The 20 Most Expensive Prescription Drugs in 2020

A doctor holds a vaccine in a vial
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Drug price hikes began right away this year. By February, manufacturers had increased their prices for 639 prescription drugs — more than in each of the past two years.

Still, some prescriptions remain far more expensive than others — with the most expensive drugs easily costing more than the typical household income in the U.S. (That’s a median of $61,937 per year or $5,161 per month as of 2018.)

A recent analysis by drug price watchdog GoodRx shows that the 20 most expensive drugs of 2020 all cost five figures — for a one-month supply.

The analysis was based on list prices — the prices set by drug manufacturers — which often are higher than patients end up paying. However, list prices provide a way to track drug costs, measure changes and make apples-to-apples comparisons.

As GoodRx explains:

“Few patients actually pay this price because they are typically shielded by their health insurance. But the list price is still a good proxy for the price of a drug. In essence, rising list prices lead to rising out-of-pocket costs for patients.”

Following is a closer look at the most unaffordable medications of 2020 based on list price.

20. Tibsovo

Melanie Vollmert / Shutterstock.com

List price: $27,421 for a typical 30-day supply

Manufacturer: Agios Pharmaceuticals

Tibsovo is a tablet used in the treatment of certain cases of acute myeloid leukemia, a cancer of the blood and bone marrow. Approved by the U.S. Food and Drug Administration in 2018, Tibsovo is the first treatment of its kind, GoodRx reports.

18. Viekira XR (tie)

Jarun Ontakrai / Shutterstock.com

List price: $27,773 for a typical 30-day supply

Manufacturer: AbbVie

Viekira XR is an extended-release tablet used to treat adults who have chronic hepatitis C genotype 1, the most common strain in the U.S. This viral infection is spread by contaminated blood, according to the Mayo Clinic, and can cause inflammation in the liver and lead to serious liver damage.

18. Viekira Pak (tie)

fotovapl / Shutterstock.com

List price: $27,773 for a typical 30-day supply

Manufacturer: AbbVie

Viekira Pak consists of multiple medicines in tablet form that are packaged together. Like Viekira, Viekira Pak is used to treat adults who have chronic hepatitis C genotype 1.

17. Sovaldi

Tada Images / Shutterstock.com

List price: $28,000 for a typical 30-day supply

Manufacturer: Gilead

Sovaldi is used to treat certain genotypes of chronic hepatitis C in both adults and children. Taken by mouth, it comes in tablets or pellets.

16. Kynamro

TuckerBlade / Shutterstock.com

List price: $30,444 for a typical 30-day supply

Manufacturer: Kastle Therapeutics

Kynamro is a drug delivered in an injection to lower the levels of multiples types of cholesterol in patients who have homozygous familial hypercholesterolemia.

People with this rare diagnosis have extremely high levels of low-density lipoprotein cholesterol — aka “LDL cholesterol” or “bad cholesterol” — and are at risk of developing early-onset heart disease. The word “homozygous” refers to the fact that people inherit this genetic condition from both of their parents.

15. Ayvakit

David A. Litman / Shutterstock.com

List price: $32,000 for a typical 30-day supply

Manufacturer: Blueprint Medicines

Ayvakit tablets are used in treating certain gastrointestinal stromal tumors. Blueprint Medicines, which manufactures the drug, may offer financial support to some patients receiving the drug.

14. Vitrakvi

Alfred Sonsalla / Shutterstock.com

List price: $32,800 for a typical 30-day supply

Manufacturer: Bayer Pharmaceuticals

Vitrakvi comes in capsule form or an oral solution and is used to treat certain cancerous tumors in children and adults.

Manufacturer Bayer Pharmaceuticals, through its TRAK Assist program, may provide financial assistance for patients who don’t have insurance or whose insurance doesn’t cover Vitrakvi.

13. Tegsedi

ChWeiss / Shutterstock.com

List price: $34,600 for a typical 30-day supply

Manufacturer: Akcea Therapeutics

Tegsedi is administered by injection. It is used to treat nerve damage in adults with polyneuropathy of hereditary transthyretin-mediated amyloidosis. This rare inherited condition involves an accumulation of a protein called “amyloid” in tissues and organs, which can lead to various symptoms, according to the National Institutes of Health.

12. H.P. Acthar

goodluz / Shutterstock.com

List price: $39,864 for a typical 30-day supply

Manufacturer: Mallinckrodt Pharmaceuticals

H.P. Acthar (or “Acthar”) is a drug delivered by injection with multiple uses, including the treatment of:

  • Infantile spasms in infants and children under age 2
  • Exacerbations of multiple sclerosis in adults
  • The following types of disorders and diseases: rheumatic, collagen, dermatologic, allergic states, ophthalmic, respiratory and edematous state

11. Gattex

Jonathan Weiss / Shutterstock.com

List price: $40,450 for a typical 30-day supply

Manufacturer: Takeda

Gattex is a drug administered by injection for certain adults and children who have short bowel syndrome, a rare condition stemming from the loss of a portion of the small or large intestine or both, or from loss of the function of an intestine, which causes poor absorption of nutrients.

Manufacturer Takeda offers the OnePath program that can help patients with the insurance process, financial assistance options and prescription delivery.

10. Chenodal

JStone / Shutterstock.com

List price: $42,570 for a typical 30-day supply

Manufacturer: Retrophin

Chenodal was previously prescribed as a treatment for gallstones. Today, the tablets are used to treat cerebrotendinous xanthomatosis (CTX), which the drug manufacturer describes as a rare, progressive and underdiagnosed genetic disorder in which the body does not properly break down cholesterol.

Chenodal is made by Retrophin, a drug company founded in 2011 by Martin Shkreli (pictured above), whose notoriety related to huge drug price hikes earned him the media nickname “Pharma Bro.” Retrophin subsequently ousted Shkreli, who now is serving a seven-year prison term for fraud, according to Reuters.

9. Cinryze

H_Ko / Shutterstock.com

List price: $44,141 for a typical 30-day supply

Manufacturer: Takeda

Cinryze is administered through intravenous injection. It is used to prevent episodes of angioedema — severe swelling — in people who have hereditary angioedema. According to the National Institutes of Health, this rare disease often begins in childhood or adolescence.

The drug manufacturer offers copay assistance through the OnePath program to eligible Cinryze patients.

8. Juxtapid

StudioMolekuul / Shutterstock.com

List price: $44,714 for a typical 30-day supply

Manufacturer: Amryt Pharma

Juxtapid is taken orally in a capsule. Like Kynamro, mentioned earlier, it is used to treat patients with homozygous familial hypercholesterolemia, a condition involving extremely high levels of low-density lipoprotein cholesterol, aka “bad cholesterol,” that can lead to heart disease.

Juxtapid’s current list price reflects a 9.9% increase at the start of this year, GoodRx reports.

7. Daraprim

Raimundo79 / Shutterstock.com

List price: $45,000 for a typical 30-day supply

Manufacturer: Vyera Pharmaceuticals

Daraprim is used in the treatment of toxoplasmosis. The disease is caused by a parasite and, according to the Centers for Disease Control and Prevention, is a leading cause of death from foodborne illnesses in the United States. For pregnant women or people with a compromised immune system, toxoplasmosis can be particularly dangerous, the CDC says.

In 2015, pharmaceutical company exec Martin Shkreli sparked outrage for hiking the price of Daraprim from $13.50 per pill to about $750 per pill in a matter of days.

6. Takhzyro

Vaccine
Santipong Srikhamta / Shutterstock.com

List price: $45,464 for a typical 30-day supply

Manufacturer: Takeda

Takhzyro is an injected drug used in preventing attacks of hereditary angioedema. This rare inherited disorder involves episodes of fluids accumulating outside of blood vessels, which can lead to an array of complications.

5. Oxervate

InnerVisionPRO / Shutterstock.com

List price: $48,498 for a typical 30-day supply

Manufacturer: Dompé

Oxervate is a prescription eyedrop medicine for treating neurotrophic keratitis, a rare disease that causes reduced sensation in the cornea, the eye’s clear, protective outer layer.

Early this year, Oxervate’s list price rose 2.7%, GoodRx reports.

4. Actimmune

Javier Regueiro / Shutterstock.com

List price: $52,777 for a typical 30-day supply

Manufacturer: Horizon Therapeutics

Actimmune is an injection with two uses:

  • To slow disease progression in people who have severe malignant osteopetrosis, a rare bone disease
  • To reduce the severity and frequency of serious infections related to chronic granulomatous disease, a rare immune deficiency disorder that affects certain white blood cells

The current list price of Actimmune reflects a 4.8% increase that took effect in January. But the manufacturer, Horizon Therapeutics, has a patient support program offering education and financial help for eligible patients.

3. Mavenclad

CC7 / Shutterstock.com

List price: $53,730 for a typical 30-day supply

Manufacturer: EMD Serono

Mavenclad is a tablet used in treating relapsing forms of multiple sclerosis, a potentially disabling disease of the brain and spinal cord.

2. Ravicti

StudioMolekuul / Shutterstock.com

List price: $55,341 for a typical 30-day supply

Manufacturer: Horizon Therapeutics

Ravicti is a liquid taken by mouth and used to manage urea cycle disorders in adults and children as young as 2 months. These rare genetic disorders affect the urea cycle, the process by which the waste product nitrogen is removed from the blood, according to a National Institutes of Health report.

The current list price for Ravicti reflects a 4% increase from last year, according to GoodRx. But the manufacturer of Ravicti, Horizon Therapeutics, has a patient support program offering education and financial help for eligible patients.

1. Myalept

Davizro Photography / Shutterstock.com

List price: $71,306 for a typical 30-day supply

Manufacturer: Amryt Pharma

Myalept is an injected drug used to treat deficiencies of the hormone leptin in people with generalized lipodystrophy. According to the nonprofit Mayo Clinic, generalized lipodystrophy is a rare disorder characterized by selective loss of the body’s adipose (fat) tissue.

The current list price of Myalept reflects a 9.9% increase in January.

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