As policies from the last two presidential administrations put heightened focus on drug affordability in the United States, a new report suggests much work remains to be done when it comes to the launch prices of novel medicines.
From a starting rate of $190,000 in 2022, the median net launch price of U.S. drugs jumped up 35% by 2025, when that median price grew to $257,000, the Institute for Clinical and Economic Review (ICER) and West health said in their Launch Price and Access Report published (PDF) this week.
The net price for new drugs—which reflects the practical cost of a medicine after rebates and discounts—did decrease slightly between 2024 and 2025 at 2%, although it nevertheless “remained at historically high levels,” putting a strain on U.S. healthcare systems, ICER and West Health said separately in an Oct. 20 release.
“This independent analysis shows that we are facing a critical moment in the US health care system,” Sarah Emond, ICER’s president and CEO, said in a statement Monday.
“While the US has produced some of the world’s most incredible innovations, patients are still experiencing significant barriers to care,” she continued. “Now more than ever, it is crucial that we start working towards the goal of pairing fair pricing with fair access—leading to a more affordable health system for us all.”
Parsing the net price increase on launches, ICER pointed out (PDF) that the “most substantial increase” happened between 2022 and 2023, after which, “launch prices remained relatively stable.” The pattern may have been informed, at least in part, by the differences in types of drugs launched each year, with ICER suggesting that launch prices seemed to “trend upward when accounting for these differences.”
ICER is a nonprofit that performs cost-benefit calculus on medicines and diagnostics in the U.S., helping to appraise those interventions’ value and suggest fair prices.
West Health, for its part, was founded by philanthropists Gary and Mary West, with a focus on lowering healthcare costs to help seniors “successfully age in place.”
ICER noted in its research protocol (PDF) that it gleaned its net price data from multiple sources, including SSR Health, IPD Analytics and the Federal Supply Schedule.
Digging deeper into the findings, ICER and West Health’s report noted that nearly one-fourth of drugs rolled out last year had an annual net price topping $500,000, while an additional 34% had launch prices ranging from $200,000 to $500,000.
Moreover, only around 1 in 3 newly approved drugs that ICER previously reviewed between 2022 and 2025 fell at or below the organization’s recommended price benchmark.
Topping the list of drugs with prices ICER has deemed insufficient value for money was Insmed’s Brinsupri, approved in non-cystic fibrosis bronchiectasis last summer and which the cost watchdog suggested needs an up to 95.5% discount to be priced in line with its value benchmark.
Merck’s pulmonary arterial hypertension drug Winrevair also landed near the top of the rankings, with ICER suggesting that the activin signaling inhibitor could benefit from a price cut between 82.7% and 91.2%.
ICER reached those discount targets according to the price cuts needed to reach a cost-effectiveness threshold of $150,000 per equal value life year gained and $100,000 per quality-adjusted life year gained.
Other notable products tagged for suggested discount included Bristol Myers Squibb’s cardiomyopathy drug Camzyos, Merck’s Ohtuvayre for COPD, Novartis’ kidney disease med Fabhalta, Eisai and Biogen’s Alzheimer’s disease antibody Leqembi, and the gene therapy Casgevy and CAR-T treatment Carvykti, to name a few.
Those high launch prices add to an already complex confluence of factors when it comes to new drug access, ICER and West Health explained. In their research, the partners found that just one-third of outpatient prescriptions for drugs launched between July 2024 and June 2025 were ultimately filled within 30 days, adding that nearly 4 in 10 prescriptions of drugs approved over that same timeframe were rejected due to non-coverage, with patients on Medicare facing the biggest roadblocks.
The majority of those rejections can be credited to new-to-market blocks, ICER argued, calling on payers to have coverage policies available on a quicker timeline following FDA sign-off.
“A rapid shift in behavior to price drugs in line with value is needed, and should be met with streamlined access to new drugs with little to no cost-sharing for patients,” ICER concluded in a summary of the report.
Drugmakers within the industry have frequently taken issue with how ICER appraises the value of medicines, also reflected in the organization’s regular drug price increase reports, which leverage similar assessment metrics.
The report comes as U.S. lawmakers have made efforts to corral high drug costs on multiple fronts, from the Biden-era Inflation Reduction Act and the Medicare price negotiations it installed, to the more recent “Most Favored Nation” policy rolled out by the second Trump White House, which broadly seeks to align the costs of medicines in the U.S. with prices paid in a basket of high-income comparator countries.
Both approaches have received pushback, with IRA the target of multiple—albeit frequently unsuccessful—challenges by the industry, which has broadly argued that the Medicare negotiations are unconstitutional and force manufacturers’ hands if they hope to participate in the program.
President Trump’s MFN pacts with major drugmakers, meanwhile, have become a target of patient advocacy groups and political rivals who’ve drawn attention to the lack of clarity around the agreements and their exact terms.
Against that backdrop, the issue of healthcare affordability remains top of mind for many Americans.
In a recent poll from the West Health-Gallup Center on Healthcare from July, nearly 40% of people surveyed said they were “concerned” or “very concerned” about the ability of their households to pay for needed prescription drugs in the next year. That was up from 25% who reported that rate of concern in 2022, ICER and West Health pointed out.