Prices for dozens of popular prescription drugs increased, sometimes doubling in cost, over the five-year period from 2012 to 2017, according to a new study published on the American Medical Association’s JAMA Network Open site.

Surveying 49 top-selling brand-name drugs, the study found that 78% of them have seen more than a 50% increase in insurer and out-of-pocket patient costs, with 44% of them priced at more than twice as much.

The drugs studied all exceeded $500 million in U.S. sales or (when U.S. data were unavailable) $1 billion in worldwide sales, and figured in more than 100,000 pharmacy claims. “Substantial cost increases among these drugs was near universal,” notes the study. Pharmaceutical drug spending in America reached $324 billion in 2017 and is expected to increase 2% to 5% annually over the next five years. In comparison, a 24/7 Wall St. study last year on what each state spends on health care found that the combined nationwide total was $605 billion.

The trend is associated primarily with drugs granted government-protected market exclusivity.

The drugs whose prices more than doubled were Chantix, Cialis, Enbril, Forteo, Humalog, Humira, Humulin, Lexapro, Lipitor, Lyrica, Novolog, Onfi, Premarin, Renvela, Simponi, Viagra, and Zetia. Three of these — Lexapro, Lipitor, and Viagra — and when combined with certain other medications, are considered among the world’s most dangerous drugs.

Competition between drugs with similar functions, like Humira and Enbrel, had little effect on rising costs. The prices of brand-name drugs, the study also found, don’t seem to be influenced by the existence of generic equivalents. Drug transparency legislation passed in October 2018 might encourage patients to seek lower-priced alternatives to some brand-name drugs in the future, the study added, but “this likelihood is unknown.”

The study also states that “High and continually increasing pharmaceutical drug spending is a major health and health policy concern in the United States.” Drug spending is also one reason why the U.S. ranks among the countries that spend the most on public health.

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