Medicare Drug Spending
How much Medicare, the US health plan for people 65 and older, spent on each drug, and which costs grew fastest.
Medicare Part D and Part B spent $428.2B on drugs in 2025 before manufacturer rebates, up 23% from 2024. Mounjaro grew the most, from $6.34B to $14.1B.
- Spending, 2025: $428.2B
- 2024: $349.5B
- Jan–Mar 2026: $93.9B
- Drugs with spending: 4,465
Spending by Year, 2020–2025
Gross Part D and Part B drug spending each year; Jan–Mar 2026 so far: $93.9B.
Negotiated Drugs: Spending Jan–Mar 2026 vs 2025
The first 10 drugs with Medicare-negotiated prices, in effect since Jan 1, 2026: Jan–Mar 2026 spending against the same share of 2025's total. Where cheaper generic or biosimilar copies also launched, part of the drop is theirs. Late claims can still raise recent quarters a little.
- $982M → $39.8M−96%
- $807M → $143M−82%
- $1.68B → $385M−77%
- $1.03B → $304M−70%
- $1.64B → $548M−67%
- $3.77B → $1.34B−65%
- $538M → $195M−64%
- $6.01B → $2.59B−57%
- $589M → $309M−48%
- $141M → $139M−2%
Biggest Increases, 2024 to 2025
Dollar growth among drugs Medicare already paid for at the start. Part B skin substitutes are billed per square centimeter. Click a drug to find it below.
- $6.34B → $14.1B+$7.74B
- $11.4B → $15.1B+$3.65B
- $20.8B → $24.0B+$3.27B
- $13.0B → $16.2B+$3.18B
- $1.80B → $3.97B+$2.16B
- $3.40B → $5.13B+$1.73B
- $5.29B → $6.72B+$1.43B
- $1.78B → $3.20B+$1.42B
- $26.8M → $1.44B+$1.42B
- $2.64B → $3.93B+$1.29B
- $998M → $2.24B+$1.24B
- $5.29B → $6.45B+$1.16B
- $2.83B → $3.92B+$1.08B
- $387K → $1.04B+$1.04B
- $775M → $1.76B+$982M
Largest, 2025
Gross spending by brand. Click a drug to find it below.
- $24.0B
- $16.2B
- $15.1B
- $14.1B
- $6.72B
- $6.55B
- $6.45B
- $6.36B
- $5.13B
- $4.83B
- $4.64B
- $4.01B
- $3.97B
- $3.93B
- $3.93B
The 1,000 largest of 4,746 drugs, by 2025 spending
| Part | 2020–2025 | |||||
|---|---|---|---|---|---|---|
| EliquisApixaban is used to prevent serious blood clots from forming due to a certain irregular heartbeat (atrial fibrillation) or after hip/knee replacement surgery.Apixaban | Part D | $24.0B | +142% | +16% | $2.59B | 4,806,752 |
| OzempicSemaglutide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes.Semaglutide | Part D | $16.2B | +1010% | +25% | $3.96B | 2,044,798 |
| JardianceEmpagliflozin is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes.Empagliflozin | Part D | $15.1B | +535% | +32% | $1.34B | 2,977,956 |
| MounjaroTirzepatide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes.Tirzepatide | Part D | $14.1B | New 2022 | +122% | $4.51B | 1,592,517 |
| FarxigaDapagliflozin is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes.Dapagliflozin Propanediol | Part D | $6.72B | +812% | +27% | $385M | 1,421,744 |
| XareltoRivaroxaban is used to prevent blood clots from forming due to a certain irregular heartbeat (atrial fibrillation) or after hip or knee replacement surgery.Rivaroxaban | Part D | $6.55B | +39% | +5% | $548M | 1,258,760 |
| Trelegy ElliptaThis product is used to control and prevent symptoms (such as wheezing and shortness of breath) caused by asthma and ongoing lung disease (chronic obstructive pulmonary…Fluticasone/Umeclidin/Vilanter | Part D | $6.45B | +334% | +22% | $1.54B | 1,373,320 |
| KeytrudaPembrolizumab is used to treat cancer.Pembrolizumab | Part B | $6.36B | +82% | +6% | $1.50B | 77,692 |
| XtandiEnzalutamide is used to treat prostate cancer.Enzalutamide | Part D | $5.13B | +161% | +51% | $1.24B | 48,505 |
| TrulicityDulaglutide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes.Dulaglutide | Part D | $4.83B | +47% | -12% | $1.03B | 582,333 |
| Humira(Cf) PenAdalimumab is used to reduce pain and swelling due to certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, ankylosing spondylitis).Adalimumab | Part D | $4.64B | +114% | +7% | $715M | 70,059 |
| BiktarvyThis combination product is used by itself to help control HIV infection.Bictegrav/Emtricit/Tenofov Ala | Part D | $4.01B | +126% | +16% | $996M | 101,565 |
| Dupixent PenThis medication is used to treat certain skin conditions (eczema, prurigo nodularis, bullous pemphigoid) and a certain esophagus problem (eosinophilic esophagitis).Dupilumab | Part D | $3.97B | +29541% | +120% | $1.23B | 133,291 |
| EntrestoThis product is used to treat certain types of heart failure.Sacubitril/Valsartan | Part D | $3.93B | +226% | -2% | $39.7M | 826,563 |
| LenalidomideLenalidomide is used to treat various types of cancers.Lenalidomide | Part D | $3.93B | New 2022 | +49% | $950M | 45,338 |
| VyndamaxThis medication is used to treat a certain type of heart failure (transthyretin-mediated amyloidosis).Tafamidis | Part D | $3.92B | +1446% | +38% | $1.16B | 19,958 |
| StelaraUstekinumab is used to treat plaque psoriasis, a certain type of arthritis (psoriatic arthritis), or certain bowel conditions (Crohn's disease, ulcerative colitis).Ustekinumab | Part D | $3.23B | +192% | -4% | $143M | 24,947 |
| Skyrizi PenThis medication is used to treat plaque psoriasis and psoriatic arthritis.Risankizumab-Rzaa | Part D | $3.20B | New 2021 | +80% | $969M | 44,580 |
| Darzalex FasproThis medication is used to treat a certain type of cancer (multiple myeloma).Daratumumab-Hyaluronidase-Fihj | Part B | $3.18B | New 2021 | +26% | $839M | 31,349 |
| Enbrel SureclickThis medication is used alone or in combination with an immunosuppressant (such as methotrexate) to treat certain types of arthritis (such as rheumatoid, psoriatic…Etanercept | Part D | $3.11B | +127% | +33% | $235M | 47,433 |
| OfevThis medication is used to treat certain types of lung disease (idiopathic pulmonary fibrosis- IPF, interstitial lung disease).Nintedanib Esylate | Part D | $2.96B | +156% | +42% | $701M | 31,813 |
| AMCHOPLAST, PER SQ CM | Part B | $2.91B | New 2025 | New | $18.4M | 4,355 |
| RevlimidLenalidomide is used to treat various types of cancers.Lenalidomide | Part D | $2.67B | -50% | -36% | $329M | 26,112 |
| Repatha SureclickEvolocumab is used along with a proper diet to help lower "bad" cholesterol (LDL) in the blood.Evolocumab | Part D | $2.63B | +742% | +54% | $753M | 539,135 |
| ProliaDenosumab is used to treat bone problems that may occur in people with multiple myeloma or in people with cancer that has spread to the bones.Denosumab | Part B | $2.62B | +61% | +8% | $516M | 726,483 |
| IbrancePalbociclib is used to treat a certain type of breast cancer.Palbociclib | Part D | $2.62B | +24% | +29% | $688M | 20,018 |
| BrukinsaThis medication is used to treat certain cancers (mantle cell lymphoma, marginal zone lymphoma, Waldenstrom's macroglobulinemia, chronic lymphocytic leukemia, small…Zanubrutinib | Part D | $2.56B | +20370% | +48% | $769M | 23,841 |
| CalquenceThis medication is used to treat certain types of cancer (such as mantle cell lymphoma, small lymphocytic lymphoma - SLL, chronic lymphocytic leukemia - CLL).Acalabrutinib | Part D | $2.51B | +618% | +48% | $717M | 21,731 |
| VabysmoFaricimab is used to treat certain serious eye conditions (such as wet age-related macular degeneration, macular edema).Faricimab-Svoa | Part B | $2.38B | New 2022 | +24% | $555M | 213,777 |
| RinvoqUpadacitinib is used to treat certain types of arthritis (such as psoriatic arthritis, rheumatoid arthritis, axial spondyloarthritis, polyarticular juvenile idiopathic…Upadacitinib | Part D | $2.36B | +1132% | +70% | $689M | 46,182 |
| ImbruvicaThis medication is used to treat certain cancers (such as chronic lymphocytic leukemia/small lymphocytic lymphoma, Waldenstrom's macroglobulinemia).Ibrutinib | Part D | $2.36B | -21% | +4% | $309M | 14,773 |
| LinzessSee also Warning section.Linaclotide | Part D | $2.35B | +105% | +18% | $288M | 692,734 |
| JakafiThis medication is used to treat certain bone marrow disorders (myelofibrosis, polycythemia vera).Ruxolitinib Phosphate | Part D | $2.34B | +81% | +12% | $590M | 17,288 |
| PomalystPomalidomide is used to treat certain types of cancers (such as multiple myeloma, Kaposi sarcoma).Pomalidomide | Part D | $2.32B | +60% | +8% | $495M | 14,946 |
| TagrissoThis medication is used to treat lung cancer.Osimertinib Mesylate | Part D | $2.30B | +190% | +41% | $653M | 16,672 |
| IngrezzaValbenazine is used to treat involuntary movements of the face, tongue, or other body parts (tardive dyskinesia).Valbenazine Tosylate | Part D | $2.25B | +186% | +15% | $586M | 36,122 |
| NubeqaDarolutamide is used to treat a certain type of prostate cancer.Darolutamide | Part D | $2.24B | +2143% | +125% | $809M | 26,013 |
| JanuviaSitagliptin is used with a proper diet and exercise program and possibly with other medications to control high blood sugar.Sitagliptin Phosphate | Part D | $2.15B | -44% | -44% | $195M | 787,305 |
| MyrbetriqThis medication is used to treat certain bladder problems (overactive bladder, neurogenic detrusor overactivity).Mirabegron | Part D | $2.10B | +20% | -9% | $396M | 679,975 |
| ErleadaApalutamide is used to treat men with prostate cancer.Apalutamide | Part D | $2.08B | +342% | +50% | $537M | 19,179 |
| RybelsusSemaglutide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes.Semaglutide | Part D | $2.03B | +2663% | +7% | $500M | 280,455 |
| OpdivoNivolumab is used to treat cancer.Nivolumab | Part B | $2.00B | +26% | +3% | $442M | 26,991 |
| Invega SustennaThis medication is used to treat certain mental/mood disorders (such as schizophrenia, schizoaffective disorder).Paliperidone Palmitate | Part D | $1.95B | +42% | +4% | $482M | 71,656 |
| CreonThis medication contains digestive enzymes to help break down and digest fats, starch, and proteins in food.Lipase/Protease/Amylase | Part D | $1.86B | +94% | +25% | $419M | 184,896 |
| TRI MEMBRANE WRAP, PER SQ CM | Part B | $1.82B | New 2025 | New | $611K | 4,060 |
| KisqaliRibociclib is used to treat breast cancer.Ribociclib Succinate | Part D | $1.76B | +1265% | +127% | $556M | 17,371 |
| CabometyxThis medication is used to treat various types of cancer.Cabozantinib S-Malate | Part D | $1.54B | +305% | +27% | $398M | 11,335 |
| EyleaAflibercept is used to treat certain serious eye conditions (such as macular edema/degeneration, diabetic retinopathy, retinopathy of prematurity).Aflibercept | Part B | $1.54B | -49% | -35% | $250M | 222,280 |
| SIMPLIMAX, PER SQ CM | Part B | $1.54B | New 2025 | New | $1.2M | 3,423 |
| VerzenioThis medication is used to treat certain types of breast cancer.Abemaciclib | Part D | $1.51B | +426% | +43% | $457M | 14,851 |
Gross Medicare spending by drug from CMS's yearly dashboards: Part D (pharmacy) and Part B (drugs given in clinics and hospital outpatient settings). Totals are before manufacturer rebates and discounts, so net spending is lower. Part D counts each brand's total across manufacturers. The newest full year and the running year come from CMS's quarterly files, earlier years from its yearly files. Part B rows are per billing code. “Used for” lines are CMS's own descriptions where it gives one. CMS Medicare Part D and Part B Spending by Drug