Biggest drugs by total Medicare Part D spending
The drug with the highest total Medicare Part D spending in 2023 is Eliquis at $18,273,451,967, ahead of Ozempic ($9,194,048,435) and Jardiance ($8,839,935,063). Total Part D spending was about $275,924,520,551 across 3,598 drugs (CMS, data year 2023). The full top-100 ranking is below. These are aggregate gross program costs, not the price you pay.
Source: CMS Medicare Part D Spending by Drug (data year 2023). Data as of June 2026.
Top 100 drugs by total Part D spending (2023)
| # | Drug | Total spend | Per dosage unit | Beneficiaries | Spend YoY |
|---|---|---|---|---|---|
| 1 | <a href="/drug/eliquis-apixaban/">Eliquis (Apixaban)</a> | $18,273,451,967 | $9.74 | 3,927,848 | +20.1% |
| 2 | <a href="/drug/ozempic-semaglutide/">Ozempic (Semaglutide)</a> | $9,194,048,435 | $355.90 | 1,464,468 | +98.7% |
| 3 | <a href="/drug/jardiance-empagliflozin/">Jardiance (Empagliflozin)</a> | $8,839,935,063 | $20.32 | 1,882,768 | +51.1% |
| 4 | <a href="/drug/trulicity-dulaglutide/">Trulicity (Dulaglutide)</a> | $7,363,856,224 | $483.21 | 938,731 | +18.3% |
| 5 | <a href="/drug/xarelto-rivaroxaban/">Xarelto (Rivaroxaban)</a> | $6,309,246,823 | $18.23 | 1,324,165 | +9.3% |
| 6 | <a href="/drug/trelegy-ellipta-fluticasone-umeclidin-vilanter/">Trelegy Ellipta (Fluticasone/Umeclidin/Vilanter)</a> | $4,455,884,010 | $11.18 | 1,050,583 | +33.4% |
| 7 | <a href="/drug/humira-cf-pen-adalimumab/">Humira(Cf) Pen (Adalimumab)</a> | $4,419,828,188 | $3,750.06 | 61,474 | +19.6% |
| 8 | <a href="/drug/farxiga-dapagliflozin-propanediol/">Farxiga (Dapagliflozin Propanediol)</a> | $4,342,182,307 | $19.55 | 993,909 | +68.0% |
| 9 | <a href="/drug/januvia-sitagliptin-phosphate/">Januvia (Sitagliptin Phosphate)</a> | $4,090,836,821 | $18.88 | 843,391 | -0.2% |
| 10 | <a href="/drug/revlimid-lenalidomide/">Revlimid (Lenalidomide)</a> | $3,859,804,789 | $878.21 | 36,967 | -35.0% |
| 11 | <a href="/drug/entresto-sacubitril-valsartan/">Entresto (Sacubitril/Valsartan)</a> | $3,430,441,590 | $11.64 | 663,587 | +37.8% |
| 12 | <a href="/drug/lantus-solostar-insulin-glargine-hum-rec-anlog/">Lantus Solostar (Insulin Glargine,Hum.Rec.Anlog)</a> | $3,157,233,282 | $30.28 | 1,198,294 | +9.9% |
| 13 | <a href="/drug/biktarvy-bictegrav-emtricit-tenofov-ala/">Biktarvy (Bictegrav/Emtricit/Tenofov Ala)</a> | $3,152,256,269 | $133.13 | 83,843 | +16.6% |
| 14 | <a href="/drug/stelara-ustekinumab/">Stelara* (Ustekinumab)</a> | $2,987,778,600 | $26,818.03 | 22,930 | +27.7% |
| 15 | <a href="/drug/xtandi-enzalutamide/">Xtandi (Enzalutamide)</a> | $2,601,510,278 | $146.13 | 28,658 | +6.8% |
| 16 | <a href="/drug/myrbetriq-mirabegron/">Myrbetriq (Mirabegron)</a> | $2,510,288,600 | $15.43 | 769,978 | +11.4% |
| 17 | <a href="/drug/imbruvica-ibrutinib/">Imbruvica (Ibrutinib)</a> | $2,371,893,292 | $486.63 | 17,100 | -16.9% |
| 18 | <a href="/drug/mounjaro-tirzepatide/">Mounjaro (Tirzepatide)</a> | $2,361,384,157 | $539.82 | 370,203 | +1539.4% |
| 19 | <a href="/drug/enbrel-sureclick-etanercept/">Enbrel Sureclick (Etanercept)</a> | $2,054,858,499 | $1,812.36 | 34,287 | +15.2% |
| 20 | <a href="/drug/ibrance-palbociclib/">Ibrance (Palbociclib)</a> | $2,020,903,604 | $753.02 | 16,015 | +3.7% |
| 21 | <a href="/drug/symbicort-budesonide-formoterol-fumarate/">Symbicort (Budesonide/Formoterol Fumarate)</a> | $2,004,295,918 | $38.98 | 984,400 | +2.0% |
| 22 | <a href="/drug/jakafi-ruxolitinib-phosphate/">Jakafi (Ruxolitinib Phosphate)</a> | $1,940,765,069 | $297.88 | 14,041 | +10.5% |
| 23 | <a href="/drug/novolog-flexpen-insulin-aspart/">Novolog Flexpen (Insulin Aspart)</a> | $1,875,605,627 | $38.82 | 588,526 | +1.9% |
| 24 | <a href="/drug/ofev-nintedanib-esylate/">Ofev (Nintedanib Esylate)</a> | $1,837,061,150 | $220.84 | 20,444 | +4.2% |
| 25 | <a href="/drug/linzess-linaclotide/">Linzess (Linaclotide)</a> | $1,825,245,843 | $18.14 | 565,088 | +15.4% |
| 26 | <a href="/drug/invega-sustenna-paliperidone-palmitate/">Invega Sustenna (Paliperidone Palmitate)</a> | $1,821,418,393 | $2,343.53 | 70,988 | +10.8% |
| 27 | <a href="/drug/pomalyst-pomalidomide/">Pomalyst (Pomalidomide)</a> | $1,709,288,465 | $1,088.76 | 12,739 | -2.0% |
| 28 | <a href="/drug/ingrezza-valbenazine-tosylate/">Ingrezza (Valbenazine Tosylate)</a> | $1,705,132,723 | $267.57 | 29,191 | +34.7% |
| 29 | <a href="/drug/lenalidomide-lenalidomide/">Lenalidomide</a> | $1,681,292,157 | $682.29 | 20,403 | +274.9% |
| 30 | <a href="/drug/rybelsus-semaglutide/">Rybelsus (Semaglutide)</a> | $1,665,906,943 | $32.41 | 285,693 | +70.9% |
| 31 | <a href="/drug/restasis-cyclosporine/">Restasis (Cyclosporine)</a> | $1,501,664,198 | $11.33 | 492,479 | -8.8% |
| 32 | <a href="/drug/creon-lipase-protease-amylase/">Creon (Lipase/Protease/Amylase)</a> | $1,466,866,603 | $8.87 | 185,325 | +11.9% |
| 33 | <a href="/drug/arexvy-rsvpref3-antigen-as01e-pf/">Arexvy (Rsvpref3 Antigen/As01e/PF)</a> | $1,387,933,256 | $315.81 | 4,390,151 | — |
| 34 | <a href="/drug/breo-ellipta-fluticasone-vilanterol/">Breo Ellipta (Fluticasone/Vilanterol)</a> | $1,373,600,714 | $6.94 | 556,799 | -3.8% |
| 35 | <a href="/drug/vyndamax-tafamidis/">Vyndamax (Tafamidis)</a> | $1,349,659,508 | $735.47 | 7,589 | +59.7% |
| 36 | <a href="/drug/tradjenta-linagliptin/">Tradjenta (Linagliptin)</a> | $1,293,567,778 | $18.04 | 286,808 | -2.5% |
| 37 | <a href="/drug/calquence-acalabrutinib-maleate/">Calquence (Acalabrutinib Maleate)</a> | $1,286,819,830 | $255.96 | 12,390 | +682.8% |
| 38 | <a href="/drug/tagrisso-osimertinib-mesylate/">Tagrisso (Osimertinib Mesylate)</a> | $1,231,962,204 | $569.45 | 9,387 | +13.9% |
| 39 | <a href="/drug/shingrix-varicella-zoster-ge-as01b-pf/">Shingrix (Varicella-Zoster Ge/As01b/PF)</a> | $1,211,171,028 | $212.26 | 3,894,337 | +57.8% |
| 40 | <a href="/drug/humalog-kwikpen-u-100-insulin-lispro/">Humalog Kwikpen U-100 (Insulin Lispro)</a> | $1,208,385,334 | $35.80 | 418,431 | +9.8% |
| 41 | <a href="/drug/skyrizi-pen-risankizumab-rzaa/">Skyrizi Pen (Risankizumab-Rzaa)</a> | $1,189,321,833 | $20,593.60 | 18,206 | +100.0% |
| 42 | <a href="/drug/austedo-deutetrabenazine/">Austedo (Deutetrabenazine)</a> | $1,123,439,045 | $103.61 | 18,283 | +26.2% |
| 43 | <a href="/drug/cabometyx-cabozantinib-s-malate/">Cabometyx (Cabozantinib S-Malate)</a> | $1,109,315,042 | $878.24 | 8,210 | +20.7% |
| 44 | <a href="/drug/repatha-sureclick-evolocumab/">Repatha Sureclick (Evolocumab)</a> | $1,092,210,722 | $286.44 | 229,666 | +45.0% |
| 45 | <a href="/drug/xifaxan-rifaximin/">Xifaxan (Rifaximin)</a> | $1,090,110,101 | $54.93 | 96,011 | +12.4% |
| 46 | <a href="/drug/dupixent-pen-dupilumab/">Dupixent Pen (Dupilumab)</a> | $1,081,417,351 | $951.72 | 41,263 | +107.0% |
| 47 | <a href="/drug/erleada-apalutamide/">Erleada (Apalutamide)</a> | $1,057,789,083 | $156.58 | 11,077 | +20.5% |
| 48 | <a href="/drug/tresiba-flextouch-u-200-insulin-degludec/">Tresiba Flextouch U-200 (Insulin Degludec)</a> | $1,047,670,731 | $71.71 | 197,096 | +4.5% |
| 49 | <a href="/drug/levemir-flexpen-insulin-detemir/">Levemir Flexpen (Insulin Detemir)</a> | $1,025,556,477 | $32.59 | 346,204 | — |
| 50 | <a href="/drug/opsumit-macitentan/">Opsumit (Macitentan)</a> | $1,018,837,123 | $424.66 | 9,031 | +24.7% |
| 51 | <a href="/drug/victoza-3-pak-liraglutide/">Victoza 3-Pak (Liraglutide)</a> | $1,004,635,145 | $126.95 | 142,213 | -18.9% |
| 52 | <a href="/drug/atorvastatin-calcium-atorvastatin-calcium/">Atorvastatin Calcium</a> | $1,000,689,622 | $0.21 | 16,778,185 | +18.2% |
| 53 | <a href="/drug/rinvoq-upadacitinib/">Rinvoq (Upadacitinib)</a> | $976,330,771 | $219.05 | 21,424 | +56.9% |
| 54 | <a href="/drug/vraylar-cariprazine-hcl/">Vraylar (Cariprazine HCl)</a> | $935,653,082 | $48.81 | 98,229 | +32.0% |
| 55 | <a href="/drug/spiriva-respimat-tiotropium-bromide/">Spiriva Respimat (Tiotropium Bromide)</a> | $923,556,171 | $123.39 | 333,929 | +3.6% |
| 56 | <a href="/drug/abiraterone-acetate-abiraterone-acetate/">Abiraterone Acetate</a> | $877,469,517 | $33.61 | 45,661 | +25.1% |
| 57 | <a href="/drug/epclusa-sofosbuvir-velpatasvir/">Epclusa (Sofosbuvir/Velpatasvir)</a> | $877,398,115 | $928.11 | 13,024 | -2.5% |
| 58 | <a href="/drug/otezla-apremilast/">Otezla (Apremilast)</a> | $876,955,030 | $79.73 | 26,816 | +23.5% |
| 59 | <a href="/drug/anoro-ellipta-umeclidinium-brm-vilanterol-tr/">Anoro Ellipta (Umeclidinium Brm/Vilanterol Tr)</a> | $872,959,570 | $8.07 | 294,512 | +0.7% |
| 60 | <a href="/drug/advair-diskus-fluticasone-propion-salmeterol/">Advair Diskus (Fluticasone Propion/Salmeterol)</a> | $868,795,720 | $7.03 | 397,554 | -8.3% |
| 61 | <a href="/drug/cosentyx-sensoready-2-pens-secukinumab/">Cosentyx Sensoready (2 Pens) (Secukinumab)</a> | $852,693,125 | $3,527.02 | 14,435 | +13.3% |
| 62 | <a href="/drug/humira-pen-adalimumab/">Humira Pen (Adalimumab)</a> | $835,162,056 | $3,558.10 | 13,638 | -8.7% |
| 63 | <a href="/drug/venclexta-venetoclax/">Venclexta (Venetoclax)</a> | $814,653,975 | $118.55 | 18,792 | +7.5% |
| 64 | <a href="/drug/brukinsa-zanubrutinib/">Brukinsa (Zanubrutinib)</a> | $801,426,531 | $122.42 | 9,470 | +164.2% |
| 65 | <a href="/drug/janumet-sitagliptin-phos-metformin-hcl/">Janumet (Sitagliptin Phos/Metformin HCl)</a> | $798,865,849 | $9.45 | 168,527 | -2.1% |
| 66 | <a href="/drug/breztri-aerosphere-budesonide-glycopyr-formoterol/">Breztri Aerosphere (Budesonide/Glycopyr/Formoterol)</a> | $795,861,627 | $61.88 | 257,853 | +73.3% |
| 67 | <a href="/drug/spiriva-handihaler-tiotropium-bromide/">Spiriva Handihaler (Tiotropium Bromide)</a> | $782,927,125 | $17.73 | 236,984 | -16.3% |
| 68 | <a href="/drug/lenvima-lenvatinib-mesylate/">Lenvima (Lenvatinib Mesylate)</a> | $778,834,824 | $492.97 | 7,904 | +24.4% |
| 69 | <a href="/drug/vascepa-icosapent-ethyl/">Vascepa (Icosapent Ethyl)</a> | $763,988,447 | $3.13 | 279,946 | -3.0% |
| 70 | <a href="/drug/uptravi-selexipag/">Uptravi (Selexipag)</a> | $758,070,464 | $353.08 | 3,727 | +30.1% |
| 71 | <a href="/drug/verzenio-abemaciclib/">Verzenio (Abemaciclib)</a> | $756,850,867 | $275.07 | 8,217 | +59.6% |
| 72 | <a href="/drug/lantus-insulin-glargine-hum-rec-anlog/">Lantus (Insulin Glargine,Hum.Rec.Anlog)</a> | $735,735,411 | $29.55 | 279,981 | -11.7% |
| 73 | <a href="/drug/tresiba-flextouch-u-100-insulin-degludec/">Tresiba Flextouch U-100 (Insulin Degludec)</a> | $726,928,549 | $35.94 | 258,451 | +8.6% |
| 74 | <a href="/drug/abrysvo-rsv-vacc-pref-a-and-pref-b-pf/">Abrysvo (Rsv Vacc, Pref A And Pref B/PF)</a> | $698,160,178 | $327.30 | 2,131,906 | — |
| 75 | <a href="/drug/lumigan-bimatoprost/">Lumigan (Bimatoprost)</a> | $697,002,199 | $99.66 | 347,753 | -0.6% |
| 76 | <a href="/drug/brilinta-ticagrelor/">Brilinta (Ticagrelor)</a> | $691,725,954 | $7.64 | 234,770 | +8.4% |
| 77 | <a href="/drug/trikafta-elexacaftor-tezacaftor-ivacaft/">Trikafta (Elexacaftor/Tezacaftor/IVacaft)</a> | $674,525,362 | $321.58 | 2,534 | +4.3% |
| 78 | <a href="/drug/prolia-denosumab/">Prolia (Denosumab)</a> | $673,286,887 | $1,667.47 | 255,565 | +23.2% |
| 79 | <a href="/drug/tivicay-dolutegravir-sodium/">Tivicay (Dolutegravir Sodium)</a> | $657,133,269 | $74.72 | 30,088 | +1.0% |
| 80 | <a href="/drug/gabapentin-gabapentin/">Gabapentin</a> | $655,916,853 | $0.15 | 7,553,448 | -5.6% |
| 81 | <a href="/drug/levothyroxine-sodium-levothyroxine-sodium/">Levothyroxine Sodium* (Levothyroxine Sodium)</a> | $653,594,902 | $0.25 | 8,687,969 | -3.8% |
| 82 | <a href="/drug/basaglar-kwikpen-u-100-insulin-glargine-hum-rec-anlog/">Basaglar Kwikpen U-100 (Insulin Glargine,Hum.Rec.Anlog)</a> | $647,548,319 | $23.18 | 352,073 | -8.4% |
| 83 | <a href="/drug/abilify-maintena-aripiprazole/">Abilify Maintena (Aripiprazole)</a> | $636,857,891 | $2,732.27 | 29,378 | +13.0% |
| 84 | <a href="/drug/dupixent-syringe-dupilumab/">Dupixent Syringe (Dupilumab)</a> | $633,292,043 | $966.09 | 20,849 | +14.0% |
| 85 | <a href="/drug/triumeq-abacavir-dolutegravir-lamivudi/">Triumeq (Abacavir/Dolutegravir/Lamivudi)</a> | $631,607,443 | $123.90 | 18,047 | -5.7% |
| 86 | <a href="/drug/rexulti-brexpiprazole/">Rexulti (Brexpiprazole)</a> | $630,013,840 | $50.02 | 66,421 | +28.4% |
| 87 | <a href="/drug/enbrel-etanercept/">Enbrel (Etanercept)</a> | $627,419,987 | $1,781.42 | 10,678 | +2.5% |
| 88 | <a href="/drug/genvoya-elviteg-cob-emtri-tenof-alafen/">Genvoya (Elviteg/Cob/Emtri/Tenof Alafen)</a> | $626,148,344 | $133.22 | 16,335 | -6.2% |
| 89 | <a href="/drug/rosuvastatin-calcium-rosuvastatin-calcium/">Rosuvastatin Calcium</a> | $604,421,766 | $0.31 | 6,945,233 | +1.0% |
| 90 | <a href="/drug/adempas-riociguat/">Adempas (Riociguat)</a> | $598,223,220 | $152.26 | 4,980 | +3.7% |
| 91 | <a href="/drug/nuplazid-pimavanserin-tartrate/">Nuplazid (Pimavanserin Tartrate)</a> | $595,675,170 | $161.86 | 15,984 | +12.6% |
| 92 | <a href="/drug/descovy-emtricitabine-tenofov-alafenam/">Descovy (Emtricitabine/Tenofov Alafenam)</a> | $589,840,789 | $75.49 | 29,514 | +2.8% |
| 93 | <a href="/drug/metoprolol-succinate-metoprolol-succinate/">Metoprolol Succinate</a> | $587,676,864 | $0.26 | 7,156,614 | +5.6% |
| 94 | <a href="/drug/xeljanz-xr-tofacitinib-citrate/">Xeljanz XR (Tofacitinib Citrate)</a> | $585,772,572 | $191.75 | 12,497 | -0.9% |
| 95 | <a href="/drug/albuterol-sulfate-hfa-albuterol-sulfate/">Albuterol Sulfate HFA (Albuterol Sulfate)</a> | $583,910,454 | $2.80 | 6,126,707 | -17.8% |
| 96 | <a href="/drug/nubeqa-darolutamide/">Nubeqa (Darolutamide)</a> | $576,350,299 | $113.38 | 7,174 | +78.8% |
| 97 | <a href="/drug/promacta-eltrombopag-olamine/">Promacta (Eltrombopag Olamine)</a> | $557,676,106 | $397.68 | 5,708 | +22.6% |
| 98 | <a href="/drug/gammagard-liquid-immun-glob-g-igg-gly-iga-ov50/">Gammagard Liquid (Immun Glob G(IgG)/Gly/IgA Ov50)</a> | $542,812,337 | $16.27 | 4,401 | +6.5% |
| 99 | <a href="/drug/toujeo-solostar-insulin-glargine-hum-rec-anlog/">Toujeo Solostar (Insulin Glargine,Hum.Rec.Anlog)</a> | $541,871,908 | $94.16 | 163,635 | +7.3% |
| 100 | <a href="/drug/tremfya-guselkumab/">Tremfya (Guselkumab)</a> | $531,497,098 | $13,584.02 | 8,945 | +21.0% |
Source: CMS Medicare Part D Spending by Drug (data year 2023). Data as of June 2026.
Frequently asked questions
Which drug has the highest Medicare Part D spending?
Eliquis had the highest total Medicare Part D spending in 2023 at $18,273,451,967, ahead of Ozempic ($9,194,048,435) and Jardiance ($8,839,935,063). These are gross program costs, not the price patients pay. Source: CMS, data year 2023.
How much does Medicare Part D spend in total?
Across all drugs, Medicare Part D spending was about $275,924,520,551 in 2023 (CMS). The top 10 drugs alone account for a large share of that total — a handful of high-cost medicines drive most program spending.
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Last updated: 2026-06-21