Humira and Rituxan cited as costliest price hikes unsupported by new clinical evidence

The USA’s Institute for Clinical and Economic Review (ICER) has published its first annual report on Unsupported Price Increases (UPI) of prescription drugs in the United States, showing that Humira (adalimumab) and Rituxan (rituximab) topped the list of costliest medicines, with the hikes on seven identified drugs leading to additional costs of $5.1 billion for insurers and patients over two years..

The ICER began its analysis by ranking the top 100 drugs by sales revenue in the US. Working with data from SSR Health, drugs were then evaluated to see whether their price increases net of rebates and other concessions were more than twice the level of increase than growth in the medical consumer price index over the 24-month period from the beginning of 2017 to the end of 2018. Ultimately, the ICER identified the top 10 drugs whose price increases would have contributed to the largest net increase in drug spending in the USA. One drug was added to this list following public nomination. The ICER then evaluated whether there had been relevant new evidence at any time during the preceding three years that could have supported these price increases.

Upon analysis, two drugs on the initial list were found to have price increase data that appeared unreliable, and these drugs were excluded from further consideration, leaving nine drugs for full evaluation. Following consideration of input from manufacturers and a systematic review of evidence available in published studies, ICER determined that seven of the nine drugs had evidence that was not adequate to support a claim of additional clinical benefit.