsupported” by clinical data, found that AbbVie’s rheumatoid arthritis drug Humira was the chief culprit. A 2% rise in the drug’s price, then in the last year of a lengthy patent-protected monopoly, caused healthcare spending to climb by $386 million. Johnson & Johnson’s multiple myeloma treatment Darzalex, Pfizer’s breast cancer therapy Ibrance and Amgen’s bone drug Prolia each individually added more than $100 million in spending because of unsupported price hikes, the report found. 

The report is the fifth published by ICER, an influential drug price watchdog backed by a mix of non-profit foundations and at least one insurer. Over that time, the organization has expanded its probe by evaluating more drugs, with its latest report covering 250 medicines. Its initial version had only 100 and flagged seven medicines. 

ICER developed its analysis by identifying the 250 therapies with the largest U.S. sales revenue as estimated by drug pricing data company SSR Health. It only included drugs whose list price climbed more than two percentage points higher than the rate of inflation, which was just over 4% in 2022. 

ICER then identified drugs whose revenue climbed because of price hikes, and pinpointed the ones with higher increases to the “net” prices companies ultimately receive. The authors gave manufacturers the chance to correct any errors in the pricing data.

To determine whether a price increase was “supported,” the group searched for clinical results in the last two years proving “a substantial improvement in net health benefit.” 

The final list included 10 drugs identified using these methods, and another three responsible for the biggest increases in Medicare spending between 2020 and 2021 because of price hikes.  

Eight of the 10 drugs from the main list lacked new clinical evidence that could support a price increase. The two that did were Novartis’ heart failure drug Entresto and Incyte’s myelofibrosis treatment Jakafi.

Of the three drugs on the Medicare list, only Amgen’s bone marrow stimulant Nplate was flagged by ICER. Its 7% increase in 2021 raised healthcare spending by $17 million, the report said. 

Two Amgen drugs derived from the same active ingredient were also highlighted: the osteoporosis medicine Prolia and Xgeva, a higher-dose version used in cancer patients.

Darzalex is included in both lists, but ICER said its price increases in Medicare were justified by evidence from a study published in 2020. 

ICER’s findings drew immediate criticism from the pharmaceutical industry. In a statement, the National Pharmaceutical Council, a nonprofit health policy organization backed by drugmakers, called the yearly reports “consistently flawed.” The group called the report’s pricing data unreliable, and claimed ICER ignored a wealth of peer-reviewed evidence and used an “arbitrary and insufficient timeframe.”

“Relying on these reports could lead to ill-advised policies and inappropriately limit patient access to needed treatments,” said Kimberly Westrich, the council’s chief strategy officer, in a statement.