Highest Medicare Part D spending per dosage unit
The drug with the highest average Medicare Part D spending per dosage unit in 2023 is Amvuttra at $239,745.73 per unit, ahead of Vabysmo ($46,702.42) and Givlaari ($41,427.37). A dosage unit is one pill, milliliter or other billing unit, so this is not the price of a prescription. These high-per-unit drugs are usually specialty or biologic medicines used by relatively few beneficiaries. Source: CMS, data year 2023.
Source: CMS Medicare Part D Spending by Drug (data year 2023). Data as of June 2026.
Top 100 by spend per dosage unit (2023)
| # | Brand | Generic | Per dosage unit | Total spend | Beneficiaries |
|---|---|---|---|---|---|
| 1 | Amvuttra | Vutrisiran Sodium | $239,745.73 | $67,368,549 | 195 |
| 2 | Vabysmo | Faricimab-Svoa | $46,702.42 | $14,996,148 | 1,262 |
| 3 | Givlaari | Givosiran Sodium | $41,427.37 | $14,748,145 | 37 |
| 4 | Beovu | Brolucizumab-Dbll | $40,425.23 | $602,256 | 68 |
| 5 | Eylea Hd | Aflibercept | $40,244.02 | $656,380 | 128 |
| 6 | Eylea | Aflibercept | $39,673.66 | $73,869,613 | 7,025 |
| 7 | Lucentis | Ranibizumab | $37,071.41 | $3,838,736 | 465 |
| 8 | <a href="/drug/gattex-teduglutide/">Gattex</a> | Teduglutide | $35,921.06 | $330,401,875 | 914 |
| 9 | Lemtrada | Alemtuzumab | $31,448.72 | $908,742 | — |
| 10 | <a href="/drug/krystexxa-pegloticase/">Krystexxa</a> | PEGloticase | $28,509.17 | $178,838,011 | 603 |
| 11 | Spinraza | Nusinersen Sodium/PF | $28,331.89 | $3,116,508 | — |
| 12 | <a href="/drug/stelara-ustekinumab/">Stelara*</a> | Ustekinumab | $26,818.03 | $2,987,778,600 | 22,930 |
| 13 | Zynlonta | Loncastuximab Tesirine-Lpyl | $25,958.69 | $674,926 | — |
| 14 | Cimerli | Ranibizumab-Eqrn | $25,496.23 | $81,885 | 27 |
| 15 | Syfovre | PEGcetacoplan/PF | $23,173.22 | $1,557,241 | 233 |
| 16 | Somatuline Depot | Lanreotide Acetate | $22,849.88 | $53,027,638 | 674 |
| 17 | Izervay | Avacincaptad PEGol Sodium/PF | $22,040.88 | $216,001 | 44 |
| 18 | <a href="/drug/kesimpta-pen-ofatumumab/">Kesimpta Pen</a> | Ofatumumab | $21,596.16 | $413,095,697 | 5,267 |
| 19 | Besponsa | Inotuzumab Ozogamicin | $21,107.18 | $1,730,789 | — |
| 20 | <a href="/drug/skyrizi-pen-risankizumab-rzaa/">Skyrizi Pen</a> | Risankizumab-Rzaa | $20,593.60 | $1,189,321,833 | 18,206 |
| 21 | <a href="/drug/skyrizi-risankizumab-rzaa/">Skyrizi*</a> | Risankizumab-Rzaa | $18,680.38 | $289,245,101 | 4,806 |
| 22 | Lanreotide Acetate | Lanreotide Acetate | $18,397.50 | $6,935,856 | 122 |
| 23 | Ilaris | Canakinumab/PF | $18,235.71 | $39,279,713 | 229 |
| 24 | Enspryng | Satralizumab-Mwge | $17,518.27 | $33,897,861 | 220 |
| 25 | Ilumya | Tildrakizumab-Asmn | $17,326.25 | $31,759,015 | 629 |
| 26 | Signifor Lar | Pasireotide Pamoate | $16,975.57 | $5,805,759 | 42 |
| 27 | <a href="/drug/tepezza-teprotumumab-trbw/">Tepezza</a> | Teprotumumab-Trbw | $16,209.70 | $129,065,494 | 455 |
| 28 | <a href="/drug/tremfya-guselkumab/">Tremfya</a> | Guselkumab | $13,584.02 | $531,497,098 | 8,945 |
| 29 | <a href="/drug/takhzyro-lanadelumab-flyo/">Takhzyro</a> | Lanadelumab-Flyo | $12,855.79 | $194,367,297 | 468 |
| 30 | <a href="/drug/simponi-golimumab/">Simponi</a> | Golimumab | $11,515.32 | $177,180,473 | 3,463 |
| 31 | Neulasta Onpro | PEGfilgrastim | $11,380.67 | $40,795,149 | 1,543 |
| 32 | Neulasta | PEGfilgrastim | $11,243.23 | $41,507,763 | 1,671 |
| 33 | Adcetris | Brentuximab Vedotin | $11,155.93 | $3,056,726 | 22 |
| 34 | Crysvita | Burosumab-Twza | $10,968.76 | $38,599,104 | 120 |
| 35 | Actimmune | Interferon Gamma-1b,Recomb. | $10,814.43 | $26,300,697 | 43 |
| 36 | Polivy | Polatuzumab Vedotin-Piiq | $10,382.77 | $1,291,224 | 25 |
| 37 | <a href="/drug/mavenclad-cladribine/">Mavenclad</a> | Cladribine | $10,204.59 | $156,344,544 | 1,130 |
| 38 | Vyjuvek | Beremagene Geperpavec-Svdt | $10,014.11 | $4,205,926 | 16 |
| 39 | Yutiq | Fluocinolone Acetonide | $9,550.97 | $200,570 | 12 |
| 40 | Jevtana | Cabazitaxel | $9,358.85 | $6,064,538 | 87 |
| 41 | <a href="/drug/acthar-corticotropin/">Acthar</a> | Corticotropin | $9,272.14 | $377,839,859 | 942 |
| 42 | Uzedy | Risperidone | $9,214.19 | $9,765,799 | 1,164 |
| 43 | <a href="/drug/skyrizi-on-body-risankizumab-rzaa/">Skyrizi On-Body</a> | Risankizumab-Rzaa | $9,002.43 | $125,306,777 | 1,803 |
| 44 | Reblozyl | Luspatercept-Aamt | $8,930.69 | $26,119,753 | 256 |
| 45 | Hyrimoz(Cf) Pen | Adalimumab-Adaz | $8,778.40 | $330,068 | 16 |
| 46 | Mozobil | Plerixafor | $8,772.85 | $3,484,575 | 111 |
| 47 | Revcovi | Elapegademase-Lvlr | $8,306.03 | $28,107,616 | — |
| 48 | Zepzelca | Lurbinectedin | $8,284.64 | $2,435,684 | 50 |
| 49 | Plegridy* | PEGinterferon Beta-1a | $8,280.64 | $6,466,500 | 90 |
| 50 | Plegridy Pen | PEGinterferon Beta-1a | $8,260.43 | $34,651,455 | 443 |
| 51 | <a href="/drug/avonex-pen-interferon-beta-1a/">Avonex Pen</a> | Interferon Beta-1a | $8,233.91 | $178,045,109 | 2,255 |
| 52 | Entyvio | Vedolizumab | $8,230.97 | $99,999,923 | 2,238 |
| 53 | <a href="/drug/avonex-interferon-beta-1a/">Avonex</a> | Interferon Beta-1a | $8,211.49 | $139,326,335 | 1,786 |
| 54 | Cablivi | Caplacizumab-Yhdp | $8,068.10 | $20,162,189 | 48 |
| 55 | Besremi | Ropeginterferon Alfa-2b-Njft | $8,026.42 | $39,923,392 | 333 |
| 56 | Rolvedon | Eflapegrastim-Xnst | $7,932.87 | $661,601 | 51 |
| 57 | Bimzelx | Bimekizumab-Bkzx | $7,879.91 | $299,437 | 13 |
| 58 | Ruconest | C1 Esterase Inhibitor, Recomb | $7,659.62 | $49,404,559 | 106 |
| 59 | Bimzelx Autoinjector | Bimekizumab-Bkzx | $7,588.94 | $956,206 | 48 |
| 60 | Xenpozyme | Olipudase Alfa-Rpcp | $7,410.75 | $5,083,777 | — |
| 61 | Humira(Cf) Pen Crohn'S-Uc-Hs | Adalimumab | $7,306.51 | $70,488,871 | 3,111 |
| 62 | Humira(Cf) Pediatric Crohn'S | Adalimumab | $7,263.79 | $1,204,107 | 37 |
| 63 | Udenyca Autoinjector | PEGfilgrastim-Cbqv | $7,245.64 | $1,007,144 | 99 |
| 64 | <a href="/drug/cosentyx-sensoready-pen-secukinumab/">Cosentyx Sensoready Pen</a> | Secukinumab | $7,222.37 | $205,397,019 | 3,872 |
| 65 | Cosentyx Syringe | Secukinumab | $7,219.78 | $28,302,735 | 589 |
| 66 | Cortrophin | Corticotropin | $7,182.10 | $70,772,429 | 326 |
| 67 | Taltz Autoinjector (2 Pack) | Ixekizumab | $6,922.15 | $59,232,799 | 2,151 |
| 68 | Udenyca | PEGfilgrastim-Cbqv | $6,917.24 | $7,543,946 | 533 |
| 69 | Taltz Autoinjector (3 Pack) | Ixekizumab | $6,905.72 | $30,764,995 | 1,258 |
| 70 | Taltz Syringe | Ixekizumab | $6,895.18 | $41,798,563 | 730 |
| 71 | <a href="/drug/taltz-autoinjector-ixekizumab/">Taltz Autoinjector</a> | Ixekizumab | $6,885.05 | $474,538,369 | 8,491 |
| 72 | Ziextenzo | PEGfilgrastim-Bmez | $6,776.49 | $10,427,658 | 809 |
| 73 | Nyvepria | PEGfilgrastim-Apgf | $6,675.48 | $4,121,441 | 282 |
| 74 | Tivdak | Tisotumab Vedotin-Tftv | $6,639.08 | $703,742 | — |
| 75 | Tegsedi | Inotersen Sodium | $6,565.00 | $6,341,793 | 20 |
| 76 | Yuflyma(Cf) Autoinjector | Adalimumab-Aaty | $6,474.04 | $123,007 | 13 |
| 77 | Myalept | Metreleptin | $6,437.02 | $17,122,465 | 13 |
| 78 | Xiaflex | Collagenase Clostridium Hist. | $6,386.18 | $66,001,126 | 4,112 |
| 79 | Fulphila | PEGfilgrastim-Jmdb | $6,242.85 | $9,464,384 | 691 |
| 80 | <a href="/drug/strensiq-asfotase-alfa/">Strensiq</a> | Asfotase Alfa | $6,180.92 | $258,940,106 | 207 |
| 81 | Fasenra | Benralizumab | $5,900.11 | $69,166,950 | 2,747 |
| 82 | <a href="/drug/fasenra-pen-benralizumab/">Fasenra Pen</a> | Benralizumab | $5,836.92 | $172,931,998 | 6,317 |
| 83 | Kalbitor | Ecallantide | $5,761.69 | $24,976,935 | 37 |
| 84 | <a href="/drug/cimzia-certolizumab-pegol/">Cimzia</a> | Certolizumab PEGol | $5,649.06 | $275,055,734 | 5,602 |
| 85 | Arcalyst | Rilonacept | $5,616.45 | $24,779,791 | 173 |
| 86 | Aliqopa | Copanlisib Di-HCl | $5,496.50 | $362,769 | — |
| 87 | Sandostatin Lar Depot | Octreotide Acetate,Mi-Spheres | $5,332.27 | $53,086,150 | 1,252 |
| 88 | Xpovio | Selinexor | $5,276.84 | $85,562,246 | 1,117 |
| 89 | Evkeeza | Evinacumab-Dgnb | $5,240.14 | $6,739,753 | 16 |
| 90 | <a href="/drug/lupron-depot-leuprolide-acetate/">Lupron Depot</a> | Leuprolide Acetate | $5,223.03 | $128,884,249 | 8,570 |
| 91 | Tecvayli | Teclistamab-Cqyv | $5,153.09 | $289,558 | — |
| 92 | Kimyrsa | Oritavancin Diphosphate | $5,135.20 | $1,027,040 | 102 |
| 93 | Fabrazyme | Agalsidase Beta | $4,995.99 | $39,532,208 | 101 |
| 94 | Blincyto | Blinatumomab | $4,881.63 | $1,523,068 | — |
| 95 | Humira(Cf) Pen Psor-Uv-Adol Hs | Adalimumab | $4,837.86 | $24,706,946 | 1,681 |
| 96 | Uplizna | Inebilizumab-Cdon | $4,641.61 | $12,977,952 | 48 |
| 97 | Kadcyla | Ado-Trastuzumab Emtansine | $4,568.05 | $3,847,823 | 51 |
| 98 | Fylnetra | PEGfilgrastim-Pbbk | $4,501.85 | $81,033 | 11 |
| 99 | Entyvio Pen | Vedolizumab | $4,489.86 | $253,408 | 26 |
| 100 | Brixadi | Buprenorphine | $4,383.89 | $362,555 | 139 |
Source: CMS Medicare Part D Spending by Drug (data year 2023). Data as of June 2026.
Frequently asked questions
What does 'spending per dosage unit' mean?
A dosage unit is one billing unit of a drug — a pill, tablet, capsule, milliliter or gram. CMS divides total spending by total dosage units (volume-weighted) to get average spending per dosage unit. It is useful for comparing how costly drugs are per unit, but it is not the price of a prescription, which depends on how many units are dispensed.
Which drug has the highest Medicare spend per dosage unit?
In 2023, Amvuttra had the highest average Medicare Part D spending per dosage unit at $239,745.73, followed by Vabysmo ($46,702.42) and Givlaari ($41,427.37). High per-unit drugs are typically specialty or biologic medicines. Source: CMS, data year 2023.
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Last updated: 2026-06-21