A report from the AARP Public Policy Institute released Thursday found that many top-brand drugs in the United States continue to become more expensive as people age, while the same drugs often become cheaper in the country.
According to the report, U.S. list prices for 25 top branded drugs have increased by an average of 81% since their launch, while prices for the same drugs have fallen by an average of 13% in 19 other high-income countries.
AARP also found early signs that Medicare price negotiations may be putting pressure on some list prices. Six of the 25 drugs received a one-time, average price reduction of 40% in the U.S. from 2024 to 2026. Prices for all six are negotiated by Medicare.
However, these reductions do not change the broader pricing trajectory. The analysis identifies post-launch pricing as a key driver of international price differences, as U.S. branded drug prices often start out high and continue to rise over time. This has the compounding effect of making already expensive medicines even more expensive, and making it more likely that other countries will adopt pricing systems that reduce costs once they are released.
The AARP analysis, which tracked the price of each drug from launch to April 1, 2026, looked at the 25 branded drugs with no generic or biosimilar competition that had the highest total Medicare Part D spending in 2024. Together, these drugs accounted for more than $100 billion in Medicare prescription drug spending and were used by nearly 15 million beneficiaries.
Across 25 drugs, changes in U.S. lifetime list prices ranged from a 46% decrease to an 873% increase. Outside the United States, the trend was in the opposite direction. List prices for 24 out of 25 drugs fell after their launch, causing an average drop of 13% across comparable countries.
Enbrel, Amgen’s blockbuster autoimmune disease treatment, posted the biggest increase in the U.S., where its list price has increased 873% since its launch. By comparison, prices fell 27% outside the US, and Incyte’s blood cancer drug Jakafi rose 160% in the US but fell 9% overseas. Merck’s diabetes drug Januvia rose 126% domestically, but fell 40% in comparable countries.
The only drug analyzed whose list price in the U.S. was lower than when it was released was Amgen’s cholesterol drug Repatha. Its prices fell 46%, an AARP decline attributed to the 60% price cuts Amgen made in 2018 amid market competition and payer resistance. The drug’s list price has since increased by 30% from its lowered level, according to the report.
The findings are specific to branded drugs, Lee Purvis, director of prescription drug policy at AARP’s Public Policy Institute and author of the report, said Thursday at a press conference at the Association of Healthcare Journalists’ Health Journalism 2026 conference in Minneapolis. He noted that generic drug prices are often lower in the United States than in other countries, making the market for these drugs more competitive.
“Generic prices are actually lower here than in other countries,” Purvis said. “We have a strong system.”
The report also provides a more nuanced view of Medicare negotiations under the Inflation Control Act. The six drugs analyzed (Linzess, Jardiance, Eliquis, Januvia, Imbruvica, and Ibrance) underwent a one-time major price reduction in the United States from 2024 to 2026.
Lindsays had the steepest decline at 50%, followed by Jardiance at 44%, Eliquis at 43%, Januvia at 42%, Imbruvica at 41%, and Ibrance at 18%. Medicare negotiated prices for Ibrance and Lindseth go into effect in 2027, while negotiated prices for four other drugs went into effect earlier this year.
Still, list price reductions were not consistent across all negotiated drugs. The analysis found that six additional drugs with Medicare-negotiated prices were not eligible for list price reductions in the United States.
“These savings will not necessarily be passed on to other payers,” Purvis said at a briefing. “There is still work to be done.”
The findings come as the Trump administration continues to promote “most-favored-nation” pricing as a central part of its drug affordability policies. The White House said a voluntary agreement with 17 major drug companies is expected to save $529 billion over the next 10 years, primarily by pegging future U.S. launch prices to prices in other high-income countries.
AARP said international price comparisons could be incorporated into Medicare negotiations, potentially increasing savings. The group also pointed to other potential reforms, including early post-approval drug price negotiations and expanding the number of drugs eligible for negotiation.
