A Look at the Top 20 Most Expensive Drugs in the U.S.

Drug prices have become a hot-button issue in general, although even more so during election years. In January, most drug companies increase the price of their drugs, and this year was no different, with more than 250 drugs manufactured by different companies being increased from 1% to 10%, with the average drug price rising by about 5%. The median increase over the past several years has been 9% to 10%.

While not including the extravagantly expensive gene therapies, like Novartis’ Zolgensma for spinal muscular atrophy (SMA), which has a price tag of $2.1 million, here’s a look at GoodRx’s list of the top 20 most expensive prescription drugs in the U.S.

These prices refer to the company’s list price. Most patients will not pay that price because of various forms of health insurance or patient assistance programs. The prices are a reflection of the drug’s most common 30-day prescription.

1. Amryt Pharma’s Myalept. $71,306. Myalept is used with diet to treat complications caused by leptin deficiency in people with lipodystrophy. It is not for use by people who have lipodystrophy as the result of taking HIV drugs.
2. Horizon Therapeutics’ Ravicti. $55,341. Ravicti is prescribed as an ammonia-controlling treatment for urea cycle disorders. People with urea cycle disorders have genetic mutations that cause ammonia to build up in their bodies, which can result in coma or death if untreated.
3. EMD Serono’s Mavenclad. $53,730. Mavenclad is used to treat relapsing forms of multiple sclerosis (MS). EMD Serono is a unit of Merck KGaA, Darmstadt, Germany.
4. Horizon Therapeutics’ Actimmune. $52,777. Actimmune is prescribed to treat chronic granulomatous disease (CGD), a genetic disorder that affects the immune system.
5. Dompe’s Oxervate. $48,498. Oxervate is indicated for treatment of neurotrophic keratitis. Sometimes called neurotrophic keratopathy, it is a disease caused by damage to the corneal nerves.
6. Takeda Pharmaceutical’s Takhzyro. $45,464. Takhzyro is prescribed to prevent attacks of hereditary angioedema (HAE), a rare genetic condition that results in swelling in the face, hands, feet or genitals, but can also occur in the lungs or intestinal walls.
7. Vyera Pharmaceuticals’ Daraprim. $45,000. Daraprim is used with leucovorin to treat toxoplasmosis and cystoisosporiasis. This is the drug, when it was marketed by Turing Pharmaceuticals, that launched the major outcry over drug pricing when Martin Shkreli acquired the rights and dramatically increased the price from $13.50 a tablet to $750 per tablet.
8. Amryt Pharma’s Juxtapid. $44,714. Justapid with a low-fat diet and other lipid-lowering treatments, is used to decrease severe cases of high cholesterol in patients with homozygous familial hypercholesterolemia (HoFH).
9. Takeda Pharmaceutical’s Cinryze. $44.141. Cinryze is indicated for treatment of HAE.
10. Retrophin’s Chenodal. $42,570. Chenodol is prescribed to dissolve gallstones in people who can’t have gallbladder surgery.
11. Takeda Pharmaceutical’s Gattex. $40,450. Gattex is indicated for Short Bowel Syndrome (SBS), a malabsorption disorder caused by lack of a functional small intestine.
12. Mallinckrodt Pharmaceuticals’ HP Acthar. $39,864. Acthar is used to treat proteinuria in patients with nephrotic syndrome of the idiopathic type without uremia, for infantile spasms in infants and children, for acute relapses or flares of MS, certain eye infections, sarcoidosis, lupus, dermatomyositis or polymyositis and adjunctive therapy in psoriatic and rheumatoid arthritis and ankylosing spondylitis.
13. Akcea Therapeutics’ Tegsedi. $34,864. Tegsedi is indicated for hATTR amyloidosis. These patients have a gene mutation that causes transthyretin to cluster, with amyloid building causing damage to organs and tissues.
14. Bayer‘s Vitrakvi. $32,800. Vitrakvi is used to treat patients with NTRK gene fusion-positive solid tumors.
15. Blueprint Medicines’ Ayvakit. $32,00. Ayvakit is approved to treat adults with unresectable gastrointestinal stromal tumor (GIST), a tumor in the GI tract.
16. Kastle Therapeutics’ Kynamro. $30,444. Kynamro is indicated for the treatment of homozygous familial hypercholesterolemia, which is an inherited form of severe high cholesterol.
17. Gilead Sciences’ Sovaldi. $28,000. Sovaldi is prescribed to treat Hepatitis C infections.
18. AbbVie’s Viekira Pak. $27,773. Viekira Pak is indicated for Hepatitis C infections.
19. AbbVie’s Viekira XR. $27,773. As in Viekira Pak, Viekira XR is used to treat Hepatitis C infections.
20. Agios Pharmaceuticals’ Tibsovo. $27,421. Tibsovo is used to treat acute myeloid leukemia (AML) with an isocitrate dehydrogenase-1 (IDH1) mutation.