STAT+: Net prices for medicines inched up in last year’s fourth quarter after falling a year ago, analysis finds

Net prices that health plans paid for medicines rose a modest 0.4% in the fourth quarter, but that compared unfavorably with a 3% decline in the same period a year…

Mar 25, 2025 - 16:16
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STAT+: Net prices for medicines inched up in last year’s fourth quarter after falling a year ago, analysis finds

The net prices that health plans paid for medicines — after subtracting rebates, discounts, and fees — rose a modest 0.4% in last year’s fourth quarter, but that compared unfavorably with a 3% decline in the same period a year earlier, according to the latest data from SSR Health, a research firm that tracks the pharmaceutical industry and its pricing trends.

A key reason was that net prices rose for so-called protected oncology medicines, one of six classes of drugs for which Medicare Part D generally covers an entire category. Typically, these six classes have smaller and more stable discounts compared with other medicines in the marketplace. As a result, net prices rose faster for protected classes, but it is not clear why this occurred more so with cancer drugs.

Tugging in the other direction was a type of medicine known as disease-modifying antirheumatic drugs, such as Humira, which are used to treat rheumatoid arthritis and other maladies. Ongoing pricing pressure caused by a growing number of biosimilars — nearly identical variants of brand-name biologic medicines that yield the same health outcomes but at a lower cost — stifled further rises in net prices.

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