High prescription drug prices and the ongoing bipartisan push for further drug pricing reform are among the top healthcare concerns in modern America, but which drugs have had the most excessive price increases?

AARP released a list of the top 10 drugs from 2020 with price increases that outpaced the 1.3% inflation rate that year.

Leading the way was Nerlynx, an early stage breast cancer drug from Puma Biotech, which experienced a price hike of 20.8%.

In second place was Actemra, a rheumatoid arthritis medicine from Genentech, at 11%, followed by Tyvaso, a hypertension treatment from United Therapeutics, at 9.6%. Rounding out the top five were Bausch Health’s anxiety and depression drug Ativan at 9.2% and Velphoro, a chronic kidney disease treatment from Fresenius Medical Care, at 8.5%.

The bottom half of the list included Xyrem, a daytime narcolepsy drug from Jazz Pharmaceuticals, at 8.5%; Vascepa, an ethyl eicosapentaenoic acid used to prevent heart attack or stroke from Amarin, at 8.3%; Tymlos, an injectable osteoporosis medicine from Radius Health at 7.9%; Northera, a low blood pressure medication from Hikma Pharmaceuticals, at 7.9% and Xifaxan, an antibiotic for irritable bowel syndrome from Salix Pharmaceuticals, 7.9%.

The average annual cost of commonly used drugs was $26,000 in 2020, which the report posited would have been lower by $14,000 had drug prices not been allowed to increase faster than inflation.

These findings reflect a world prior to the passage and enactment of the Inflation Reduction Act of 2022, which requires drug manufacturers to pay rebates to Medicare if their drug prices increase faster than inflation.

A report released by the Department of Health and Human Services in the fall of 2022 found that prices for more than 1,200 prescription drugs rose faster than inflation over a yearlong period.

Leigh Purvis, coauthor of the report and AARP’s prescription drug policy principal, wrote that the findings indicate that the emergence of generic drugs are having a positive impact on affordability. Still, Purvis urged leaders on Capitol Hill to take up legislative proposals that would prevent Big Pharma from using tactics to keep generics from being developed and commercialized.

Purvis added that the findings show “the magnitude of the price increases over time and how not allowing them to increase so dramatically can have a real, meaningful impact on the price of these products.”