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Several Big Pharma companies unveiled price increases for some 250 drugs during the first month of the year, according to data from 3 Axis Advisors.

Most notably, Pfizer is raising the price of its COVID-19 medication Paxlovid, while Bristol Myers Squibb is hiking the price of several cancer cell therapies.

Most of the drug price increases are lower than 10%, with the median price increase reaching 4.5%. That’s about the same as the median increase last year.

Annual price drug hikes have become less frequent in recent years due to increased scrutiny from lawmakers and the public, but drugmakers have turned to higher launch prices to get around that, 3 Axis president Antonio Ciaccia told Reuters. 

Launch prices in 2023 were 35% higher than in 2022, according to an analysis by the outlet.

“Drugmakers don’t have much real estate any longer to increase prices over time, which means taking greater liberties on launch prices is really the only option they have in the face of expanded penalties for year-over-year price increases,” Ciaccia said.

Pfizer came out on top in raising the prices of most drugs for the third year in a row, accounting for about 60 on the list. 

The pharma giant, which has experienced a tumultuous few years following a sharp decline in its COVID business, raised the prices of its migraine drug Nurtec and some cancer drugs including Adcentris, Ibrance and Xeljanz.

Leadiant Biosciences was responsible for the biggest price hikes this month, including a 15% increase on its Hodgkin’s disease therapy Matalune — as well as a 20% increase on cystinosis treatment Cystaran.

BMS increased the prices of its oncology drugs, Abecma and Breyanzi, by 6% and 9%, respectively.

Dan Ollendorf, chief scientific officer and director of health technology assessment methods and engagement at healthcare nonprofit Institute for Clinical and Economic Review (ICER), told MM+M that the context around the list prices is important to understand their impact. 

List prices are different from net prices, or the money drugmakers take home after paying rebates, discounts or other concessions to middlemen and insurers.

“Before we make too much out of the yearly list price increases, we have to think about what that actually will mean in terms of net pricing,” he said.

Notably, some list prices also went down this month. 

Merck decided it will reduce the list price of its diabetes drugs, Januvia and Janumet, noting it wants to align the list price more closely to the net price. Januvia is one of the first 10 drugs chosen to be part of the Medicare negotiation process, though it’s unclear if the January price drop is related to that.

Last month, ICER published a report that examined the top 10 drugs with the most substantial net price increases in 2023. 

The report found that five of those drugs — Biktarvy, Darzalex, Entresto, Cabometyx and Xeljanz — saw “unsupported” price increases that did not add value to patients and resulted in $815 million in added costs to payers.

“The higher prices we pay for drugs, and if those prices are not aligned with value to the patient, the more pressure that puts on the system,” Ollendorf explained.

In an emailed statement, a BMS spokesperson said “it is important to note that most patients will not pay the list price for their medication,” and that it does not reflect the discounts provided to insurers, PBMs and other purchasers.

“At BMS, we are committed to achieving unfettered patient access to our potentially life-saving medicines and our approach to pricing prioritizes the value our medicines deliver for patients, healthcare systems and society,” the spokesperson continued.

Drug pricing advocacy organization the Campaign for Sustainable Rx Pricing (CSRxP), however, wasn’t as pleased with the news.

“Big Pharma makes a tradition of ringing in each new year with egregious price hikes on hundreds of brand name prescription drugs,” CSRxP executive director Lauren Aronson said in a statement. “Big Pharma’s price hikes this January will continue to grow but already outpace the rate of inflation and include significant increases on drugs for serious conditions, like cancer.”

It’s still not clear how the January price hikes might impact net prices or ultimately impact patients, Ollendorf said. Higher list prices don’t always translate to higher net prices and even reductions in price — as seen with Januvia — might not always provide savings to patients.

“It depends both on whether the net price trend is following the same pattern [as the list price trend],” Ollendorf explained. “If the net price trend is flatter, then it may not have as much of an impact on patients unless that patient has insurance that is still basing the co-insurance level on the list price rather than the net price.”

Another area that might have an impact on increasing drug costs is the newly implemented provision of the Inflation Reduction Act that requires drugmakers to pay rebates to the federal government for raising the prices of drugs faster than the rate of inflation.

“It will be interesting to track not just whether the net price trend is different from the list price trend, but also how the effects of inflation rebates in the Medicare program play out,” Ollendorf said.