OBJECTIVES

To describe trends in list prices, net prices, and discounts for all self-administered tumor necrosis factor inhibitors (TNF-Is) from 2007-2019.

METHODS

We obtained 2007-2019 pricing data for etanercept, adalimumab, certolizumab pegol, and golimumab from SSR Health, which provides quarterly estimates of list prices, net prices, and discounts in Medicaid and other payers for branded products manufactured by publicly traded companies. For each drug and year, we calculated average list and net annual costs of treatment for patients with rheumatoid arthritis based on Food and Drug Administration (FDA)-approved recommended dosing; and average discounts in Medicaid and in other payers.

RESULTS

: List prices of etanercept and adalimumab increased by 294% from 2007-2019; however, discounts offset approximately 45% of these increases, leading to net price increases of 171% and 203%, respectively. Similarly, list prices of certolizumab and golimumab increased by 183% from 2010-2019; however, discounts offset approximately 58% of these increases, leading to net price increases of 109% and 103%, respectively. Net prices of self-administered TNF-Is substantially increased from 2007-2019 and began to stabilize in 2016.

Across the study period, Medicaid discounts increased by 66 percentage points for etanercept, by 63 for adalimumab, 33 for certolizumab, and 13 for golimumab. By 2019, Medicaid discounts exceeded 80% for etanercept, adalimumab, and certolizumab. Across the study period, discounts in other payers increased by 26 percentage points for etanercept, 16 for adalimumab, 21 for certolizumab, and 27 for golimumab. By 2019, discounts in other payers averaged 34% for etanercept and adalimumab, and 46% for certolizumab and golimumab.

CONCLUSIONS

: Prices of self-administered TNF-Is rose substantially in 2007-2019, even after accounting for increases in manufacturer discounts. Our findings support the development of policies that aim to lower drug prices in the biologic market.