10 Prescription Drugs That Medicare Spends the Most On

While Medicare Part D’s prescription drug program paid for more than 3,500 different medications in 2021, the 10 top-selling Rx drugs accounted for nearly one-quarter of the $216 billion in total Part D spending that year, according to a new analysis by the nonpartisan KFF.

“Our analysis shows that Medicare Part D spending is highly concentrated among a small share of covered brand-name drugs, and that increases in gross spending on the 10 top-selling drugs have contributed to a substantial increase in overall Medicare drug spending in recent years,” the report from KFF (formerly the Kaiser Family Foundation) says. The top 100 Part D drugs paid for by Medicare accounted for 61 percent of all Part D spending in 2021, the latest year for which data is available.

The KFF analysis points out how much spending on these most expensive medications has increased. For example, total Part D spending on the blood thinner Eliquis increased two and a half times from $5 billion in 2018 to $12.6 billion in 2021. Spending for the diabetes drug Trulicity more than tripled from $1.4 billion in 2018 to $4.7 billion in 2021. The number of Medicare enrollees taking these drugs did not increase as much as Medicare spending on the medication did, KFF data shows.

Of the $216 billion Medicare spent on prescription drugs in 2021, $48 billion went toward the top 10 selling medications. Half of those brand-name drugs treat diabetes, two are blood thinners, two treat cancer and one treats rheumatoid arthritis. Here’s the full list: 

10 costliest Medicare Part D prescription drugs

• Eliquis, a blood thinner, $12.6 billion
• Revlimid, treats cancer, $5.9 billion
• Xarelto, a blood thinner, $5.2 billion
• Trulicity, treats diabetes, $4.7 billion
• Januvia, treats diabetes, $4.1 billion
• Jardiance, treats diabetes, $3.7 billion
• Imbruvica, treats cancer, $3.2 billion 
• Humira (CF) Pen, treats rheumatoid arthritis, $2.9 billion
• Lantus Solostar, treats diabetes, $2.8 billion
• Ozempic, treats diabetes, $2.6 billion