Oct. 3, 2017 -- Humira once again was the top-selling drug in the United States in 2016, earning manufacturer AbbVie more than $13.6 billion in sales, according to the latest report from QuintilesIMS Institute, which tracks drug spending and prescriptions annually.
Spending on the drug, an anti-inflammatory, has tripled from $4.5 billion in 2012. It is the fifth straight year Humira topped the list of all drug sales.
Levothyroxine, for thyroid conditions, was the most commonly prescribed drug, as it has been for each of the 5 years, with 123 million prescriptions in 2016.
The total number of all prescriptions dispensed in 2016 hit 4.4 billion, up 1.9% from 2015, on par with increases seen in earlier years.
"Notably," the authors of the report say, "chronic prescriptions with 3-month duration have increased dramatically in the last 2 years, and prescriptions grew by 3.3% when adjusting for prescription size."
Use of pain medications, both narcotic and nonnarcotic, was down 1% as restrictions on prescribing and distributing have become more common, according to the report.
In the report, authors Murray Aitken, executive director of the QuintilesIMS Institute, and Michael Kleinrock, research director, write that invoice spending on medications -- the amount pharmacy or hospital customers paid distributors -- in 2016 grew more slowly than in the previous year.
Spending grew by 4.8% in 2016, slowing significantly from 8.9% in 2015.
The report says that was largely due to smaller price increases for name-brand products, fewer new products, and lower spending on hepatitis C treatments in 2016.
The report estimates that 226,000 new patients were treated with hepatitis C medicines in 2016, down by 23,000 from the year before. The drugs are potentially curing 13% to 22% of the 3 million to 5 million infected patients in the United States, the authors write.
The report predicts spending will continue to lessen in the next 5 years.
"The outlook for medicine spending through 2021 is for mid-single digit growth driven by further clusters of innovative treatments, offset by a rising impact from brands facing generic or biosimilar competition," the authors write.
Table 1: Top 10 Branded Medicines by Sales (in billions). Sales spending is based on QuintilesIMS National Sales Perspectives and is not adjusted for estimates of off-invoice discounts and rebates.
| Medicine | 2021 | 2016 |
| Humira (adalimumab; made by AbbVie) | 4.5 | 13.6 |
| Harvoni (ledipasvir and sofosbuvir; made by Gilead) | 0.0 | 10.0 |
| Enbrel (etanercept; made by Amgen) | 4.2 | 7.4 |
| Lantus Solostar (insulin glargine injection; made by Sanofi) | 2.3 | 5.7 |
| Remicade (infliximab; made by Janssen Biotech) | 3.8 | 5.3 |
| Januvia (sitagliptin; made by Merck) | 2.6 | 4.8 |
| Advair Diskus (fluticasone/salmeterol; made by GlaxoSmithKline) | 4.6 | 4.7 |
| Lyrica (pregabalin; made by Pfizer) | 1.9 | 4.4 |
| Crestor (rosuvastatin; made by AstraZeneca) | 4.8 | 4.2 |
| Neulasta (pegfilgrastim; made by Amgen) | 3.4 | 4.2 |
| Total U.S. market | 317.8 | 450.0 |
Table 2: Top 10 Medicines by Prescriptions (in millions). Includes prescriptions and insulins dispensed through chain and independent pharmacies, food store pharmacies, mail services, and long-term care facilities. Over-the-counter medications are not included.
| Medicine | 2012 | 2016 |
| Levothyroxine | 112 | 123 |
| Lisinopril | 99 | 110 |
| Atorvastatin | 55 | 106 |
| Acetaminophen/hydrocodone | 136 | 90 |
| Metoprolol | 82 | 88 |
| Amlodipine | 69 | 87 |
| Metformin | 68 | 87 |
| Omeprazole | 67 | 76 |
| Albuterol | 61 | 70 |
| Gabapentin | 39 | 64 |
| Total U.S. market | 4,154 | 4,453 |