Launch and Postlaunch Price Developments of New Drugs in the US, Germany, and Switzerland

Importance: High prices of new drugs are concerning. What remains to be understood are price developments after entering the market because not only initial prices, but also postlaunch prices, contribute to drug spending. Objective: To analyze launch and postlaunch price developments of new drugs in the US, Germany, and Switzerland. Design, setting, and participants: This cohort study used the public databases of the US Food and Drug Administration, European Medicines Agency, and Swissmedic to identify all new drugs approved between January 2011 and December 2022. Data were collected and analyzed between January 2024 and September 2024. During the revision process in October 2024, SSR data were also analyzed. Drugs for which price data were available were included in the study cohort. Launch prices and postlaunch price developments in the US, Germany, and Switzerland were calculated from 2011 until 2023. Main outcomes and measures: Standard statistics (mean, median, and IQR) were applied to analyze launch drug prices and postlaunch drug price developments over time in the US, Germany, and Switzerland. Results: The cohort study included 254 drugs in the US, 298 in Germany, and 235 in Switzerland. In the US, mean (SD) launch prices increased from \$31 699 (\$36 439) in 2011 to \$228 658 (\$571 252) in 2022, with an average increase of 19.7% per year. In Germany, mean (SD) launch prices increased from \$77 237 (\$228 672) to \$146 072 (\$306 091), with an average increase of 6.0% per year. In Switzerland, mean launch prices increased from \$29 211 (\$41 919) to \$41 399 (\$39 697), with an average increase of 3.2% per year. Post launch, trimmed mean prices of included drugs in the study cohort increased -0.6% at 3 years, 2.4% at 5 years, and 4.1% at 10 years post launch in the US. A larger increase of postlaunch prices was observed for cancer drugs compared with noncancer drugs. In Germany, trimmed mean drug prices decreased -30.9% at 3 years, -33.4% at 5 years, and -45.2% at 10 years post launch. In Switzerland, trimmed mean drug prices decreased -9.3% at 3 years, -13.5% at 5 years, and -29.5% at 10 years post launch. In Switzerland and Germany, postlaunch price developments were similar for cancer and noncancer drugs, but treatment costs of cancer drugs remained substantially higher compared with noncancer drugs. Conclusions and relevance: The results of this cohort study suggest that, in contrast to Germany and Switzerland, prices of cancer drugs increased substantially post launch in the US. When developing solutions how drug prices can be decreased, launch as well as postlaunch prices require attention from policymakers.