The Institute for Clinical and Economic Review (ICER) is an independent, non-profit research institute that conducts evidence-based reviews of health care interventions, including prescription drugs, other treatments, and diagnostic tests. In collaboration with patients, clinical experts, and other key stakeholders, ICER analyzes the available evidence on the benefits and risks of these interventions to measure their value and suggest fair prices. ICER also regularly reports on the barriers to care for patients and recommends solutions to ensure fair access to prescription drugs.
ICER just released its new 118 page “Launch Price and Access Report,” finding that drug launch prices continue to rise at a rate that exceeds inflation, gross domestic product (GDP) growth, and overall healthcare costs.
ICER’s analysis focused on “net price,” or the actual price paid after rebates and discounts, offering crucial information to policymakers, given that most previous analyses of drug pricing trends focus on the publicly available “list price,” which does not always reflect the actual price paid.
The report, using net prices, found that the inflation-adjusted median annual launch price of drugs increased by 51% from 2022 to 2024, while the annual list price increased 24% during the same period. Even after accounting for the differences in the mix of drugs approved each year (by holding certain characteristics constant, like the number of gene therapies approved), the annual net launch price increased by 33% per year.
ICER also conducted an in-depth review of the 23 drugs in scope that had been previously reviewed by ICER. The analysis indicated that aligning the prices of these therapies with ICER’s Health Benefit Price Benchmark (HBPB) could have saved approximately $1.3 to $1.5 billion in the first year post-approval alone – savings that could have been redirected to higher-value drugs and services.
To evaluate the patient access barriers to newly launched drugs, ICER focused on the novel drugs approved in 2024. For the majority of these drugs, insurance coverage policies were not publicly available, even up to one year after approval, and the majority of commercial first-time prescriptions for newly approved drugs were rejected. Non-coverage of the drug was the most common reason for rejection.
“The results of ICER’s independent analysis on trends in launch pricing and patient access highlight the critical moment facing the U.S. health care system,” stated ICER’s President and CEO Sarah K. Emond, MPP. “Launch prices are going up, patient access is going down, and in many cases, we are overpaying for treatments. As Americans confront rising health insurance premiums and risk losing health insurance altogether, it has never been more critical to move towards a system that pays for value. When we price treatments based on the benefits they deliver to patients, we ensure Americans have access to affordable, high-quality treatments, all while continuing to reward the hallmark innovation of the U.S. pharmaceutical industry.”