25 priciest drugs for hospitals in 2022

Remdesivir was nonfederal hospitals' costliest drug expense two years in a row despite a 58.1 percent drop in expenditures from 2021 to 2022, according to research published April 24 in the American Journal of Health-System Pharmacy.

In 2021, remdesivir — the first approved COVID-19 drug — cost U.S. hospitals $3.15 billion. The next year, nonfederal hospitals spent $1.31 billion as utilization fell and the list price stayed the same, according to Eric Tichy, PharmD, the study's author and division chair of pharmacy supply chain at Mayo Clinic in Rochester, Minn.

Two drugs saw a steep increase in hospital spending, including pneumococcal vaccine conjugate (96.4 percent higher than 2021) and daratumumab/hyaluronidase (76.4 percent higher). The latter two generics are used to treat multiple myeloma; the oncology treatment cost hospitals $492 million in 2022. 

The research calculated healthcare drug expenditure among three factors: a drug's list price; newly approved drugs treating conditions that didn't already have a therapy; and utilization — the ongoing, formal review of prescribing, dispensing and the use of a drug.

Here are the top 25 drugs ranked by nonfederal hospital expenditure in 2022:

Drug

Expenditure in 2022

Percent change from 2021

Remdesivir

$1.31 billion

-58.1

Pembrolizumab

$1.3 billion

+17.9

Immune globulin

$1.05 billion

+6.2

Alteplase

$630 million

-29

Nivolumab

$589 million

+8.9

Inactivated influenza virus

$580 million

-7.3

Rituximab

$555 million

-14.2

Bictegravir/emtricitabine/tenofovir alafenamide

$537 million

+21.7

Sugammadex

$519 million

+20

Natalizumab

$496 million

-12.2

Daratumumab/hyaluronidase

$492 million

+76.4

Ocrelizumab

$466 million

-2.9

Antithymocyte immunoglobulin

$451 million

+14.4

Pneumococcal vaccine conjugate

$450 million

+96.4

Denosumab

$432 million

+7.1

Infliximab

$396 million

-8.4

Pegfilgrastim

$385 million

-13.3

Bupivacaine

$359 million

+1.4

Sodium intravenous solutions

$347 million

+11.5

Albumin

$345 million

-2.9

Vedolizumab

$309 million

+4.8

Iopamidol

$309 million

+20

Factor II/factor IX/factor VII/factor X/
protein C/protein S

$296 million

+10.6

Iohexol

$290 million

-19.7

Atezolizumab

$286 million

+8

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