Wednesday, October 07, 2009

The 50 Most Prescribed Drugs in 2008

If you multiply the number of prescriptions written for these drugs by their retail cost, you come up with $53.2 billion.  According to AARP, which was the source for this list, more than 10% of our annual health care costs are attributed to prescription drugs.

The top 5 money makers were Lipitor ($5.9 billion retail cost), Nexium ($4.8b), Plavix ($3.8b), Advair ($3.6b), and Prevacid ($3.3b).

Brand names are listed in red. AARP: "Though brand names make up only 22% of the names on the list, they represent 62% of the $53.2 billion."

1. Hydrocodone (pain)
2. Lisinopril (hypertension)
3. Simvastatin (high cholesterol)
4. Levothyroxine (hypothyroidism)
5. Amoxicillin (bacterial infection)
6. Azithromycin (bacterial infection)
7. Lipitor (high cholesterol)
8. Hydrochlorothiazide (edema/hypertension)
9. Alprazolam (anxiety/depression)
10. Atenolol (hypertension)
11. Metformin (type 2 diabetes)
12. Metoprolol Succinate (hypertension)
13. Furosemide oral (edema/hypertension)
14. Metoprolol tartrate (hypertension)
15. Sertraline (depression)
16. Omeprazole (ulcers/reflux)
17. Zolpidem tartrate (insomnia)
18. Nexium (ulcers/reflux)
19. Lexapro (depression)
20. Oxycodone (pain)
21. Singulair (asthma)
22. Ibuprofen (pain/inflammation)
23. Plavix (blood clottong)
24. Prednisone oral (allergies/inflammation)
25. Fluoxetine (depression)
26. Synthroid (hypothyroidism)
27. Warfarin (blood clotting)
28. Cephalexin (bacterial infection)
29. Lorazepam (anxiety)
30. Clonazepam (epilepsy/anxiety)
31. Citalopram HBR (depression)
32. Tramadol (pain)
33. Gabapentin (epilepsy/pain
34. Ciprofloxacin HCl (bacterial infection)
35. Propoxyphene-N (pain)
36. Lisinopril (hypertension)
37. Triamterene (edema/hypertention)
38. Amoxicillin (bacterial infection)
39. Cyclobenzaprine (muscle injury/spasm)
40. Prevacid (ulcers/reflux)
41. Advair (asthma)
42. Effexor XR (depression)
43. Trazodone HCl (depression)
44. Fexofenadine (allergy)
45. Fluticasone nasal (allergy)
46. Diovan (hypertension)
47. Paroxetine (depression/anxiety)
48. Lovastatin (high cholesterol)
49. Crestor (high cholesterol)
50. Trimethoprim (bacterial infection)

Let me see...

10 of the top 50 are for anxiety or depression.
That's about 19% of the total cost ($10.3b of $53.2b).  Depression is big business in this country.

4 of the top 50 are for high cholesterol, about 18% ($9.4b of $53.2b).
9 of the top 50 are for hypertension, about 9% ($4.9b of $53.2).
That adds up to 27% of the total cost, a lot of money for conditions that have been shown repeatedly to respond to diet and exercise.

These are a lot of drugs for not a lot of health.1 You have to wonder what impact disease mongering is having on this.2
1 US Ranks Last Among Other Industrialized Nations On Preventable Deaths, Report Shows, ScienceDaily, Jan 2008
2 The Fight Against Disease Mongering: Generating Knowledge For Action, PLoSMedicine, 2006

"Disease mongering is the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments. It is exemplified most explicitly by many pharmaceutical industry–funded disease-awareness campaigns—more often designed to sell drugs than to illuminate or to inform or educate about the prevention of illness or the maintenance of health."
Doug Bremner, the author of the book shown, blogs at


Ronald said...

"Depression is big business in this country." I agree. Big business is depressing in this country.

Nadia said...

Over half of the American population are prescribed daily doses of medications at prices that are skyrocketing.

One valuable resource in battling extremely high prescription costs is by taking the matter into your own hands and researching generic options found at

Discount generic prescriptions can be found for as little as $4 dollars. That's an incredible alternative to pricey brand name prescriptions, plus the search engine finds them right in your own neighborhood.

Anonymous said...

What if, instead of spending $10 billion on depression drugs, we spent $5 billion on quality EPA/DHA supplements and got people to exercise a little more ...

RB said...

“Diet and exercise”!! Are you promoting prevention? If people stay healthy, we will need fewer prescription drugs. This means less money for the pharmaceutical companies. This means the stock market valuations of these companies will go down. Wall Street won’t like that. It also means the pharmaceutical company CEOs and executives will get smaller salaries and bonuses (still 7 figures I am sure). Healthy people would be a catastrophe. But it is not only a catastrophe for the pharmaceutical industry. If we eat less, especially meat, anything with HFCS and genetically modified foods and replace them with fruit, vegetable, nuts and beans, it will be a catastrophe for the food industry. Companies like ADM, Cargill and Monsanto will also see their stock prices fall. Executive pay, stock options and bonuses will suffer. Unhealthy Americans over-eating unhealthy genetically modified food is good for business. Don’t forget that. These companies pay lobbyist to make sure congress doesn’t forget.

Anonymous said...

My guess is antidepressants are popular because the alternative is more complex and costly to treat. No doubt many lives are saved by some of these pills, but the current model is preoccupied with treating symptoms while ignoring the bigger picture. Reminds me of pumping grain-fed cattle with antibiotics, because feeding grass is no longer viewed a viable business model. Fast food, meet fast medicine.

Bix said...

Well Nadia, since you've taken this opportunity to spam me, I'll take this opportunity to say that, contrary to what you're promoting ... The answer is not in taking more medications, it's in taking fewer medications. Please see RB's comment, which was a great comment. What you promote does not address the tens of thousands of people who die every year because they took a drug they didn't need. Not to mention the scores who suffer side effects from unnecessary meds.

Bix said...

"Fast food, meet fast medicine."
Someone should write that book.

Anonymous said...

Nadia if you really had paid attention you would see that the only brand name drugs on that list are in red and the others are ALL ganeric.......

Anonymous said...

I love Lexapro! It arrests negative thinking from spiraling out of control, so that I can think about the future without fear. It's even more effective when combined with generic buspirone. Neither of these drugs interfere with cognition.

It's much easier on the liver than any other SSRI, and the patent expires in the US in 3/2012, only 28 more months.

Lexapro plus therapy are needed for a true return to wellness. You can get Lexapro from your GP and therapy from a non-MD clinical therapist and you will feel much better, you don't even need a psychiatrist.

Perovskia said...

I *hated* Effexor. It messed me up something horrible. I'm surprised Paroxetine ('Paxil') is so low on the list; it's quite popular. It also has done nothing for me.

Do you think people have an intolerance to depression/anxiety/SSRI's out of physiology or mental blocks (i.e "I don't like to medicate. I'll take it, but I'm sure it won't work")?

Anonymous said...

Some cases of hypertension are not relieved by diet changes or exercise. To believe that is to be very naive and/or simply uneducated on the facts. There are many, many people who eat a healthy diet and engage in regular exercise who develop hypertension that can only be reduced by medication.

Bix said...

Yes, to believe that diet and exercise don't work is to be very naive and/or simply uneducated on the facts.

Jacob said...

Someone better double-check the list-- Amoxicillin is on twice.