Most Expensive Drugs by NADAC Price

Reading the Most Expensive Drugs by NADAC Price

This table ranks 50 drugs by nadac/unit, sourced from Centers for Medicare & Medicaid Services (CMS), NADAC Survey. The current leader is ustekinumab at $26,794.63, followed by risankizumab and guselkumab. Each row links to a full drug profile so readers can move from headline number to the underlying FDA data, labeling, FAERS reports, recalls, pricing, and shortage status, that explains why a particular drug sits where it does.

The National Average Drug Acquisition Cost (NADAC) reflects the average price pharmacies pay to acquire drugs from wholesalers. Drugs topping this list are typically specialty biologics, oncology medications, or rare disease treatments. High per-unit costs do not always translate to high total treatment costs, some drugs require only a few doses per year while others are taken daily. NADAC excludes rebates and patient assistance programs, so out-of-pocket costs may differ significantly.

Rankings are diagnostic, not prescriptive. Absolute numbers are shaped by exposure volume, reporting practices, and data-collection methodology, so a drug near the top is not automatically "worse" than a drug near the bottom, it may simply be older, more widely prescribed, or manufactured by firms with more visible reporting. Context from Centers for Medicare & Medicaid Services (CMS) updates continuously, which means the relative order here can change from one refresh to the next. Rankings on this page are for educational research only and must not be used as a substitute for medical advice from a licensed clinician.