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The following list for the top 20 drugs by total charges accounts for nearly $46 billion in charges for the year 2019. By far, the drug with the highest charges and payments is Humira. Accounting for over 16% of total charges, Humira is used in the treatment of Rheumatoid Arthritis, Crohn's Disease, Psoriatic Arthritic (PsA,) and Plaque Psoriasis (PsO,) amongst a number of other conditions. Following Humira on the list, Stelara accounts for 7.4% of total charges and treats similar conditions including Crohn's Disease, PsA, and PsO.

Of the top 20, four drugs are related to the treatment of diabetes — Humalog, Novolog, JANUVIA, and Trulicity. Drugs treating diabetes related conditions accounted for over 13% of the charges for the list.

Top 20 Drugs by Total Charges

Rank Drug Name Total Charges % of Total Charges Total Payments Number of Prescriptions
1 Humira $7,736,528,488 16.40% $2,219,090,212 885,238
2 Stelara $3,797,384,034 7.40% $806,102,383 170,732
3 Xyrem $3,305,836,589 6.20% $1,989,763,166 230,430
4 IMBRUVICA $3,133,845,462 5.90% $1,103,279,716 212,886
5 Biktarvy $2,292,186,280 4.30% $851,582,566 553,182
6 ENBREL $2,202,123,396 4.20% $855,062,741 300,500
7 Epclusa $2,140,540,323 4.30% $466,000,206 67,675
8 Revlimid $2,110,144,764 4.00% $785,884,233 116,825
9 ELIQUIS $2,064,957,858 3.70% $926,955,226 2,895,868
10 COSENTYX $2,034,678,975 4.00% $413,274,132 158,203
11 Mavyret $1,986,125,095 3.80% $379,545,824 116,701
12 Humalog $1,691,298,530 4.70% $576,722,288 1,400,519
13 NovoLog $1,552,356,962 2.90% $625,447,928 1,414,108
14 JANUVIA $1,488,567,450 2.90% $657,705,407 1,782,821
15 Trulicity $1,482,099,197 2.70% $573,251,821 1,147,846
16 Truvada $1,468,945,228 2.70% $462,043,822 564,050
17 Genvoya $1,459,947,241 2.70% $548,122,043 358,087
18 Xarelto $1,437,444,363 2.70% $589,426,859 1,819,252
19 XIFAXAN $1,296,023,157 2.40% $310,757,297 456,690
20 INVEGA SUSTENNA $1,275,256,664 2.40% $455,277,476 350,751

Fig 1 Data from Definitive Healthcare based on All-Payor Commercial Claims analytics from CY 2019.