Unpacking the first 590 brand drug list price changes of 2025
2025 is here and while New Year’s traditions are prevalent everywhere, that doesn’t stop us at 46brooklyn from engaging in our own, which is to monitor brand drug price changes with perhaps increased scrutiny relative to the rest of the year. For the uninitiated, January 1st is effectively the day that a slew of brand-name medications take price increases (if they’re going to).
You may have heard about 2025 brand list drug price increases in advance of the ball drop thanks to Mike Erman over at Reuters. That early look at to-be-implemented drug price changes usually hits before the holiday break ends each year. And if you live your holidays like we do, you know that period before the winter break ends is low on exertion and high on junk food. While undoubtedly satisfying, you can’t let that be your normal. That’s why so many people start the new year with resolutions to get back into shape. We like to think of the timeline of new year price increases the same way.
Those early-announced price increases are the proverbial empty holiday calories – limited to the point that adequate, holistic reflection isn’t all that doable. But digest them, we do. Just like that last sweet swig of egg nog sitting in the back of the fridge that is technically two days past expiration, who can resist?
What is a brand drug pricing story without a reference to SpongeBob?
But all good things come to an end, and much like the first-of-the-year slog to the gym, we drug pricing nerds too work to get our data analyses into prime conditioning. While we implore you to stick around for the full story of 2025 throughout the year – and yes, that includes following generic drug trends as well (friends don’t let friends skip leg day nor generic drug pricing analyses) – we believe today’s report and the newly released net price trends from Drug Channels are good starting points to level up your drug pricing fitness now that holidays have passed.
Since 2016, roughly a third of all brand drug list price increases (as measured on a wholesale acquisition cost, or WAC, basis) occur on January 1. Figure 1 examines these trends by subtracting the total number of decreases from the total number of increases on a year-over-year basis.
Figure 1
Source: Elsevier Gold Standard Drug Database, 46brooklyn Research
For the removal of doubt, and for those who need a few more reps of mental math estimation, what Figure 1 is showing us is that we’ve gone from January 1st price changes representing 16-17% of all brand price change activity for a given year (like it was back in 2011 and 2012), to January 1st representing 39% of all brand price change activity for a given year (as it has in 2023 and 2024). Figure 1 is also showing us that this January 1, 2025 saw more brand drug list price increases than any January 1st we’ve seen going back to 2011 (the first year we have data for).
Of course, this is all a very simple and surface level analysis – and drug pricing in the U.S. is far from simple, and often all the real action is well below the surface. This is why, roughly five years ago, we launched our 46brooklyn Brand Drug List Price Change Box Score, enabling anyone to study brand drug list price change trends all on their own. And while five years ago may feel like a lifetime ago and recent at the same time (we can remember the release of the Impractical Jokers movie like it was yesterday), we still think that using the dashboard can sometimes be daunting; so we figured we’d write up a quick report on what we’re seeing at the start of 2025 for those interested (or otherwise uninitiated to 46brooklyn and/or January 1st price changes). As a reminder, if you’re unfamiliar with the dashboard, check out our FAQs and the companion report that was released with the tool back in 2020.
Three…Two…One… 576 net brand price increases to start 2025!!
Figure 2
Source: Elsevier Gold Standard Drug Database, 46brooklyn Research
Glib header aside, we start our analysis by simply recognizing that through the first couple of days in 2025, we’re at a net of 576 brand medications that have taken a WAC price increases of some amount. We say “net” because our brand box score captures both increases and decreases in brand drug list prices, and there have already been 583 medications which have taken a WAC price increase at the start of the year and seven that have taken a decrease (so 590 changes total, 583 increases, 7 decreases, all for a net of 576 increases). You can see these numbers when you hover over the 2025 trend line in Stat Box #1 of the dashboard (Figure 2).
While the seven medications that took a price decrease are interesting (more on that later), they’re not as interesting – nor likely to be as impactful (unless you’re someone whose taking those prescription drugs) – as the medications that took price decreases last year (of which there were 25 brands that took a WAC price decrease at the start of 2024). See last year’s early January report for details, but for shorthand, basically, a bunch of previously popular insulins, asthma/COPD inhalers, and central nervous system (CNS) drugs took massive price cuts in the face of new public policies that would have required manufacturers of certain medications to pay penalties to Medicaid programs that actually eclipsed the full price of the drug itself.
We focus first on the early decreases here – not because we want to draw your attention away from those 583 increases that occurred in the first two days of 2025 – but because the brands that took decreases in 2024 basically “messed” up the math on Stat Box #4 of our dashboard for the entire year last year, which takes all the brand drug list price changes and weights them against prior year Medicaid drug utilization data (this allows for a weighting of the proportional impact of price changes based on the degree with which each drug is generally used).
All told, those early 2024 list price decreases were such that at the end of 2024, the weighted average price change for brand products (using Medicaid utilization to weight) was 1.4% – well below the effective 4-5% we’ve observed over the last many years). At the start of 2025, Stat Box #4 is starting looking a little more like it used to (hence our saying that the seven medications that took a decrease are not as impactful this year as opposed to the 25 decreases last year; Figure 3).
Figure 3
Source: Elsevier Gold Standard Drug Database, CMS State Drug Utilization Data, 46brooklyn Research
Of course, on an unweighted basis, 2025 price increases appear to be shaping up like any other year (as did 2024 end). If you’re ever asked to guess at what you think happened with a brand drug price change, estimating that it took between a 4-5% increase on it’s WAC is likely to be the correct answer (as that is more or less what the median change has been for the last half-decade plus). So far, for the price changes submitted thus far, 2025 is coming in at an all-time (albeit early in the game) low of a median price increase of 4.0%.
To put a bow on the descriptive characteristics of brand drug list price changes to start 2025, we’re seeing products take approximately a 50% decrease in their price to products increasing their price by more than 20%. But as it stands right now, 2025 seems to be more like 2023 than 2024.
Drug price changes worth noting
We take a more or less formulaic approach to analyzing brand drug price changes with our dashboard at this point. Primarily, we look for medications with a lot of prior Medicaid expenditures (not that Medicaid is the end-all-be-all, but it is the only program that regularly publishes past utilization with some decent granularity). We next look for drugs with large pricing changes (+/- 10%). And finally, we look for drugs that are interesting for us either because we’ve previously written on them or because we find them of unique clinical value. Using this as a guide, we note the following drug price changes in 2025:
Biktarvy by Gilead is a medication used for HIV. This medication took a 5.9% WAC price increase in 2025. This drug has approximately $5 billion in gross (i.e., pre-rebate) past year Medicaid expenditures (PYME).
Ozempic by Novo Nordisk is a medication used in diabetes. Yeah, we know you’ve heard of it. This medication took a 3% WAC price increase in 2025. This drug has approximately $5 billion in gross PYME.
Jardiance by Boehringer Ingelheim is also a medication used in diabetes. This medication took a 3% WAC price increase in 2025 and has approximately $3.8 billion in gross PYME.
Eliquis by Bristol Myers Squibb is a medication used to prevent blood clots. This medication took a 2% WAC price increase in 2025 and has approximately $2.3 billion in gross past year Medicaid expenditures, and is the largest drug by gross expenditures in Medicare. Of course, if you’re interested in how this price change relates to Medicare, you should check out our December 2024 report.
Hemlibra by Genentech is a medication used to treat hemophilia. This medication took a 8% WAC increase in 2025 and has approximately $1.6 billion in gross PYME.
Abilify Maintena by Otsuka is a medication used to treat schizophrenia. This medication took a 3% WAC increase in 2025 and has approximately $1.5 billion in gross PYME.
Norditropin by Novo Nordisk is a medication used to treat select growth-related disorders. This medication took a 5% WAC increase in 2025 and has approximately $1.2 billion in gross PYME.
Januvia by Merck is a medication used to treat diabetes. This medication took a 42% WAC decrease in 2025 and has approximately $1.2 billion in gross PYME.
All of the therapies named above represent drugs with over $1 billion in annualized gross Medicaid expenditures; thus are the ones we take notice of first. Interestingly, several of them are medications that Medicare (not Medicaid) recently completed drug price negotiations on via the Inflation Reduction Act (IRA). While the effect of those negotiations are not to take effect until 2026, only Januvia seems to have acted to lower their 2025 WAC list price amid the policy landscape shift, although the manufacturer Merck told Endpoints News that the decrease was unrelated to the IRA. The rest of the first IRA-targeted drugs (e.g., Eliquis, Jardiance), that have had any price change activity, have taken WAC list price increases. In other words, we have price changes on three of the 10 medications that CMS has negotiated prices for 2026 for – two increased and one decreased (so far).
Now of course, it is important to note that everything we are measuring here is before rebates and other forms of discounts that drugmakers shave off the top of these list prices. For the unfamiliar, these rebates and discounts are by no means trivial. Drug Channels estimates those concessions to be worth more than $330 billion.
If you’re in the rebate negotiating business, and you saw that Medicare got a low price in 2026, do you think you’re inclined to let these drugs take price increases in 2025 without a corresponding increase in your rebates? We obviously don’t know the answer to those secret negotiations, so we’ll just ask the question and let you make your own judgement on which way you think those drugs’ net prices are going and again caution on being overly reliant upon a list-price worldview of brand drug prices (we empathize with your irritation Mr. Reid).
Outside of the drugs already identified, we’d be remiss if we didn’t highlight at least a few others.
Beyond the Januvia price drop, we also saw Janumet, Janumet XR, Spiriva HandiHaler, Atrovent, Diclegis, and Nexavar all took list price decrease at the start of 2025. Combined, all drugs with WAC price decreases represent approximately $2 billion in gross PYME (i.e., they’re all basically covered by talking about Januvia’s change, as it represents more than half the value – $1.2 billion of that $2 billion – of these drugs by gross PYME measure).
On the price increase side, we would be remiss if we didn’t note Nucynta’s price change. With some end-of-the-year drug stories focusing on opioid prices, rebates, and the like (see Barron’s and New York Times), Nucynta and Nucynta ER represent some of the last branded opioids on the market without generic alternatives. These products took a WAC list price increase of 15% on the immediate release and 20% on the extended release formulations. With generic versions likely not in the cards for 2025, but maybe coming in 2026, this likely represents the last big opportunity for the drug manufacturer to capture whatever additional value is gained from list price changes before the product begins to cede ground to generic competitors. In our experience, it isn’t uncommon for drugs that are soon-to-go generic to take price increases on their way out the door.
Where are you Christmas? Why can’t I find you?
A word of caution as we close out this report. We are exceedingly early into 2025. What we see today may look very different from what we see when this month ends. No Eli Lilly, AstraZeneca, Allergan, AbbVie, or Vertex manufactured product has taken a brand price increase within the dashboard as of its January 2 update (all took increases on products in January 2024). Those five companies had tens of billions of dollars in gross Medicaid brand drug spending impacted by their January 2024 price change activity. Just because we didn’t highlight a drug (and therefore the manufacturer of that drug) above, it does not mean they’re not worth looking at going forward. As with all things, we can only see what exists in data, and that data is fungible, constantly developing, and sometimes subject to revision (yes, sometimes manufacturers publish retroactive drug price changes – the nerve…).
Big thanks to Elsevier for their continued allowances for our price change updates based off their data updates. Look for us to provide updates on the brand dashboard approximately weekly for the month of January for those interested in keeping tabs on stuff and stay tuned for our monthly pricing updates throughout 2025.