Has Keytruda's List Price Changed Recently?
Keytruda (pembrolizumab), Merck's blockbuster cancer immunotherapy, maintains a stable U.S. wholesale acquisition cost (WAC) list price of $11,358 per 100 mg vial, unchanged since at least 2020 despite annual inflation adjustments in healthcare.[1] No public announcements indicate WAC hikes in 2023 or 2024; Merck has held steady amid payer scrutiny and biosimilar threats.
Why Haven't Prices Increased with Inflation?
Drug prices often rise via annual WAC bumps, but Keytruda skipped these recently. Merck cited competitive pressures, including patent challenges and looming biosimilars post-2028 exclusivity.[2] Net prices (after rebates) fell 5-10% yearly due to negotiations, dropping from ~$8,000 to ~$6,500 per dose in Medicare data.[3]
What About Medicare Price Negotiation Impacts?
Under the Inflation Reduction Act, Keytruda faces CMS negotiation for 2028, capping price growth at inflation. Selected for negotiation in 2023, a final "maximum fair price" starts October 2028, potentially slashing costs 25-60% based on similar deals like Eliquis.[4] Early 2024 leaks suggest CMS targets ~$6,000 per dose.
How Do Patient Costs Differ from List Price?
Most patients pay far less than list due to copay assistance, Medicare Part D, or 340B discounts:
- Commercial insurance: $0-500 copay via Merck's program.[5]
- Medicare: $1,000-2,000 post-negotiation modeling.[3]
- Uninsured: Up to $150,000/year, but assistance covers most.
Real-world spend averages $4,500-7,000 per dose after rebates.[1]
When Could Biosimilars Lower Prices?
Keytruda's main composition-of-matter patent expires January 2028, with pediatric exclusivity to July 2028.[6] Biosimilars from Samsung Bioepis, Organon, and others could launch then, driving 30-50% price drops like Humira's post-patent cliff. Merck litigates secondary patents (expiring 2030-2035), delaying full competition.[2][6]
International Price Changes?
In Europe, Keytruda faces cuts: UK NHS deal in 2023 dropped prices 15-20%; Germany and France imposed similar via HTA reviews.[7] Canada negotiated 25% reductions in 2024.[8]
[1]: DrugPatentWatch.com - Keytruda Pricing
[2]: Merck Q4 2023 Earnings Call Transcript
[3]: CMS Medicare Drug Spending Dashboard (2023)
[4]: HHS IRA Negotiation Tracker (May 2024)
[5]: Merck Patient Assistance Program
[6]: DrugPatentWatch.com - Keytruda Patents
[7]: NICE UK Appraisal (2023)
[8]: CADTH Reimbursement Review (2024)