Acoramidis

iStock, pilli Just one-third of patients prescribed new medicines filled them within 30 days, with a new report from the Institute for Clinical and Economic Review and West Health suggesting that cost is the problem. Despite the White House’s efforts to cut drug prices, the biopharma industry continues to launch new medicines that cost in excess of $250,000, putting further strain on the U.S. healthcare system, according to a drug pricing watchdog. The median net launch price, which is the price paid after rebates and discounts, increased by 35% from $190,000 in 2022 to $257,000 in 2025, according to a new report from the Institute for Clinical and Economic Review (ICER) and West Health. Prices have remained “at historically high levels,” the firms said in an accompanying release. And about one in four drugs launched in 2025 exceeded $500,000 in annual net price, according to the report. Another 34% had prices between $200,000 and $500,000. “This independent analysis shows that we are facing a critical moment in the U.S. health care system,” Sarah Emond, president of ICER, an independent group that monitors drug pricing, said in a Tuesday statement . President Donald Trump has made drug pricing a key policy of his second term, rolling out Most Favored Nation drug pricing that seeks to match costs with other comparable nations. But the policy has affected just a handful of specific drugs, and many experts have questioned the impact. The ICER report includes about 50 drugs that have recently launched. On the list is Vertex Pharmaceuticals’ non-opioid pain drug Journavx, Eli Lilly’s Alzheimer’s treatment Kisunla and BridgeBio Pharma’s Attruby for transthyretin-mediated amyloidosis cardiomyopathy (ATTR-CM), among others. Not only can the high costs of these drugs put a strain on the patient and the healthcare system, they can also result in unfilled prescriptions, cutting into the manufacturers’ bottom lines. Just one-third of patients prescribed these new medicines actually filled them and picked them up within 30 days, with a significant portion of these unfilled prescriptions resulting from a lack of insurance coverage in the early days following approval, ICER said. ICER took a closer look at a few select drugs, including Eli Lilly’s recently launched Ebglyss for atopic dermatitis. The therapy has a net price of $41,622, with fairly high Medicaid fill rates of 54%, compared to just 27% for patients going through commercial payers. Fill rate is when a patient orders the prescription, it’s approved and they are able to pick it up. The watchdog believes that the drug was likely rejected by payers because of the many other options available for atopic dermatitis, a common but stubborn skin condition that causes dry, itchy and inflamed skin. Medicare had the highest overall rate of rejection, the report stated. These prescriptions included out-of-pocket payments for patients, with about 20% paying $500 or more and 15% over $1,500 per month. The fill rate for Journavx was 55% of the 251,696 patients who received a prescription. The therapy is available to those with coverage for as little as $2 but self-pay consumers could pay as much as $500 for a month’s supply. “Overpayment for drugs beyond their value to patients is contributing to decreased patient access,” Emond said. “While the U.S. has produced some of the world’s most incredible innovations, patients are still experiencing significant barriers to care. Now more than ever, it is crucial that we start working towards the goal of pairing fair pricing with fair access—leading to a more affordable health system for us all.”

A year after warning that new medicines were becoming increasingly expensive and difficult to obtain, the Institute for Clinical and Economic Review (ICER) says US drug launch prices remain stubbornly high, while patients continue to face barriers in accessing new treatments."Overpayment for drugs beyond their value to patients is contributing to decreased patient access," said ICER CEO Sarah Emond. "Now more than ever, it is crucial that we start working towards the goal of pairing fair pricing with fair access."In its second annual Launch Price and Access Report, released Tuesday with West Health, the watchdog found that median annual net launch prices rose 35% between 2022 and 2025, reaching approximately $257,000 last year, while around a quarter of newly launched drugs carried annual net price tags exceeding $500,000 and two drugs topped $2 million.ICER's inaugural report last October had identified a 51% inflation-adjusted jump in median net launch prices between 2022 and 2024.The latest analysis suggests the pace of increases may have eased; most of the rise was concentrated between 2022 and 2023, and prices remained "relatively stable" thereafter, "with a slight decrease observed in 2025," the report said.However, ICER cautioned that changes in the mix of medicines entering the market could obscure that launch prices may "still be drifting upward." Last year's crop of approved treatments, for example, skewed away from the priciest categories, such as gene and cell therapies, biologics and ultra-rare disease drugs, the report noted.Value gapMeanwhile, of the 26 drugs previously reviewed by ICER between 2022 and 2025, 18 launched above its Health Benefit Price Benchmark, the price range the watchdog considers a fair reflection of a treatment's value to patients over their lifetimes.Among the largest discrepancies, according to Tuesday's report, were Insmed's Brinsupri (brensocatib), Merck & Co.'s Winrevair (sotatercept), BridgeBio's Attruby (acoramidis) and Bristol Myers Squibb's Camzyos (mavacamten), which ICER estimated would each need discounts ranging from roughly 82% to 95% to reach a cost-effectiveness threshold of $100,000 per quality-adjusted life year (QALY) gained.By contrast, some multimillion-dollar gene therapies, including Orchard Therapeutics' Lenmeldy (atidarsagene autotemcel), as well as Vertex Pharmaceuticals and CRISPR Therapeutics' Casgevy (exagamglogene autotemcel), required smaller percentage reductions, ranging from 39% to 46%. Both are administered as one-time treatments.New-to-market blocksThe report also said insurance restrictions continue to stand between patients and newly approved medicines. According to ICER, nearly four in 10 prescriptions for outpatient drugs approved between July 2024 and June 2025 were rejected due to non-coverage, while only a third of outpatient prescriptions for newly launched drugs were filled within 30 days."With an average launch net price of over $250,000, and many drugs priced out of line with value, new-to-market blocks to temporarily delay coverage pending clinical and economic review and utilisation strategies to ensure that only patients for whom a treatment is clinically appropriate receive insurance coverage have become routine," the report said. "While these measures are intended to help keep insurance premiums more affordable for patients and all health plan members, they also risk delaying care or creating other barriers to effective care for certain patients."