Medicare Drug Costs: Where $275.6 Billion Goes
Medicare Part D drug spending grew 51% in just 5 years — from $183.05B in 2019 to $275.65B in 2023. Here's what's driving the surge.
$275.65B
Total Drug Costs (2023)
1,615,685,370
Total Claims
$171
Avg Cost Per Claim
+51%
5-Year Growth
5-Year Cost Trend
2019
$183.05B
1,502,024,872 claims
2020
$198.51B
1,496,175,155 claims
2021
$215.52B
1,498,820,252 claims
2022
$240.22B
1,542,626,610 claims
2023
$275.65B
1,615,685,370 claims
Top 25 Most Expensive Drugs
These 25 drugs account for $45.15B — 16% of all Part D spending.
| # | Drug | Total Cost | Cost/Claim |
|---|---|---|---|
| 1 | Eliquis | $7.75B | $862 |
| 2 | Ozempic | $4.30B | $1,347 |
| 3 | Jardiance | $3.58B | $1,074 |
| 4 | Trulicity | $2.99B | $1,373 |
| 5 | Xarelto | $2.45B | $934 |
| 6 | Humira(Cf) Pen | $2.17B | $8,997 |
| 7 | Revlimid | $2.15B | $16,471 |
| 8 | Lantus Solostar | $1.94B | $622 |
| 9 | Trelegy Ellipta | $1.81B | $885 |
| 10 | Farxiga | $1.65B | $989 |
| 11 | Januvia | $1.54B | $983 |
| 12 | Entresto | $1.30B | $1,066 |
| 13 | Biktarvy | $1.29B | $4,154 |
| 14 | Enbrel Sureclick | $1.12B | $7,682 |
| 15 | Xtandi | $985.0M | $13,547 |
| 16 | Myrbetriq | $927.5M | $659 |
| 17 | Mounjaro | $877.9M | $1,290 |
| 18 | Imbruvica | $875.8M | $15,537 |
| 19 | Stelara | $852.3M | $26,655 |
| 20 | Invega Sustenna | $832.3M | $3,298 |
| 21 | Novolog Flexpen | $831.6M | $867 |
| 22 | Symbicort | $759.4M | $523 |
| 23 | Ibrance | $755.1M | $15,624 |
| 24 | Ofev | $703.7M | $13,049 |
| 25 | Jakafi | $698.1M | $14,962 |
What's Driving the Cost Surge?
1. GLP-1 Drugs: The $8.4 Billion Category
Ozempic, Trulicity, and Mounjaro represent the fastest-growing drug category in Medicare. Originally for diabetes, these drugs have gained massive popularity for weight loss. GLP-1 spending has tripled since 2019. Track GLP-1 spending →
2. Brand-Name Drug Prices Keep Rising
Brand-name drugs account for just 13.4% of prescriptions but 67% of total cost — $185.46B vs $39.45B for generics. The average brand-name claim costs 4.7x more than generic. See the brand vs generic breakdown →
3. IRA Negotiation: A Drop in the Bucket?
The Inflation Reduction Act allows Medicare to negotiate prices on 10 drugs starting in 2026, saving an estimated $1.5 billion in year one. But with $275 billion in annual spending, that's just 0.5%. See which drugs are being negotiated →
4. Specialty Drugs: Low Volume, Massive Cost
Drugs like Revlimid (cancer: $2.15B), Xtandi (prostate cancer: $985.0M), and Biktarvy (HIV: $1.29B) serve relatively few patients at extremely high per-claim costs.