HC Statistics Pharmaceuticals

Changes in prices and out-of-pocket costs for brand-name clinician-administered drugs

Using commercial claims data between 2009-2018, a paper in Health Services Research by Lalani et al (2024) finds that:

  • Rebates are rising as a share of cost
  • Fewer patients have $0 out-of-pocket cost
  • Patient out-of-pocket costs growth was 2.9x as large as net drug cost growth


List prices increased 4.4%/yr (interquartile range [IQR], 1.1% to 6.0%) and net prices 3.3%/yr (IQR, 0.3% to 5.5%). The median percentage of patients with any out-of-pocket costs increased from 38% in 2009 to 48% in 2018, and median non-zero annual out-of-pocket costs increased by 9.6%/yr (IQR, 4.1% to 15.4%). There was no association between changes in prices and out-of-pocket costs for individual drugs.

The full article is here.