Humira is the best-selling prescription drug in the world. You may have seen the commercials.
Because of Humira, a woman with rheumatoid arthritis can wash her puppy in the bathtub, another with colitis can stroll happily through a fair packed with food vendors, while a third suffering from psoriasis can go to the gym without hiding her neck.
But they probably wouldn’t all look so relieved if they saw the bill. The price of Humira, an anti-inflammatory drug dispensed in an injectable pen, has risen from about $19,000 a year in 2012, to more than $38,000 today, per patient, after rebates, according to SSR Health, a research firm. That’s an increase of 100 percent.
Pharma bosses probably miss Martin Shkreli, the reigning villain of the industry. If you’ll recall, Mr. Shkreli, as chief executive of Turing Pharmaceuticals, acquired Daraprim, a drug used to fight infections in AIDS patients, and then raised the price overnight to $750 a pill from $13.50. He also trolled critics and spent $2 million on a one-of-a-kind Wu Tang Clan album, before his conviction on three securities fraud charges last year.
For a time, Mr. Shkreli’s antics, along with the soaring price of EpiPens, sold by Mylan, deflected attention from the rest of the industry. A more typical play for drug companies — the Humira play — is to start at a high price and keep raising it ever higher, but incrementally.
“What they have done with Humira is just as unfair, just as morally wrong, but they did it over five years,” said Ben Wakana, a former Obama administration spokesman who became executive director of Patients for Affordable Drugs, an advocacy group, because his younger brother couldn’t afford Humira without the financial support of their parents.
“People are skipping doses, people are rationing, people are going into bankruptcy because of this drug,” he said in an interview, arguing that Humira is both more expensive per dose and has a far higher volume than Daraprim.
AbbVie, which was spun off from Abbott Laboratories in 2013, declined to comment.
How much you actually pay out of pocket, and whether you can afford Humira at all, depend on your insurance and eligibility for discounts.
Anne Marie Garza, 51, an administrative assistant in Houston who suffers from colitis and Crohn’s disease, said she had held off buying her latest dose because her insurer had changed. She was trying to see if she could avoid an out-of-pocket payment of more than $1,200, one of two she would have to make this year, on top of her rising expenses for vitamins and supplements to manage the disease. She has relatively good insurance, but the payments will strain her budget.
“During the holidays, I was contemplating what am I’m going to do,” she said. “I was thinking should I just go on a liquid diet, because I can’t afford this.”
It’s a difficult choice.
“It does give you your life back,” she said of the drug. “I literally couldn’t go away from the house or very far from a bathroom, 20, 25 times in the bathroom all day long, I can’t imagine living like that,” she said, adding, “I was becoming a hermit because I was so sick.”
Humira, which accounted for nearly two-thirds of AbbVie’s $25.6 billion in revenue in 2016, was not simple to develop. It is among a new class of drugs known as biologics, which are made from living cells rather than synthetic chemicals. The industry has argued that high American prices are needed to fund drug development, but a 2016 study published by the Journal of the American Medical Association found “no evidence of an association between research and development costs and prices; rather, prescription drugs are priced in the United States primarily on the basis of what the market will bear.”
Competitive pressures have been muted. Copies of biologic drugs, known as biosimilars, are not as easy to produce as normal generic drugs, and AbbVie’s aggressive patent strategy has allowed it to further push off rivals. While there are name brand competitors to Humira, they are not exactly alike, complicating efforts by doctors or insurers to switch a patient from one drug to another.
Looking at the international picture tells its own story about drug costs. A prefilled carton with two syringes costs $2,669 in the United States, compared with $1,362 in Britain, $822 in Switzerland and $552 in South Africa, according to a 2015 report from the International Federation of Health Plans.