The most expensive drugs of 2019

Americans spend more on prescription drugs than any other population in the world. The average U.S. citizen spends $1,025 per year on medication—that’s an inflation-adjusted 11-fold increase since 1960, according to data from the Peterson Center on Healthcare and Kaiser Family Foundation. 

It’s because prescriptions are expensive.

The 10 most commonly advertised drugs have list prices ranging from $488 to $16,938 per month or course of treatment, says the Department of Health and Human Services. And, our research shows that many oft-prescribed medications regularly cost much more than that. 

In other words, there are a lot of very costly drugs out there. These are the most expensive drugs, according to SingleCare data. The prices listed below reflect the cash price—what a customer would be expected to pay if he or she did not have insurance or prescription coverage.

1. Afinitor

28-day supply price: $33,001.08

Afinitor, a chemotherapy medication used to treat kidney, pancreatic, breast, and brain cancers, is one of the most expensive medications out there—but those with a prescription need to have it for their treatment plan. Often, the duration of treatment with Afinitor is defined by the medical diagnosis. Patients diagnosed with Subependymal Giant Cell Astrocytoma received a median duration of treatment of 24.4 months. The median duration of treatment for patients diagnosed with Renal Cell Carcinoma is 141 days. That’s a minimum cost of (gulp): $166, 184.01 for an average treatment cycle. 

Currently, there is no generic alternative for the drug to help bring down the costs. A would-be generic manufacturer lost a patent case in courts earlier in 2019, which would have allowed the formulation of a generic version. Cash-paying patients are beholden to the $33,000-plus price tag. But there are ways to save on Afinitor 5 mg tablets. According to Medicare, 100 percent of Medicare Part D and Medicare Advantage plans cover this drug.

2. Humira

28-day supply price: $7,037.81

Humira is an immunosuppressant used to treat arthritis, psoriasis, Crohn’s disease, and ulcerative colitis. It’s been the top-selling (aka the most profitable) drug in the nation since 2012, and shows no signs of slowing down. In 2018, Humira prescriptions topped more than $14 billion, which was an increase of more than 60% than the previous year—despite the controversial reputation of biologic medications. 

A 2016 study published by the Journal of the American Medical Association that found “no evidence of an association between research and development costs and prices; rather, prescription drugs are priced in the United States primarily on the basis of what the market will bear.” But still, Humira costs continue to rise. The price of Humira has gone up from about $19,000 a year (in 2012) to more than $38,000 a year (in 2019), per patient, after rebates—according to data reported by the New York Times, from SSR Health, a research firm. That’s an increase of 100 percent. But for those who rely on the drug, there’s good news coming in 2023: a biosimilar drug called Hyrimoz. Not to be confused with generic drugs, biosimilars are “highly similar” medications that are close enough in duplication to accomplish the same therapeutic and clinical results (while generics are chemically identical to the original medication). The FDA has approved Hyrimoz and it will be available for sale in the United States on September 30, 2023.

3. Enbrel 

28-day supply price: $4,944.95

Enbrel is a biopharmaceutical medication that is used to treat rheumatoid arthritis, psoriatic arthritis, and other autoimmune conditions. Just like Humira, Enbrel is seeing a rise in sales and prescriptions filled, despite the wallet-crippling cost. Enbrel—which landed in the U.S. market in 1998—recorded $4.8 billion in U.S. sales in 2018, according to manufacturer Amgen, Inc. 

Currently, the drug manufacturer prices a year’s supply of Enbrel’s 50-mg dose at more than $67,000. And there are no generics on the horizon to help ease costs for patients. Two biosimilars of Enbrel were approved by the FDA and have not been launched yet—including one from Swiss drugmaker Novartis AG that the health agency approved in 2016, according to Wall Street Journal health reporter Jared S. Hopkins. More than 40 patents protect Enbrel, and its manufacturer, Amgen Inc., won a court ruling in August related to Enbrel patents. 

4. Xeljanz 

30-day supply price: $4,694.13

Xeljanz is a popular biopharmaceutical that is prescribed to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. But recently, the drug made headlines because of the new FDA black-label warning that the JAK inhibitor’s 10-mg twice daily dose, which was formulated to ease joint pain and swelling, increases risk of blood clots—and potentially, death. 

The drug’s approval to treat ulcerative colitis has been nixed—it’s now only approved for patients who do not respond to or are not suitable for other medicines. But despite all the serious warnings surrounding the 10-mg dose, the 5-mg is still considered safe, and in turn has seen an increase in sales and use. 

5. Forteo

28-day supply price: $3,639.85

Forteo is an injectable medication that helps strengthen bones for people with osteoporosis who are at high risk of a fracture—especially those with osteoporosis from taking steroids like prednisone. It’s a synthetic form of a hormone naturally found in the body that promotes growth of new bone and increased bone density. Injections are typically taken in the thigh or belly.  It’s approved for up to 24 months of use. 

There is currently no generic available. But, Pfenix won patent approval for a similar product, which could drive the price down when it hits manufacturing. There are already two comparable treatments in Europe, but they have been blocked in the United States. If you need Forteo, there is a manufacturer’s discount available for eligible patients.

6. Glatiramer Acetate Injection

30-day supply price: $3,378.50

Glatiramer acetate injection is the generic version of Copaxone, an injectable medication used to treat multiple sclerosis and prevent MS relapse. Even as a generic, the price is high—not much lower than the brand-name counterpart.

In the past 20 years, there have been big advances in MS treatment, but the increase in available treatment options has not led to a parallel decrease in prices. They have been escalating. From 2013 to 2018, the average median cost of disease modifying therapies like glatiramer acetate rose from $60,000 to $80,000 according to the National Multiple Sclerosis Society. If you’re having trouble affording your medication, Mylan offers savings for certain people.

7. Norditropin Injection

30-day supply price: $3,377.89

Norditropin is a synthetic growth hormone that imitates hormones in the pituitary gland that stimulate growth in the body: height, organs, bones, and muscles. When used for children who don’t make enough growth hormone, it can help them become taller. For adults, it can stimulate muscle growth. When used for patients without a deficiency, it’s not effective. 

It’s considered a specialty medication, like those used to treat conditions such as cancer, HIV, or rheumatoid arthritis. These types of medication are typically more expensive, and norditropin is no exception. Novo Nordisk has a patient assistance program in place to help navigate insurance benefits and afford medications.

8. Stribild

30-day supply price: $3,356.06

Stribild is a four-medication cocktail in one tablet used to treat HIV and lower the risk of transmitting the condition to others. It contains three antiretroviral medications and a medication that helps the others work better. Though pricey, there’s some evidence that once a day combination treatments for HIV are less expensive long term than some other options because they improve medication adherence in patients, which can lower risk of complications or expensive hospitalizations. The manufacturer of Stribild, Gilead, offers patient assistance programs if you’re having trouble affording the treatment.

9. Atripla

30-day supply price: $3,215.15

Atripla is another combination medication used to treat HIV, and lower the risk of transmitting the condition to others. It contains three medications. There is currently no generic version of this medication available, which keeps the price high. But, starting at the end of September 2020, Teva Pharmaceuticals is approved to launch generic versions, which could help to ameliorate the cost. The manufacturer of Atripla, Gilead, offers patient assistance programs if you’re having trouble affording the treatment.

10. Biktarvy

30-day supply price: $3,214.05

Biktarvy is a three-medication combination pill used to treat HIV. There is no generic version available. New data shows it’s very effective in new patients, and patients switching from other medications, which has led to nearly-quadrupling sales of this medication in a single year despite the expense. Like other combination medications for HIV, there is some evidence that it reduces long-term treatment costs because of improved adherence. The manufacturer of Biktarvy, Gilead, offers patient assistance programs if you’re having trouble affording the treatment.

So what’s causing the high prices?

How (and why) is the cost for so many necessary medications get so high? It’s complicated—and impacted by a number of factors.

Brand-name medications

The brand-name market is where medications are first created, and developing a new medication is an expensive and time-consuming process. “Brands have patent and regulatory protection in their early market years, enabling manufacturers to take full advantage of demand for their novel treatments, and reward investors for their patience and high cost of research and development,” explains Dana Goldman, director’s chair at the USC Schaeffer Center for Health Policy and Economics and Professor of Public Policy, Pharmacy, and Economics. In other words, prices of new treatments are high because of the high cost of bringing them to market.

Generic medications

In the generic market, it’s a different story. When a patent on a new drug ends, manufacturers can create a generic version and sell it for a much lower price because the original developer has recouped costs. Yet, occasionally, generics are just as expensive as their branded counterparts, such as the sudden price sprike for the antimalarial drug Daraprim, which made the news in 2015. 

Martin Shkreli and Turing Pharmaceuticals took the $13.50 per pill Daraprim (which has been available since the 1950s) and increased the price to $750 per pill.  Shrkeli could do this because the price of Daraprim had dropped so low that all the suppliers had opted out. Turing then swooped in and leveraged its monopoly power over a drug that had no patent protection. 

This proves how, ironically, the generic medication market can sometimes work too well: Drugs get too cheap too quickly and adequate supply is jeopardized.

How SingleCare can help

Due to the high cost of medication, more and more people rely on healthcare companies like SingleCare to help them save hundreds (and thousands) of dollars on their prescriptions. “At SingleCare, we believe it’s really important to provide prescription discounts to everyone in America that are free to access, regardless of insurance status,” says Manav Malhotra, VP of data at SingleCare. “And as we strive to make drugs more affordable and accessible, a big part of that is making sure there is price transparency for the consumer.”

And while Americans are used to shopping around for prices, they don’t do it with medications. “It’s hard to imagine purchasing any product without any idea of what it’s going to cost you until you get to the register, but that’s traditionally how the pharmacy industry worked,” Malhotra says. “We want consumers to know exactly what they are going to pay at any of our pharmacy partners before they set foot inside. Many consumers don’t even realize that prices vary between pharmacies just across the street from each other. A market driven by an informed consumer making informed decisions is the first step toward lowering prices.”

SingleCare offers price transparency charts that let you compare the cash price to the SingleCare savings for drugs over the past year. Offering the best possible savings is at the heart of everything SingleCare does. “We also look at the drugs that consumers really care about to determine where to focus our efforts on driving prices down,” Malhotra says. “It drives how we make our pricing decisions and our discussions with our pharmacy partners.”

Start searching for your medication here to see how much you can save.