Analytics platform Cursor has published a ranking of the most expensive drugs in Russia based on maximum procurement price per pack in the first quarter of 2026, as well as a list of the costliest annual therapy courses, the company said. Based on tender and contract monitoring, the median price per pack was 1.39 million roubles and the weighted average was 2.81 million roubles. For annual treatment courses, the median cost reached 19.7 million roubles with a weighted average of 20.8 million roubles.
Leading the ranking by price per pack was voretigene neparvovec (Luxturna), which treats vision loss caused by inherited retinal dystrophy in adults and children, at 30.87 million roubles per pack. In second place was tisagenlecleucel (Kymriah) at 28.3 million roubles per vial. This CAR-T therapy is used for B-cell acute lymphoblastic leukaemia (in children and adults up to age 25) and aggressive B-cell lymphomas. Both drugs are innovative gene and cell therapies used for rare and severe diseases.
The top five most expensive drugs also included:
asfotase alfa (Strensiq) — for the treatment of hypophosphatasia, a rare inherited bone mineralisation disorder — 6.65 million roubles per pack;
lumasiran (Oxlumo) — for primary hyperoxaluria type 1, a rare genetic metabolic disorder — 5.37 million roubles;
nusinersen (Spinraza) — for the treatment of spinal muscular atrophy (SMA) — 5.03 million roubles.
The rest of the ranking consists mostly of orphan drugs and high-tech treatments, including palovarotene (4.03 million roubles), metreleptin (3.82 million roubles) and iptacopan (3.7 million roubles). The analysts separately noted that Zolgensma (onasemnogene abeparvovec), one of the potentially most expensive drugs in Russia, was not procured in the first quarter of 2026.
However, the top three drugs by price per pack did not make the top five by annual course cost. Luxturna ranked only seventh, Kymriah tenth, and Strensiq twenty-fourth.
The top five drugs by annual treatment course cost were:
beremagene geperpavec (Vidjuvec) — the world’s first genetically engineered gel for treating dystrophic epidermolysis bullosa, or “butterfly disease” — 96.72 million roubles;
palovarotene (Sohonos) — for hereditary angioedema — 72.6 million roubles;
iptacopan (Fabhalta) — for paroxysmal nocturnal haemoglobinuria, a rare blood disorder — 48.1 million roubles;
lumasiran (Oxlumo) — for primary hyperoxaluria type 1, a rare genetic metabolic disorder — 42.9 million roubles;
dinutuximab beta (Qarziba) — immunotherapy for neuroblastoma, a rare malignant tumour in children — 40.5 million roubles.
A significant portion of the list consists of drugs for rare genetic diseases, oncology and severe chronic conditions. Many are included in government patient support programmes.
