GoodRx: These are the most expensive drugs in the U.S.

GoodRx has released its latest list of the most expensive drugs in America, with orphan drugs and therapies for rare conditions continuing to top the ranking.

The most expensive drug as of July is Myalept, an orphan drug that treats leptin deficiency in patients who have generalized lipodystrophy, which is a genetic disorder where a patient has an almost total lack of body fat.

Myalept's list price is $5,093 per vial, and patients typically use 14 vials in a year, GoodRx said. The drug's price most recently went up January.

Manufacturer Aegerion Pharmaceuticals does offer a copayment coupon for people enrolled in commercial plans that can mitigate costs, GoodRx said. While most people with health insurance don't pay list prices for drugs, the list price does serve as a "good proxy" for cost, according to the report.

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Tori Marsh, director of research at GoodRx, told Fierce Healthcare that the trends in the types of drugs on the list is consistent, as it's uncommon for drugs treating rare conditions to see competition.

"Since these drugs are incredibly expensive, the two ways in which the list changes is if a generic is released or a new expensive drug comes to the market," she said. "Both of these are relatively rare occurrences, although we did see anti-parasitic medicine Daraprim drop off the list due to the development of a generic alternative."

Here's a look at the rest of the list's top five:

  • Ravicti, a drug that treats urea cycle disorders, conditions that lead patients to have high levels of ammonia in their blood. Ravicti's list price is $5,031 per bottle, though manufacturer Horizon Pharma offers a Patient Services program that aims to make it easier to secure the drug.
  • Mavenclad, which treats relapsing forms of multiple sclerosis. Patients typically are treated in two courses that are 12 months apart, and a single course costs $56,954. Maker EMD Serono does offer a copay card for the commercially insured.
  • Actimmune is another product from Horizon, and it treats osteopetrosis and chronic granulomatous disease, a rare immune condition. Patients typically take 11 vials per month, with a list price of $4,797 per bottle. Horizon offers supports through its Patient Services program.
  • Oxervate, a drug approved in 2019, is the first to treat neurotrophic keratitis, a disease that reduces sensitivity of the cornea. Patients generally go through 28 vials in a four-week course, at a list price of $1,732 per vial. Dompe, Oxervate's manufacture, offers both supports for the uninsured or underinsured and a copay card for commercial plan members.