Merck discard jumps straight to the top of the chart of the most expensive drugs in the US at $1M-plus

Back late last fall, when Eiger Pharmaceuticals $EIGR completed its victory lap with an old Merck discard it had developed for rare cases of progeria, the company told reporters that it was thinking of pricing the newly dubbed Prokinvy at the usual rate reserved for ultra rare diseases. Merck abandoned the drug years ago after giving up on a cancer indication, and let Eiger have it for Progeria several years ago without tacking on any milestones in the deal.

It turns out, the small cap player may have gone one or two steps past the usual point, though.

GoodRx just came out with their new top 10 list of the most expensive drugs in the US. And Zokinvy makes the list as the new number 2 therapy with an average annual cost of $1,032,480.

Right behind it is the second new entry on the list: Danyelza, the new drug from Y-mAbs Therapeutics that weighs in just under 7 figures, at $977,664. That drug is approved as a combination treatment for high-risk cases of neuroblastoma. A group of ex-Genmab execs licensed this in when they grabbed a pair of drugs from Memorial Sloan Kettering.

Novartis holds on to the number 1 spot, way out front with their SMA therapy Zolgensma, just now being cleared in the UK at a discount price. In the US, the drug sells for $2.1 million, and can be curative if the disease is caught early enough.

Pharma defenders are quick to point out that the cost of the drug still qualifies as a big saver compared to the cost of tending to these infant patients suffering from a terrible and lethal disease. Payers who have a hard time covering the cost, notes GoodRx, can pay overtime in 5 annual installments of $425,000.

Whatever the arguments, though, price tags like these tend to attract considerable outrage among the people who face out-of-pocket drug costs that can routinely force them off their medication schedule. And that makes the top 10 price list of interest to everyone in the industry, particularly as small outfits like Eiger and Y-mAbs join the major players on the pricey roster.

Of the other 7 drugs on the list, 4 have hiked the price.

  • Myalept from Aegerion jumped from $71,306 to $74,159 per month — an annual cost weighing in at $889,904. The therapy is used to treat leptin deficiency.
  • Brineura, which treats one form of Batten disease, rose 2.14%, reports GoodRx, to $730,340 a year. That breaks down to 300 mg every 2 weeks.
  • The price of Amgen’s Blincyto, number 8 on the list, was hiked by 5.89% to $712,672.
  • Horizon Therapeutics, which routinely makes an appearance in the ultra-expensive list, increased the price of Ravicti 4.8% to $695,970. That’s number 9.

At number 10 we have Alexion’s Soliris — long the one-time reigning champ in the most-expensive-drugs category. It now sells for $678,392 as Alexion makes way for a successor therapy — and AstraZeneca looks to take over the franchise once it completes a $39 billion acquisition.

That leaves Luxturna, a breakthrough eye gene therapy acquired by Roche which sells for $850,000 for a pair of eyes — or $425,000 each. Folotyn for a rare blood cancer costs $793,870.

Here’s the straight list from GoodRx, ranked 1 through 10.