New drugs launched at a median net price near $257,000 a year in 2025, report finds
A report from the Institute for Clinical and Economic Review and West Health found that launch prices for new drugs rose sharply after 2022 and that most first prescriptions for those drugs were not filled within a month.
Novel drugs approved by the Food and Drug Administration (FDA) in 2025 launched at a median estimated net price of $257,369 a year, according to the 2026 Launch Price and Access Report1 published October 20 by the Institute for Clinical and Economic Review (ICER), a nonprofit that assesses the value of medical treatments, in collaboration with West Health. After adjusting for inflation, the median net launch price rose 35% from 2022 to 2025, the report found.
Launch prices set the starting point for what insurers, employers and patients pay for new treatments, and the report ties them to rising premiums and to the coverage restrictions insurers use to manage costs. Most of the increase came between 2022 and 2023, when the inflation-adjusted median net price rose 32%, from $190,553 to $252,296. It rose 4% in 2024 and fell 2% in 2025. Median list prices, before rebates and discounts, rose 24% over the four years, reaching $293,304 in 2025.
About one in four of the 47 drugs approved in 2025 had an estimated annual net price above $500,000, two exceeded $2 million, and another 34% fell between $200,000 and $500,000, ICER found. The 2025 group included smaller shares of gene and cell therapies, biologics and drugs for ultra-rare diseases than earlier years, categories that tend to carry higher prices. When ICER adjusted for those differences across all 202 drugs approved from 2022 to 2025, it estimated that net launch prices rose 18% a year, though it noted that the result was not statistically significant.
ICER also compared prices with its own value benchmarks. Of the 26 drugs in the period that ICER had previously reviewed, only about one in three were priced at or below the range it considers fair given the health benefits they provide, according to the report.
Using IQVIA data on drugs approved from July 2024 through June 2025, ICER found that only 36% of first outpatient prescriptions were filled within 30 days, while 39% were rejected because the drug was not covered, which the report said was likely due to blocks insurers place on newly launched drugs. Fill rates differed by payer: 51% for commercial insurance, 42% for Medicaid and 20% for Medicare. Medicare enrollees also had the highest average out-of-pocket costs for most of the drugs studied. ICER pointed to two likely reasons: Medicare enrollees cannot use manufacturer copay cards, and part of the study period came before Medicare's prescription drug benefit gained an annual out-of-pocket cap on January 1, 2025.
The net prices are estimates. Actual discounts are confidential, and no manufacturer submitted net price data when ICER invited them to, the report said. ICER instead combined Medicare average sales price data, analyst estimates from IPD Analytics and SSR Health, and Federal Supply Schedule prices, then removed discounts under the federal 340B drug program, which go to hospitals and clinics rather than to the payers that reimburse them. A scenario using only Federal Supply Schedule prices produced consistent trends, ICER said. The report was funded mainly by nonprofit foundations, led by West Health and Arnold Ventures, and received no funding from insurers, pharmacy benefit managers or drugmakers, though ICER said about 20% of its overall revenue comes from those industries to host a separate policy summit.
In the announcement2, ICER President and Chief Executive Sarah Emond called for "pairing fair pricing with fair access." The report says it is too early to know how Medicare drug price negotiation and the federal government's most-favored-nation pricing efforts will affect future launch prices. ICER publishes the analysis each year.
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