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Makers of the top selling drugs in the United States are costing patients billions of dollars and worsening a drug pricing crisis by abusing the US patent system to stifle competition and inflate prices, a consumer group said on Thursday.

The New York-based Initiative for Medicines, Access & Knowledge said in a report that three of the top 10 selling drugs in the US face no competition in the country and will cost Americans an estimated further $167 billion before they are expected to so.

I-MAK said cheaper generic and bio similar versions of Bristol-Myers Squibb and Pfizer’s blood clot preventer Eliquis, AbbVie’s Humira, and Amgen’s Enbrel, both used to treat rheumatoid arthritis, will have been available in Europe for an average of 7.7 years before their expected US launch. Drug-makers have used the practice of seeking multiple patents for minor variations on a single invention, known as patent thickets, to stave off generic competition for decades. “Patent abuse is not limited to a few bad actors.

“Pharmaceutical companies secure hundreds of patents to block competition because they can,” the report concluded.

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