Hospitals spent more on remdesivir, the antiviral medication used to treat COVID-19, last year than any other drug, a new report shows.
It was the first time since 2012 that AbbVie's rheumatoid arthritis biologic Humira didn't top the list, according to Vizient's drug price outlook. Still, Humira was the largest contributor to drug price inflation last year and will likely remain that way until 2023, when multiple biosimilars are expected to hit the market.
"More and more spend is with the high-cost biologics like Humira, which take fairly routine price increases each year. A smaller group of products account for a greater amount of the spending," said Steven Lucio, senior principal of pharmacy solutions at the group purchasing organization, noting that Vizient's member hospitals spent more than $1 billion on Humira last year. "Once Humira has competition, we would expect a significant decrease in spending."
AbbVie has benefited from nearly 20 years of exclusivity for Humira, which has been protected by a thicket of patents. Humira's net price in the U.S. increased an estimated 29.6% from the beginning of 2017 to the end of 2020, related research has shown, noting that prices usually spike near the end of a drug's exclusivity.
Overall drug price inflation is expected to continue to slow in 2023 at a rate of 3.09% from July 1 through June 30, 2022, the group purchasing organization estimates. That was largely due to the growing number of generic drugs and biosimilars coming to market, according to the report.
But biosimilars have had a relatively slow adoption rate, which is why biologics like Keytruda—a cancer drug developed by Merck—will drive drug price inflation over the next several years, Lucio said.
"So much of the investigational drug pipeline is directed toward oncology, neurology and autoimmune conditions. So even when spending on Humira recedes, other drugs for rheumatoid arthritis, multiple sclerosis and other diseases will be prominent," he said.
Like other brand-name drugs, Gilead Sciences has freedom in setting the price for Veklury (the branded version of remdesivir), which costs about $2,000 for the three-day outpatient regimen and $3,000 for the five-day inpatient regimen, said Erin Fox, senior pharmacy director at University of Utah Health.
Hospitals have little choice but to accept the price, and there are no discounts, contracts nor readily available direct alternatives, she said.
"This is a very high-cost drug for the inpatient setting," Fox said.