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The United States spent a total of more than $722 billion on prescription drugs in 2023, a new report finds. That’s a nearly 14 percent increase in spending from 2022 — the largest annual rise in the last 20 years — and researchers say that growth is only expected to continue in 2024.
According to a new study published April 24 in the American Journal of Health-System Pharmacy, semaglutide — known by brand names Ozempic, Rybelsus and Wegovy, and often prescribed for diabetes or weight management — topped the list of most popular drugs by overall U.S. spending in 2023. The U.S. spent nearly $38.6 billion on the medications, which can cost upward of $1,000 a month without insurance coverage.
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Given the soaring demand for these medications, which can help some people lose, on average, 15 percent of their body weight, lead study author Eric Tichy said he expected spending would be high. “But we didn't anticipate it would be quite as high as it was,” says Tichy, a pharmacist and Mayo Clinic division chair. It’s worth noting that a similar drug known for its weight loss benefits — tirzepatide, whose brand names include Mounjaro and Zepbound — also made the list of popular drugs by overall U.S. spending for 2023.
Former front-runner adalimumab (brand name Humira, plus several biosimilar competitors), which treats autoimmune disorders like rheumatoid arthritis, Crohn’s disease and psoriatic arthritis, came in second on the list of most popular drugs, with $35.3 billion in overall U.S. spending in 2023. And apixaban (Eliquis), prescribed to prevent strokes and blood clots in people who have a heart condition known as atrial fibrillation, was third, with roughly $22 billion in spending.
Why Rx spending is on the rise
The study’s authors note that the nearly 14 percent increase in spending seen between 2022 and 2023 was driven primarily by three factors:
1. More people taking prescription medications. One likely contributor to higher utilization, Tichy says, is expanded indications. This is when an already approved medication gets approved for another use.
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