Price comparison of the 10 most expensive drugs as of 2018

The number one most expensive drug, as of 2018, was Glybera or alipogene tiparvovec with a list price of around 1.2 million U.S. dollars per year. Ravicti was ranked the second expensive drug, used in the long-term treatment of urea cycle disorders. Ravicti is marketed by Horizon Pharma, a former U.S.-based but now Irish-based pharmaceutical company. The most costly drugs worldwide based on wholesale acquisition cost (list price) are mostly orphan drugs for rare diseases.

What are orphan drugs?

Orphan drugs are pharmaceutical products for the treatment of so-called rare diseases. These are diseases with a very low prevalence within a population. Thus, it is not too appealing for companies to invest into R&D for drugs, which they potentially could sell only to a small number of patients. However, because persons afflicted by rare diseases should have the same right for care and treatment as persons with more common diseases, specific regulations were introduced over time. In 1983, the Orphan Drug Act was signed in the United States, for example.

The impact of the Orphan Drug Act

The Orphan Drug Act applies certain incentives for pharmaceutical companies to develop and market orphan drugs. This includes, for example, tax credits on clinical research, accelerated administrative procedures, and a 7-year market exclusivity after approval. These and other benefits significantly changed the level of interest in rare disease treatments. Given the fact that there are around 7,000 rare and ultra-rare diseases, drug manufacturers are increasingly entering this market with large potential. It becomes especially profitable when an already existing drug for common diseases also shows effects on a rare disease, or when an orphan drug emerges to be effective for other, more common diseases. In such cases, the orphan status of the drug helps companies to extend market exclusivity and add higher price tags, causing some critics to claim that the industry is gaming the system.

Per-year list price of the top ten most expensive drugs worldwide as of 2018*

List price per year in U.S. dollars
Glybera (alipogene tiparvovec)1,200,000
Ravicti (glycerol phenylbutyrate)793,000
Carbaglu (carglumic acid)790,000
Brineura (cerliponase alfa)700,000
Lumizyme (alglucosidase alfa)626,000
Actimmune (interferon gamma 1-b)572,000
Soliris (eculizumab)542,000
Folotyn (pralatrexate)500,000
Demser (metyrosine)472,000
Ilaris (canakinumab)462,000
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Release date

October 2018



Survey time period

as of October 2018

Supplementary notes

* All prices are rounded maximum values.

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Statistics on "Orphan drugs"

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