US Prescription Drug Spending: A Growing Trend

The US consumes more prescription drugs than any other country and spends nearly twice as much as other nations combined. Pharmaceutical sales were estimated at $1.6 trillion in 2023, with the top 10 US companies worth over $2.1 trillion. Biologics and peptides drive recent growth, with Americans accounting for 72% of the top 50 biologic drugs sold in the world in 2022. Medicare Part D paid over $22 billion for GLP-1 medications in 2023, a 130% increase in two years. US drug prices are more than double those in other countries.

The United States remains the world's largest consumer of prescription drugs, spending nearly twice as much as other nations combined. In 2023, pharmaceutical sales reached an estimated $1.6 trillion, with the top 10 US companies worth over $2.1 trillion [2]. The US pharmaceutical market is characterized by significant growth, particularly in the biologics and peptides segment. Americans accounted for 72% of the top 50 biologic drugs sold globally in 2022, reflecting the industry's dominance [1].

Medicare Part D, a federal health insurance program for seniors, has seen substantial growth in expenditures on GLP-1 medications. In 2023, Medicare Part D paid over $22 billion for these medications, marking a 130% increase in just two years [1]. This growth highlights the increasing demand for innovative treatments, such as those used to manage diabetes and obesity.

The pharmaceutical industry is highly competitive, with a diverse range of companies vying for market share. Merck & Co. remains the industry leader, with approximately $64.17 billion in revenue for FY2024, driven largely by the continued success of its cancer treatment Keytruda [2]. Pfizer, despite a post-pandemic revenue decline, maintains a strong position with $63.63 billion in revenue for FY2024. Other notable companies include Johnson & Johnson, AbbVie, and AstraZeneca, each contributing significantly to the overall market.

The US pharmaceutical market is subject to significant regulatory oversight. The federal government plays a crucial role in purchasing prescription drugs, regulating medicines, and supporting research [1]. Lobbying activities, such as those disclosed by Elevance Health Inc. in Q2 2025, reflect the industry's engagement with policymakers on various health care issues, including mental health parity, veterans' care, and drug pricing reform [3].

The market's evolution is marked by innovations in drug discovery and development. For instance, GLP-1 medications continue to grow in importance, with Novo Nordisk maintaining dominance in the market and exploring new therapeutic applications, such as neurological indications [2]. The market's future is likely to be shaped by ongoing research, regulatory changes, and the industry's ability to adapt to evolving consumer needs.

References:
[1] https://www.cbo.gov/topics/health-care/prescription-drugs
[2] https://www.drugdiscoverytrends.com/pharma-50-the-50-largest-pharmaceutical-companies-in-the-world-for-2025/
[3] https://www.nasdaq.com/articles/lobbying-update-1380000-elevance-health-inc-lobbying-was-just-disclosed