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US prescription report

US prescription report

Navin Khosla NowPatientGreen tick
Medically reviewed by Navin Khosla, BPharm and written by Rajive Patel, BPharm - Updated on 28 Dec 2023
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Advances in technology have made it easier than ever to order prescription medication through an online pharmacy, but unfortunately, healthcare can still be expensive. With the average American spending more than $1,000 on prescription medication every year, treatments are taking up a big chunk of our annual earnings.

Because of this, we have compiled a series of drug-related data to determine which prescription drugs are being claimed the most, as well as revealing which US states are home to the most significant medication spending habits.

Connecticut’s residents are spending more money per year on prescription drugs than any other state – totaling over $1,660 per person

To kick off our prescription report, we have collected data on the spending habits of US residents to reveal the states with the most significant drug spending per person. Here’s what we found.


Annual prescription drug report for US states.


1. Connecticut – $1,666 per person

Taking first place is Connecticut, where residents are spending over $1,660 per person on prescription drugs, which is more than any other US state. Despite the large sum of money paid on healthcare here, Connecticut is regarded as one of the healthiest states based on its low number of infectious disease incidents and high childhood immunization rates.

2. West Virginia – $1,640 per person

With an average spend per person of $1,640, West Virginia is the second-highest spender for prescription drugs. Opioid drugs are prescribed to people as a means of pain relief, but unfortunately, this state has seen a spike in the number of opioid overdoses in recent years.

3. Kentucky – $1,602 per person

Kentucky is revealed as the state with the third-biggest spend per person on prescription drugs. Despite the residents here spending around $1,602 on prescription drugs annually, this state offers a prescription assistance program to help the people of Kentucky who may be struggling to afford the medicine they need.

More than $12.5bn was spent on Eliquis in 2021 – the most significant total spending of any prescription drug in the US

The US population stands at over 333 million residents, and as one of the most populated countries in the world, it is no surprise that there is a lot of money spent on medicine every year. Below is a list of the prescription drugs with the biggest annual spend as of 2021.

Prescription drug spending in the UK, including an infographic and prescription report.


1. Eliquis (apixaban) – $12.58 billion total spending

Apixaban, sold under the brand name Eliquis, is a blood-thinning medication with the primary role of preventing blood clots. People who may require an Eliquis prescription include those who have previously had a stroke or patients recovering from hip or knee replacements.

A single prescription for this drug will set you back over $600, which is likely why total spending for Eliquis reached over $12 billion in 2021 – more than any other prescription drug on our list.

2. Revlimid (lenalidomide) – $5.89 billion total spending

The second-biggest spending on prescription drugs, with a total spend of $5.89 billion in 2021, belongs to Revlimid. This drug is used in chemotherapy to stop cancer cells from growing and has played a crucial role in saving the lives of many patients with multiple myeloma.

3. Xarelto (rivaroxaban) – $5.23 billion total spending

Completing our top three list of prescription drugs with the most significant total spend in 2021 is Xarelto. Also known by the name rivaroxaban, this drug is the second blood-thinner to feature in this ranking. Despite having the same uses as Eliquis, Xarelto sets itself apart as it is approved for use in both children and adults.

Trelegy Ellipta has seen an increase of more than one million percent in total spending – the most significant change of any prescription drug

The following list reveals the drugs that have seen the largest increase in total spending since 2017.

A report showing the number of prescription drugs in the United States.


1. Trelegy Ellipta (fluticasone/umeclidinium/vilanterol) – 1,150,708% increase in spending

Used to treat lung conditions such as bronchitis and asthma in adults, Trelegy Ellipta has seen a change of over 1 million percent in total spending. While it is difficult to know what has caused an increase in the use of this prescription drug, some possible contributing factors include exposure to air pollution and increasing rates of obesity in children and adults, which have both been linked to the development of asthma.

2. Zenpep (pancrelipase) – 973,899% increase in spending

With an increase in total spending of almost 974,000% since 2017, Zenpep is next on our list. Zenpep is a prescription drug made of a combination of the following three enzymes usually produced by the pancreas: Lipase, protease, and amylase. People with medical conditions, such as cystic fibrosis, which prevent them from producing these pancreas-related proteins, can be prescribed Zenpep as a form of treatment.

3. Droplet Pen Needle (pen needle, diabetic) – 529,430% increase in spending

In 2017, Droplet Pen Needles saw a total spend of almost $3,450, and this number has risen by over 529,000%, with a recorded spend of over $18 million in 2021. Pen needles are often preferred over syringes for diabetic patients with visual impairments as they are larger and issue a clicking noise when a dose is given.

With over 61 million claims in 2021, atorvastatin has more than any other prescription drug

A request must be made before you can claim a prescription drug from a pharmacy, but which medicines are the most commonly claimed? Here’s what we found.

A graph illustrating the correlation between the number of US prescription drugs and the associated fatalities.

1. Atorvastatin – 61.1 million claims

Atorvastatin has clocked up more claims than any other prescription drug on our list – totaling over 61 million claims in 2021. Caused by an unhealthy diet or a lack of exercise, high cholesterol levels can lead to a range of health conditions if left untreated.

Atorvastatin is prescribed in an attempt to improve a person’s cholesterol level. As heart disease is one of the leading causes of death in the US, it is unsurprising that many people across the country are claiming this drug.

2. Amlodipine besylate – 44.2 million claims

With 44.2 million claims in 2021, the second most commonly claimed prescription drug in the US is amlodipine besylate. Amlodipine manages high blood pressure by widening the body’s blood vessels. Although the leading causes of high blood pressure are related to poor lifestyle choices, it can also affect people who are otherwise fit and healthy in the form of a genetic disorder.

3. levothyroxine sodium – 38.4 million claims

From hypothyroidism to thyroid cancer, levothyroxine sodium is used to treat various thyroid-related conditions. This drug saw a total of 38.4 million claims in 2021 across the US, which is the third-highest of any prescription drug on our list.

Trelegy Ellipta is the prescription drug with the largest rise in claims – increasing by over 965,000% since 2017

As well as revealing the medications with the highest total claims, we also wanted to determine which drugs have grown in demand. The following list shows which prescription drugs have seen the most significant increase in claims between 2017 and 2021 in the US.

A prescription report depicting the prevalence of drug abuse in the US.


1. Trelegy Ellipta (fluticasone/umeclidinium/vilanterol) – 965,490% increase in claims

After being revealed as the prescription drug with the most considerable increase in total spending earlier in this report, it may come as no surprise to see it top this ranking, too. With a 965,490% increase, this drug went from 307 to almost 3 million claims in 2017 and 2021, respectively.

2. Zenpep (pancrelipase) – 668,830% increase in claims

Since Nestlé acquired ownership of Zenpep back in 2021, this pancreatic medication has grown in demand. From just 23 claims in 2017 to around 153,000 in 2021, this drug has seen an increase of almost 669,000% – the second most significant change of any prescription drug on our list.

3. Vyzulta (latanoprostene bunod) – 365,103% increase in claims

After being approved in the US in 2017, the number of Vyzulta claims has increased by over 365,000%, with requests reaching over 146,000 in 2021 compared to only 40 in 2017. This type of prescription drug comes in the form of eye drops and is used to reduce pressure in the eye caused by ocular hypertension.

Carbaglu has a higher average spend per claim than any other prescription drug in the US – totaling over $146,000 per claim

The list below reveals the prescription drugs with the highest average spend per claim – calculated by dividing the total spend of each prescription drug by the total number of claims in 2021.

The cost of syringes and prescription drugs per patient in the U.S.

1. Carbaglu (carglumic acid) – $146,077 average spend per claim

Carbaglu is used to treat the rare genetic disorder called NAGS deficiency, in which people cannot remove ammonia from their bodies. The rarity of this disorder means that the number of claims for Carbaglu is low, but the cost is high, which explains why there is an average spend of $146,077 per claim for this prescription drug.

2. Myalept (metreleptin) – $134,047 average spend per claim

The next type of medication on our list is Myalept, which has an average spend per claim of $134,047. Despite having a total spend of more than three times that of the drug at the top of this ranking, there were many more claims for Myalept, which is why this prescription drug has only the second-highest average spend per claim.

3. Strensiq (asfotase alfa) – $102,183 average spend per claim

Completing our top three list of prescription drugs with the most significant average spend per claim is Strensiq. Also known by its generic name, asfotase alfa, this drug is prescribed to patients with hypophosphatasia and helps by managing the levels of calcium in the body. In 2021, the average spend per claim for Strensiq prescriptions totaled over $102,000.

The price of Glucagon has increased by 30% in the last year – the most significant change of any prescription drug

It is no secret that medication in the US can cost you a lot of money, but which prescription drugs have seen the most considerable increase in price over the last 12 months? Here’s what we found.

US prescription drugs with the biggest price change - infographic.

1. Glucagon powder solution for injection – 30% increase

Glucagon powder is a medication used to treat considerably low blood sugar levels in diabetic patients. Although the price of Glucagon injections varies, one dose of this medication could set you back hundreds of dollars. One likely reason for the 30% increase in price for this medication is that manufacturing delays have led to a temporary shortage of the prescription drug.

2. Omnipaque oral solution – 26.8% increase

Omnipaque oral solution acts similarly to a dye by highlighting areas of the body, with patients consuming it before an X-ray so that medical professionals can obtain a more precise image. The increased demand for this drug over the years has led to a price increase of almost 27% in the last year.

3. Aquasol A solution for injection – 25.0% increase

Completing our top three list of prescription drugs with the most significant price change is Aquasol A, which has seen a 25% increase since 2022. This drug is used to treat people with a Vitamin A deficiency, which plays a crucial role in vision and cell growth, among others.


We used the Health Care Cost Institute to find the prescription drug spending per person for each US state. No data was available for Alabama, so this state was removed from the ranking.

We used CMS to find the following data for each prescription drug: total spending in 2017 and 2021, total claims in 2017 and 2021, and average expenditure per claim as of 2021.

We subtracted the 2021 total spending from the 2017 figure before dividing this by the 2017 total to calculate the change in total spending for each drug between 2017-2021. This calculation was repeated to find each drug’s change in total claims.

We used 46brookyln to find the price change of top Medicaid brand name drugs as of 2023. Data was collected on 27/10/2023.

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NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information in this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.

The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.

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