The median annual net launch price of new drugs rose 35% from 2022 to 2025 after adjusting for inflation, according to an Oct. 20 report from the Institute for Clinical and Economic Review and West Health that also tracked how easily patients get the drugs.
Here are six things to know:
- Most of the increase came in 2022 and 2023, and the median net launch price fell 2% from 2024 to 2025. The 2025 median was about $257,000 a year net, or $293,000 at list price. “Net” is the price after rebates and discounts, which ICER estimated because manufacturers submitted no net price data.
- About 1 in 4 drugs launched in 2025 had an annual net price above $500,000, and two topped $2 million. Another 34% launched between $200,000 and $500,000.
- Only about 1 in 3 of the 26 new drugs ICER has previously reviewed launched at or below its health benefit price benchmark, the range it considers fair for the drug’s lifetime benefit. The rest would need discounts of 7% to more than 90%, according to the report.
- The median launch price of small-molecule drugs more than doubled over the four years. ICER said that may reflect higher launch prices meant to offset losses from Medicare negotiation, which reaches small molecules seven years after launch versus 11 for biologics, though it did not prove that motive.
- For drugs launched from July 2024 to June 2025, only 36% of outpatient prescriptions were filled within 30 days, and 39% were rejected for lack of coverage. Medicare was the weakest payer, with 20% filled and 58% rejected for noncoverage. Most drugs needed multiple submissions before filling, and Medicare patients had the highest mean out-of-pocket costs.
- The report covers a period before most of the administration’s most-favored-nation pricing deals took hold and noted that 83% of 2025 approvals reached the U.S. first, up from 65% in prior years, which could mean launches abroad are being delayed. PhRMA disputes ICER’s methodology, saying it overlooks long-term pricing trends and generic competition. ICER also found last year that Wegovy and Zepbound would remain cost-effective at higher prices, and Medicare is negotiating prices on 15 more drugs for 2028, including its first Part B drugs, with manufacturers all participating.
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