Rinvoq

Rinvoq represents the third janus kinase inhibitor marketed in the United States. Xeljanz and Olumiant preceded Rinvoq. All are indicated for treatment of moderate to severe rheumatoid arthritis. Humira will lose patent protection in America in 2023 and face stiff competition from biosimilars. Rinvoq will be heavily advertised by AbbVie since it faces severe deterioration in its $20 billion a year golden goose - Humira - the most revenue derived from any single drug.

While the company quotes the annual price for Rinvoq at about $59,000, an individual paying cash for Rinvoq at the pharmacy can expect the cost to approximate $90,000. Through a sleight of hand the company offers Rinvoq copay assistance to limit the out of pocket burden, shield the consumer from sticker shock and pass the financial liability to the insurance company. Of course this results in an ever increasing spiral of premiums for everyone.

Unquestionably Rinvoq provides significant improvement for many with rheumatoid arthritis. But unfortunately its relative place among the various options lacks study. Other therapies include methotrexate, hydroxychoroquine, sulfasalazine, Simponi, Enbrel, Remicade, Humira, Actemra and the other janus kinase or JAK inhibitors. Of course many individuals with mild rheumatoid arthritis do well with aspirin, ibuprofen or naproxen.

With the billions of dollars these drugs transfer to the pharmaceutical industry, a study comparing the various options would be greatly welcome. Too often advertising drives prescriptions. And it can be expected that some individuals with mild disease will receive Rinvoq when it is not indicated. By the way, methotrexate costs as little as $20 a month without any insurance or other gimmicks.