Money and Meds

Pill Box: The seemingly ever-rising price of prescriptions

What is the most expensive prescription drug in the United States, and why are drug prices so high?

click to enlarge Money and Meds
John R. White chairs WSU-Spokane’s Department of Pharmacotherapy.

The dubious honor for the most expensive prescription drug today likely goes to the drug Sovaldi. This is a very successful and effective medication that is used to, in many cases, actually cure hepatitis C. It is typically used in combination with other antiviral medications. Usually the patient takes this medication for three to six months. The cost per tablet according to GoodRx is $1,000. This translates into a cost of approximately $30,000 per month — a very high price, but in most cases a cure for a potentially deadly disease. This drug is in a category with very few other medications that are ultra-expensive.

However, the number of medications that are considered by most people to be expensive is growing. The factors that contribute to the expense of prescription medications are complicated, but in most cases can essentially be explained by cost of development, cost of production and level of demand.

The cost of the development of a new medication today is astronomical — it was recently pegged at around $2.6 billion. Second, the cost of production can be a factor. Not only does the medication have to be produced, but it must be produced under strict FDA guidelines (and thankfully so). The complexity of this production is increased substantially in the case of specialized medications called "biologics" which are also growing in popularity. Also, demand plays a role. Medications that are older (in other words, no longer under patent) and also commonly used are typically relatively inexpensive. Conversely, medications that are infrequently used tend to be more expensive.

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