Keytruda (pembrolizumab) was nonfederal hospitals' costliest drug expense in 2023, according to research published April 24 in the American Journal of Health-System Pharmacy.
In 2021 and 2022, COVID-19 drug Veklury (remdesivir) was the No. 1 pharmaceutical expense for the nation's hospitals. Most medicines on the list saw modest changes from the prior year except for TNKase (tenecteplase), a cardiovascular therapy that cost hospitals 87.9% more in 2023.
The research calculated healthcare drug expenditure among three factors: a drug's list price, newly approved drugs and utilization.
The top 25 drugs ranked by nonfederal hospital expenditure in 2023:
Pembrolizumab — $1.4 billion (4.4% change from 2022)
Immune globulin — $1 billion (-5.1% change)
Remdesivir — $727,409,000 (-45% change)
Bictegravir/emtricitabine/tenofovir/alafenamide — $643,390,000 (18.9% change)
Sugammadex — $636,441,000 (23.9% change)
Pneumococcal vaccine conjugate — $585,635,000 (29.5% change)
Daratumumab/hyaluronidase — $584,128,000 (17.4% change)
Nivolumab — $551,518,000 (-6.4% change)
Inactivated influenza virus — $541,415,000 (-10% change)
Natalizumab — $503,380,000 (-12.8% change)
Ocrelizumab — $499,917,000 (-0.2% change)
Rituximab — $483,858,000 (-12.9% change)
Sodium intravenous solutions — $483,290,000 (8.2% change)
Antithymocyte immunoglobulin — $481,304,000 (6.5% change)
Alteplase — $475,445,000 (-24.2% change)
Denosumab — $430,814,000 (-0.1% change)
Iohexol — $358,330,000 (14.5% change)
Factor II/factor VII/ factor IX/factor x/protein C/protein S — $329,253,000 (10.2% change)
Vedolizumab — $312,172,000 (-2.1% change)
Tenecteplase — $311,081,000 (87.9% change)
Bupivacaine — $308,309,000 (-14.2% change)
Albumin — $308,166,000 (-11.3% change)
Iopamidol — $302,470,000 (-2.4% change)
Infliximab — $300,332,000 (-23.6% change)
Pegfilgrastim — $299,326,000 (-22.1% change)