Sold as Cosentyx.
Class: Interleukin inhibitors.
First FDA approval 01/21/2015: 11 years on the US market.
This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.
B
Score breakdown (78/100)
Safety ×35%
B
Evidence ×25%
D
Regulatory ×15%
A
Money & lawsuits ×15%
C
Options ×10%
C
Safety: 85
130,344 FDA reports naming it as the suspect drug per million Medicare fills, 47.1x the median drug on this site (-15)
Death share in reports is near or below the FAERS average (0.6x)
Evidence: 62
175 randomized trials and 36 systematic reviews/meta-analyses indexed in PubMed
No Cochrane review found (-5)
'Drug ineffective' is the single most-reported item about this drug in FAERS (-5)
Regulatory history: 100
No recalls on record since 2016
Money & lawsuits: 70
Pharma paid doctors $2,656,655 tied to this drug last year (-30)
Not named in any pending federal MDL
Options: 70
No generic version approved: brand-only pricing (-30)
18 same-class alternatives exist
What the FDA label says
Approved uses
Not available.
Contraindications
None listed.
Warnings and precautions
Not available.
Adverse reactions (label)
Not available.
Source: FDA SPL label, effective .
Side-effect reports sent to the FDA
These are counts of reports people filed, not rates of harm. Anyone can file one, and nobody checks whether the drug was the cause. Millions of doses are taken for every report sent, so the useful part is how this drug compares with the average across all drugs.
161,288reports that mention this drug
161,240of those blame this drug, not another one the person was taking
40%of reports describe a serious outcome, such as a hospital stay (average for all drugs: 57%)
5.4%of reports include a death, from any cause (average for all drugs: 9.1%)
130,344 reports blaming this drug for every million Medicare prescriptions filled, which is 47.1× the typical drug on this site. (23,247 reports in 2024–2026, against 178,351 Medicare fills in one year. This is the one number here that accounts for how many people take the drug.)
Source: the FDA's Adverse Event Reporting System (FAERS). Reports are voluntary and unverified. Drugs that are prescribed a lot, in the news, or in lawsuits attract more reports, so the percentages are compared with the whole database to correct for that partly, not fully.
Recalls and regulatory record
0recall actions on file
0 / 0brand / generic applications
0label changes since 2021
NoREMS program
Evidence base
175randomized trials (PubMed)
36systematic reviews
266registered trials
75%of completed trials posted results
11%terminated or withdrawn
78%industry-funded
Counts measure how much evidence exists and how transparent it is, not how big the benefit is. For that, ask your prescriber: if 100 people like me took this, how many would get better because of it, and how many would be harmed? (Doctors call these the "number needed to treat" and "number needed to harm.") It differs by condition and is the number drug ads leave out. Sources: PubMed, ClinicalTrials.gov.
Money and lawsuits
In 2024, drug companies reported $2,656,655 in payments to US physicians and hospitals tied to this drug across 79,471 transactions (Cosentyx $2,656,655).
No pending federal MDL names this drug or its brands.
Not named in any federal pharmaceutical settlement of $100M or more on record.
Sources: CMS Open Payments (Sunshine Act); Judicial Panel on Multidistrict Litigation pending docket list; DOJ settlements as tabulated on Wikipedia with links to the primary record. State-court and individual suits are not included.
Same ATC pharmacological class, graded ones first, best grade at the top. Being in the same class does not make them interchangeable for your condition; it makes them worth asking about.
Questions to ask your prescriber
The most-reported problems in FDA's adverse event data are psoriasis, pain, arthralgia. How would we recognize and handle those?
Why this one over anakinra, basiliximab, bimekizumab? What would make you pick one of those instead?
There is no generic. Is there an older generic in the same class that works as well for my situation?
The manufacturer pays physicians heavily to promote this drug. Have you received anything from them?
What result are we expecting, by when, and what is the plan if it does not happen?
If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)