Table 3. Top 10 Drugs With Accelerated Approval by Net Spending in 2019.
| Proprietary name | Active ingredient(s) | First indication with accelerated approval | Approval year | Total reimbursement, $ | ||
|---|---|---|---|---|---|---|
| Gross (2019) | Net (2019)a | Net average/y since approvalb | ||||
| Truvada | Tenofovir disoproxil fumarate and emtricitabine | For the treatment of HIV infection | 2004 | 455 007 840 | 147 818 848 | 224 187 550 |
| Avastin | Bevacizumab | For the treatment of metastatic ERBB2 (formerly HER2)-negative breast cancer in combination with paclitaxel | 2008 | 207 338 080 | 159 442 992 | 155 474 551 |
| Makena | Hydroxyprogesterone caproate injection | To reduce the risk of preterm birth in women with a singleton pregnancy and a history of singleton spontaneous preterm birth | 2011 | 161 694 160 | 124 342 816 | 118 826 324 |
| Perjeta | Pertuzumab | Neoadjuvant treatment in combination with trastuzumab and docetaxel for patients with ERBB2 (formerly HER2)-positive breast cancer | 2013 | 121 797 720 | 93 662 448 | 69 591 178 |
| Imbruvica | Ibrutinib | For the treatment of mantle cell lymphoma | 2013 | 110 119 488 | 76 098 624 | 38 511 955 |
| Opdivo | Nivolumab | For the treatment of unresectable or metastatic melanoma and disease progression following ipilimumab therapy | 2014 | 215 100 512 | 165 412 304 | 123 009 929 |
| Keytruda | Pembrolizumab | For the treatment of unresectable or metastatic melanoma and disease progression following ipilimumab therapy | 2014 | 308 625 920 | 155 043 200 | 66 731 640 |
| Ibrance | Palbociclib | For the treatment of postmenopausal women with estrogen receptor–positive, ERBB2 (formerly HER2)-negative advanced breast cancer in combination with letrozole | 2015 | 302 688 128 | 210 968 672 | 180 525 260 |
| Jadenu | Deferasirox | For the treatment of chronic iron overload in patients ≥10 y with nontransfusion-dependent thalassemia syndromes | 2015 | 166 882 992 | 85 344 304 | 97 071 340 |
| Exondys 51 | Eteplirsen | For the treatment of Duchenne muscular dystrophy in patients who have a gene alteration amenable to exon 51 skipping | 2016 | 161 106 800 | 123 891 136 | 74 338 275 |
a
Net spending for each product is the sum of its National Drug Code total reimbursement amount after deducting a minimum rebate (23.1% in 2019) and any inflation-based rebates estimated from a trend line beginning in the first year each National Drug Code is observed.
b
Beginning in the first full calendar years of sales, net average per year is the average of the annual Consumer Price Index for All Urban Consumers–adjusted (2019 US dollars) net spending for each product. This figure may be greater than net spending in 2019 owing to larger volumes of sales or higher prices for a given drug in preceding years.