It’s hardly front-page news that the U.S. holds the top spot for the most expensive prescription drugs on the planet (with prices of the most expensive among them being truly staggering). The price of U.S. drugs is estimated to be, on average, 2.5 times the average price for the very same drugs across other developed nations. This 250% markup that Americans typically pay has for decades now been the hottest of political issues, informing the campaign rhetoric of Democrats and Republicans alike.

The issue of lowering these prices has become so important for the vast majority of Americans that reducing them has become a rare bi-partisan issue in the U.S. Yet with little cross-party agreement on just how to get the prices down, it doesn’t look like the situation is set to change. And far from being a static problem, prices of U.S. prescription drugs only increase as government inaction prevents any meaningful change from coming into sight.

This state of affairs has had many different effects on the lives of American consumers, but by far the most significant one has been the boom in cross-border medication trade from Canada. North of the border, drug prices are typically around 70% cheaper than in the U.S., and this is one of the reasons so many Americans are flocking to online pharmacies such as Canada Pharmacy, which offer drugs at significantly lower prices. Adding to the popularity of Canadian drugs has been the same level of effectiveness and safety that the Canadian healthcare system and CFIA regulatory body guarantees. Significantly lower prices for safe and secure drugs has been an opportunity that many Americans, frustrated with prices in the U.S., have found unable to resist.

And as is the case with every phenomenon, things tend to explode at the extremes. For some medications, especially those that necessitate a course of weeks or months, prices can become truly stratospheric. Below we will list the ten most expensive prescriptions drugs in the U.S. (complete with their eyewatering prices). But it might be first worth delving a little deeper into just why prices in the U.S. get this high.

Why So Expensive?

In order to appreciate the situation in the U.S., you need to start thinking along the lines of government involvement. To take Canada as an example, the reason prescription drugs are significantly less expensive in that country is simple – the government makes it that way. Quite simply, the Canadian government takes an interventionist approach, calculates a maximum cost which certain prescription drugs may be sold for in Canada, and only allows their distribution if this cost is agreed to by the pharmaceutical companies. Generally, big pharma gives in, and the drugs go on the market at the government-approved price. 

In the U.S., the government does nothing besides ensuring (through the FDA) that medications meet safety and effectiveness standards. The reasoning behind this is that the U.S. is a country with a massive pharmaceutical market (by far the biggest in the world) and that revenue gathered here is particularly important for ensuring research into lifesaving drugs continues. This is something of an erroneous argument because it has been shown that these companies actually make far more than they need to continue their research and have been unwilling to increase it using that extra revenue.

So, the high prices seem set to stick around for now. And here are the highest:

The List

DrugAnnual cost based on length of therapy
Zolgensma$2,125,000
Zokivny$1,032,480
Danyelza$977,664
Myalept$889,904
Luxturna$850,000
Folotyn$793,870
Brineura$730,340
Blincynto$712,672
Ravicti$695,970
Soliris$678,392
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