Investor Presentaiton
in per unit prices for these drugs are very high, especially for drugs that have growing
market share (see Table 3.2). For example, the Humira (Cf) Pen - a version of a leading
anti-inflammatory drug used to treat auto-immune conditions - was introduced
into the market in 2019 at a price of $5,740 per unit. Two years after entering the
market, the price for the drug increased by 19 percent. The rapid introduction of new
and expensive brand name drugs into the market raises significant concerns around
affordability for employers and consumers.
Furthermore, research shows that there is often not enough clinical evidence to justify
substantial price increases for some major drugs. In 2021, the Institute for Clinical and
Economic Review (ICER) reviewed 13 drugs that significantly contributed to growth in
U.S. drug spending and found that 10 of them had price increases that were unsupported
by new clinical evidence. In previous years, ICER consistently categorized Humira - the
highest spend drug in Rhode Island - as a drug with unsupported price increases?
Table 3.2: Change in Commercial Price and Utilization for the Three Leading Immunological Agent
Brand Name Drugs
Drug
Change from 2017-2021
Humira
Stelara
Enbrel Sureclick
2017
2021
PRICE PER UNIT
UNITS/1000
PRICE PER UNIT
UNITS/1000
CHANGE IN
PRICE PER UNIT
CHANGE IN
UNITS/1000
Not on the
ΝΑ
market
$9,604
$4,431
$6,828
18
19%
(since 2019)
80%
(since 2019)
2
8
$14,624
5
52%
150%
$5,817
7
32%
-13%
Source: OHIC analysis of HealthFacts RI data. Medicare fee-for-service data are excluded.
Prescription drugs are vital to maintaining or improving health. At least half of
U.S. individuals and 69 percent of adults aged 40-79 use prescription drugs, and a
significant portion of the elderly and those with chronic conditions rely on them
to manage their conditions.3 The high and rising cost of these drugs is putting a
financial strain on families, employers, and government. Moving forward, addressing
prescription drug costs will be a vital issue for Rhode Island, as the state continues
to recover from the pandemic and turns its attention toward containing health care
costs over the long term.
1 Institute for Clinical and Economic Review (ICER), Unsupported Price Increase Report: Unsupported Price Increases Occurring in 2021, December 6, 2022.
https://icer.org/wp-content/uploads/2022/04/UPI_2022_National_Report_120622.pdf.
2 ICER has categorized Humira as a drug with price increases that were not supported by clinical evidence in 2019 and 2020. See: ICER, Unsupported Price Increase Report: 2019 Assessment,
Updated November 6, 2019, http://icerorg.wpengine.com/wp-content/uploads/2020/10/ICER_UPI_Final_Report_and_Assessment_110619.pdf; and ICER, Unsupported Price Increase Report:
2020 Assessment, January 12, 2021. https://icer.org/wp-content/uploads/2020/11/ICER_UPI 2020_Report_011221.pdf.
3 Craig M Hales et al, Prescription Drug Use Among Adults Aged 40-79 in the United States and Canada, NCHS Data Brief 347 (2019):1-8, https://pubmed.ncbi.nlm.nih.gov/31442200/.
Annual Report: Health Care Spending and Quality in Rhode Island
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