In the United States, drug approvals are made without considering a medication’s price, market impact or competitive landscape. In 2024, the average annual cost for newly approved drugs exceeded $350,000 per year, and treatments for rare diseases and oncology surpassed $400,000 per year. Combined with misaligned incentives in the pharmacy benefit manager (PBM) space, this creates an environment where high‑cost, low‑value medications can easily reach formularies. These products, whose prices far exceed their clinical value, are often referred to as wasteful, silly or stupid drugs.

Examples of High‑Cost, Low‑Value Medications

These products often appear in a plan sponsor’s spending for reasons unrelated to clinical benefit:

  • A brand‑name prescription drug even though a similar medication in the same class is available over the counter (OTC) at a low cost.
  • A brand‑name drug despite the availability of generic versions of the same medication.
  • A combination product that merges two inexpensive medications into a single dose yet is priced far higher than the cost of the individual components.
  • “Me‑too” drugs which are new products that enter the market with no meaningful improvement over existing, lower‑cost options.

 

How Innovative Rx Strategies Helps

Each month, the clinical pharmacists at Innovative Rx Strategies review every drug launched that month. These medications are categorized by:

  • New entities: entirely new drug molecules
  • Line extensions: new doses or formulations of existing drugs
  • First‑time generics and biosimilars

Our team evaluates the evidence behind each product, including the clinical studies supporting approval, the current treatment landscape and the medication’s cost. This thorough review allows us to assess true cost‑effectiveness and develop recommendations that form the basis of the Innovative Rx Strategies High‑Cost, Low‑Value Drug List—applicable to any willing PBM’s formulary. This approach helps clients achieve savings and avoid unnecessary spending without the misaligned incentives that often distort formulary decisions.

 

What Our 2025 New-Drug-to-Market Review Found

Across four quarterly webinars, we analyzed every drug launch from Q4 2024 through Q3 2025. While new generics and biosimilars often bring welcome price relief, these cost reductions are not always guaranteed.

Our findings:

  • 37 new entities reviewed → 11 recommended for exclusion
  • 124 line extensions reviewed → 47 recommended for exclusion
  • 25 first‑time generics launched → 2 recommended for exclusion

 

High‑Cost, Low‑Value Drugs Launched in 2025

Our process is designed to protect formularies from high‑cost new drugs that lack strong evidence or clinical need. But not all low-value medications arrive with a dramatic price tag. Some products are familiar, everyday medications repackaged or reformulated in ways that dramatically inflate their cost. These drugs may never make a plan’s top‑10 spending list, yet they quietly drain resources because they are priced 400%, 800%, even 1,000% higher than clinically equivalent alternatives already on the market.

Below are examples of 2025 line extensions for common medications that pack a punch when it comes to pricing. These are just a few examples of the agents that should not make it onto a well-managed PBM formulary.

  • Triamvex Kit (triamcinolone) – A brand‑name kit priced at $3,800, containing a tube of triamcinolone, gauze and tape.
    • The same triamcinolone is available generically for $3–$15, and the gauze and tape can be purchased separately for under $20. The kit markup adds thousands of unnecessary dollars.
  • Ibuprofen 300 mg (generic, prescription‑only NSAID) – Priced at $16 per tablet.
    • Over‑the‑counter ibuprofen 200 mg is widely available, and an entire bottle typically costs less than $16.
  • High‑cost prescription vitamins – Priced at $30–$80 per dose.
    • In many cases, a single dose costs as much as a bottle of 100 comparable OTC
  • Gabarone (gabapentin) – A brand‑name version priced at $20 per tablet.
    • Multiple generic gabapentin products of the same strength are available for under $2 per capsule.
  • Fenopron (fenoprofen) 300 mg – A brand‑name NSAID costing over $26 per capsule.
    • Numerous OTC NSAIDs exist, and fenoprofen itself is already available in 200 mg, 400 mg and 800 mg strengths for $3–$8 per capsule.
  • Metformin 750 mg (generic) – Priced at $35–$80 per tablet.
    • Generic metformin 500 mg and 1,000 mg has been available for roughly 30 years and typically costs around $1 per tablet. While 750 mg is a new strength, the clinical need is limited and does not justify the elevated price.
  • Combogesic (ibuprofen 97.5 mg + acetaminophen 325 mg) – A brand‑name prescription combination priced at $3.50 per tablet.
    • Both ingredients are inexpensive OTC medications, and one day of Combogesic may cost more than a full bottle of each OTC product.

 

Conclusion

As the drug landscape continues to evolve, plan sponsors must stay vigilant against products that increase costs without adding value. Innovative Rx Strategies provides the clinical expertise and independent analysis to help plans maintain formularies that avoid wasteful spending. Our High‑Cost, Low‑Value Drug List is a proven tool to strengthen benefit design, reduce unnecessary costs and ensure members receive clinically appropriate care.

To learn more—or to put our analysis to work for your organization—contact Innovative Rx Strategies and let our team help you stay ahead of the market.