Prescription drugs that reached the U.S. market last year carried a median net price of $257,000 a year, according to a report released Tuesday by the Institute for Clinical and Economic Review and West Health. That is 35% higher than in 2022, after adjusting for inflation, even though the figure slipped about 2% from 2024.
The report is the second edition of ICER’s annual Launch Price and Access Report; the first came out in October 2025. Unlike most drug pricing studies, which rely on public list prices, it tracks net prices: what insurers and other buyers actually pay after rebates and discounts. By that measure, about one in four drugs launched in 2025 cost more than $500,000 a year, and another 34% landed between $200,000 and $500,000.
Getting those drugs into patients’ hands proved just as hard. Only about a third of outpatient prescriptions for newly launched medicines were filled within 30 days of the first attempt, the ICER and West Health report found. Medicare patients fared worst.
“This independent analysis shows that we are facing a critical moment in the US health care system,” said Sarah K. Emond, ICER’s president and CEO. “Overpayment for drugs beyond their value to patients is contributing to decreased patient access.”
How much do new drugs cost in 2026?
The headline number is the median net launch price, adjusted for inflation: $173,000 in 2022, rising to $257,000 for drugs approved in 2025. The small dip between 2024 and 2025 does not change the picture, the authors wrote, because prices remain at historically high levels.
Part of that dip may reflect the mix of drugs approved. Fewer 2025 approvals were gene and cell therapies, biologics or ultra-rare disease drugs, the categories that usually carry the steepest prices.
ICER also compared launch prices with its own value benchmarks, which estimate what a drug is worth based on how much it improves patients’ health. Only about one in three newly approved drugs that ICER had reviewed came in at or below that benchmark. The rest were priced above what the group considers their value.
Why can’t patients fill prescriptions for new drugs?
The access data covers outpatient prescriptions for novel drugs approved between July 2024 and June 2025. Across all payers, 36% of those prescriptions were filled within 30 days and 39% were rejected because the drug was not covered. The authors said many of those rejections likely reflect “new-to-market blocks,” the practice of keeping a new drug off a formulary until the insurer reviews it.
Why do Medicare patients have the hardest time getting new drugs?
The gap by insurance type was wide. For prescriptions billed to commercial plans, 51% were filled within 30 days. For Medicaid, 42%. For Medicare, just 20%, with 58% rejected for non-coverage.
Medicare enrollees also paid the most when they did get a prescription filled. Out-of-pocket costs on Medicare claims were often two to five times those on commercial claims. The report points to one likely reason: federal rules bar drugmakers’ copay cards for people on Medicare. For the cancer drug Avmapki, Medicare patients paid an average of $614.50 out of pocket, compared with $122.38 for commercially insured patients.
“The data shows the struggle with high launch prices is even more stark for Medicare recipients who face higher rates of coverage rejections than all other payer types,” said Timothy Lash, president and chair of the West Health Policy Center. “Even when Medicare beneficiaries can get access, paying more for drugs means hard tradeoffs for American seniors living on a fixed income.”
Polling from the West Health-Gallup Center on Healthcare, cited in the release, shows how widely that worry has spread. In July 2026, nearly 40% of Americans said they were concerned or very concerned that their household would not be able to pay for needed prescription drugs in the next 12 months, up from 25% in July 2022.
Will Medicare negotiation and most-favored-nation pricing lower launch prices?
Not yet, as far as this data shows. The report says the effect of the Medicare Drug Price Negotiation Program, created by the Inflation Reduction Act in 2022, on launch prices “remains unclear.” Negotiation reaches only high-spending drugs, years after approval, and some analysts expect drugmakers to respond with higher launch prices.
The Trump administration’s most-favored-nation push, which began in 2025 and aims to bring U.S. prices closer to those in peer countries, can apply at launch. But the report notes that the current rollout is voluntary and not standardized, so its effect on new drugs is hard to measure.
The timing matters for families now comparing plans. Medicare’s open enrollment period runs through Dec. 7, and a drug’s coverage status can differ sharply from one Part D or Medicare Advantage plan to the next. We looked at why Americans pay so much for medicine, and the legal options some are turning to, in our earlier report on affordable prescription medications.
ICER will discuss the findings in a public webinar at noon ET on Oct. 27.
What do critics of the report say?
Not everyone accepts ICER’s findings. The National Pharmaceutical Council, a Washington-based health policy research group, questioned both the report’s methods and the decision to publish it every year.
“It’s unclear why ICER decided to publish this report annually. The report recycles most of last year’s pricing data and repeats many of last year’s claims, its value methods have ICER’s usual flaws, and its access data is internally inconsistent with ICER’s fair access judgment yet fails to include the patient voice,” said Kimberly Westrich, NPC’s chief strategy officer. “The report risks misinterpretation and stretches its conclusion beyond the evidence, leaving more questions than answers.”
Correction, Oct. 20, 2026: An earlier version of this story described the report as ICER’s first Launch Price and Access Report. It is the second; the first was published in October 2025.
Key takeaways
- The median net launch price of a new U.S. drug was $257,000 a year in 2025, up 35% from 2022 after inflation.
- About one in four 2025 launches cost more than $500,000 a year.
- Only about a third of prescriptions for newly launched drugs were filled within 30 days; Medicare’s rate was 20%.
- Medicare patients often paid two to five times more out of pocket than people with commercial insurance.
- Neither Medicare negotiation nor most-favored-nation pricing has yet shown a clear effect on launch prices, the report says.
Frequently asked questions
What is the average price of a new drug in the U.S.?
According to ICER and West Health, the median net launch price of drugs approved in 2025 was $257,000 a year, adjusted for inflation. That is the price after rebates and discounts, not the list price.
Why are new drugs often denied by insurance?
In the report, 39% of outpatient prescriptions for newly launched drugs were rejected for non-coverage. The authors say many denials likely come from new-to-market blocks, when insurers hold a new drug off their formulary while they review it.
Do Medicare patients pay more for new drugs?
Often, yes. Out-of-pocket costs on Medicare claims were frequently two to five times those on commercial claims, in part because drugmaker copay cards are not allowed for people on Medicare. Only 20% of Medicare prescriptions for new drugs were filled within 30 days.
Who published the Launch Price and Access Report?
The Institute for Clinical and Economic Review, an independent nonprofit research group, published it with West Health on Oct. 20, 2026. Its data partners were IPD Analytics and IQVIA.
