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GSK · respiratory syncytial virus vaccine, adjuvanted

Arexvy: invented in a government lab, then Medicare paid $388M for it in 2025

NIH scientists invented the technology behind Arexvy, and the government licensed it to GlaxoSmithKline.
Invented in a government lab
Reported

$388M

Medicare paid, 2025

before rebates

Calculated

$2.55B

Medicare, 2020–2025

$294 per patient in 2025

Reported

$57M

Medicare, 2026 Q1

the newest quarter CMS has published

Reported

–

Medicaid paid, 2024

before rebates

The public record, link by link

  1. 1 · Public research

    Invented in NIH labs and licensed to GlaxoSmithKline.
  2. 2 · Patent

    Patents 9738689, 10858400, 11130785, 11174292, licensed by NIH.
  3. 3 · FDA approval

    Approved May 3, 2023, sold by GSK.
  4. 4 · Public pays

    Medicare paid $388M in 2025 for 1,317,627 patients.

What Medicare paid for Arexvy

Medicare Part D and Part B gross spending by year, before manufacturer rebates.
2020: $020202021: $020212022: $020222023: $1.39B20232024: $774M20242025: $388M2025: $388M2025

Plus $57M in the first quarter of 2026, for 182,686 patients.

The government license

From NIH Technology Transfer's list of FDA-approved products built on licenses from NIH, CDC or FDA labs.
  • NIH to GlaxoSmithKline

    Arexvy (respiratory syncytial virus vaccine, adjuvanted) is a vaccine for the prevention of lower respiratory tract disease caused by respiratory syncytial virus (RSV) in individuals 60 years of age and older. Based on a recombinant subunit prefusion RSV F glycoprotein antigen it is the first RSV vaccine for older adults to be approved anywhere in the world.

    First sold 2023. Licensed patents: US 9738689, US 10858400, US 11130785, US 11174292. See the list

GSK's side

Drug makers pay for the clinical trials that take a compound from the lab to FDA approval, and they pay royalties on licensed patents. Those terms are not public. GSK's page shows its other products on this list, its federal awards, its PAC's giving and its lobbying. If GSK wants to add its account, we will publish it here.

How this is built. A product is listed for one of two public records. Either NIH's Technology Transfer office lists it as an FDA-approved product built on a license from an NIH, CDC or FDA lab, or a patent the FDA lists for the drug was reported to NIH as an invention made with NIH grant money, as the Bayh-Dole Act requires. We then add what Medicare Part D, Part B and Medicaid paid for each product, and for each company, the federal grants and contracts it received, its PAC's donations and its lobbying.

What the numbers mean. Medicare and Medicaid figures are gross spending before the rebates drug makers pay back, which are confidential. Hospital-administered therapies such as CAR-T cell treatments are mostly paid under Medicare Part A and do not appear in these files. "NIH grants" is everything NIH paid on the grants a patent was reported under, from 1985 on; a grant usually paid for more than one invention, so it is not the cost of the drug. Federal contracts include purchases, such as vaccine doses, as well as research. Companies also paid for the clinical trials that took these products to approval. None of these figures shows that public money set a price or bought a decision.

Sources: NIH Technology Transfer: FDA-approved products licensed from NIH, CDC and FDA labs; NIH RePORTER patents reported under NIH grants (from iEdison); NIH RePORTER project funding; FDA Orange Book patent, exclusivity and product files; CMS Medicare Part D and Part B Spending by Drug (annual and quarterly); CMS Medicaid Spending by Drug; USAspending.gov federal grants and contracts. Updated 2026-11-06.