Investor Presentaiton
Conditions treated 11
Humira
Crohn's disease, ulcerative
Figure 10: CCOs spent more on Humira than any other drug at pharmacies in 2021
Brand name(s)
Amount
$53 million
Claims
7,991
colitis, plaque psoriasis
Biktarvy
HIV
Mavyret
Hepatitis C
Lantus, Basaglar
Diabetes
8,178
$29 million
2,072
$27 million
71,038
$26 million
Kwickpen, Toujeo
Trikafta
Cystic fibrosis
912
$22 million
Stelara
Crohn's disease, ulcerative
947
$20 million
colitis, plaque psoriasis
Trulicity
Type 2 diabetes
21,249
$18 million
Enbrel
Plaque psoriasis, rheumatoid,
2,626
$15 million
and psoriatic arthritis
Eliquis
Humalog
Deep vein thrombosis
27,757
$14 million
Type 2 diabetes
42,706
$13 million
Source: OHA, the Food and Drug Administration, and Drugs.com
The average cost per prescription for more expensive drugs in Figure 10 ranges from $300 to $24,000.
Conversely, the most dispensed drugs — like albuterol sulfate, omeprazole, and ibuprofen - have an
average cost per prescription of $3 to $35.
Understanding the true cost of prescription drugs is difficult. Costs are often obscured by
nondisclosure agreements throughout the distribution chain. For example, wholesale acquisition cost is
the drug manufacturer's list price to wholesalers; however, this is typically not the actual price paid.
The average wholesale price is the published list price for drugs sold by wholesalers to retail pharmacies
and is used as a starting point for negotiations.
Drug cost inputs are not always available and determining actual prices paid is difficult without access
to confidential information. Many negotiated drug prices are proprietary and known only to the parties
involved in the transaction. Drug manufacturers do not provide public information on how they set the
list price and have often not been required to explain changes in a drug's list price. 12 PBMs add an
additional layer of complexity, as the prices paid to drug manufacturers and reimbursements to
pharmacies are also considered proprietary information. States are required to invoice manufacturers
for rebates on covered drugs for Medicaid. OHA has full visibility of the net cost of drugs under FFS, but
not in coordinated care. While increased transparency in prescription drug prices may not directly
lower costs, it will help policymakers better understand which prescription drugs and which portions of
the supply chain are cost drivers.
Oregon has placed an emphasis on drug manufacturers, but PBMs have received less
scrutiny
In 2018, the Oregon Legislature enacted the Prescription Drug Price Transparency Act. Housed in the
Department of Consumer and Business Services (DCBS), the act established the Task Force on Fair
11 Other conditions may be treated with these medications.
12 House Bill 2658 requires drug manufacturers to report to DCBS specific information on price increases for certain medications.
Oregon Secretary of State | Report 2023-25 | August 2023 page 11View entire presentation