Published April 5, 2026 · Updated monthly
Most Expensive Prescription Drugs in America 2026
The most expensive prescription drugs in the United States cost tens of thousands of dollars per claim. Using CMS Medicare Part D spending data covering 507 drugs and $356B in total spending, here are the 25 costliest medications ranked by average cost per claim.
Top 25 Most Expensive Drugs by Cost Per Claim
| Rank | Drug | Condition | Avg Cost/Claim | Total Spending |
|---|---|---|---|---|
| 1 | Spinraza | Rare Diseases | $73,000 | $876M |
| 2 | Soliris | Blood Disorders | $68,556 | $1234M |
| 3 | Ultomiris | Blood Disorders | $65,292 | $1567M |
| 4 | Hemlibra | Blood Disorders | $34,278 | $1234M |
| 5 | Evrysdi | Rare Diseases | $31,500 | $567M |
| 6 | Eloctate | Blood Disorders | $31,500 | $567M |
| 7 | Alprolix | Blood Disorders | $28,750 | $345M |
| 8 | Mavyret | Hepatitis C | $26,250 | $945M |
| 9 | Epclusa | Hepatitis C | $26,143 | $1098M |
| 10 | Advate | Blood Disorders | $25,333 | $456M |
| 11 | Harvoni | Hepatitis C | $24,958 | $1198M |
| 12 | Adynovate | Blood Disorders | $24,643 | $345M |
| 13 | Ocrevus | Multiple Sclerosis | $23,635 | $3498M |
| 14 | Trogarzo | HIV | $22,250 | $89M |
| 15 | Remodulin | Pulmonary Hypertension | $20,857 | $876M |
| 16 | Pemazyre | Cancer | $20,500 | $123M |
| 17 | Xospata | Cancer | $19,500 | $234M |
| 18 | Empaveli | Blood Disorders | $19,500 | $234M |
| 19 | Tibsovo | Cancer | $19,167 | $345M |
| 20 | Flolan | Pulmonary Hypertension | $19,167 | $345M |
| 21 | Keytruda | Cancer | $18,176 | $7234M |
| 22 | Orenitram | Pulmonary Hypertension | $17,719 | $567M |
| 23 | Pomalyst | Cancer | $17,250 | $3312M |
| 24 | Enhertu | Cancer | $16,930 | $1456M |
| 25 | Inrebic | Cancer | $16,714 | $234M |
Why These Drugs Cost So Much
The most expensive drugs fall into a few categories:
- Specialty biologics — Complex molecules produced in living cells, expensive to manufacture and impossible to exactly replicate as generics. These include treatments for cancer, autoimmune diseases, and rare genetic conditions.
- Orphan drugs — Medications for rare diseases with small patient populations. Manufacturers price high to recoup R&D costs across fewer patients.
- Patent-protected brands — Drugs still under patent with no generic or biosimilar competition. Manufacturers have pricing power until exclusivity expires.
The Cost to Medicare
Medicare Part D spent $$356 billion on prescription drugs, covering 231,460,840 beneficiaries. The average cost per claim across all drugs is $221, but the drugs on this list cost 10-100x the average.
The Inflation Reduction Act of 2022 gave Medicare the ability to negotiate prices on select high-cost drugs starting in 2026. The first round of negotiations targeted 10 drugs, with additional drugs added each year. Check our Generic Watch page to see which expensive drugs are approaching patent expiry.
How to Reduce Your Drug Costs
If you take an expensive brand-name medication, several strategies may lower your costs:
- Ask your doctor about generic or biosimilar alternatives — search any drug on our site to check availability
- Check manufacturer patient assistance programs — most expensive drug makers offer them
- Compare prices at Mark Cuban's Cost Plus Drugs and similar transparent pharmacies
- Review your insurance formulary — switching to a preferred drug in the same class can save thousands
Look up any drug on DrugPrice to see its full cost breakdown, generic availability, and patent expiration date.
Frequently Asked Questions
The most expensive prescription drugs by cost per claim are typically specialty biologics for rare diseases or cancer. Costs can exceed $50,000 per claim. See the full ranking table above for the current most expensive medications.
Brand-name drugs are expensive because of patent protection (no competition), high R&D costs that manufacturers need to recoup, and the ability to price based on the value to patients rather than manufacturing cost. The US also lacks the government price controls used in other countries.
For select drugs, yes. The Inflation Reduction Act allows Medicare to negotiate prices on high-cost drugs for the first time. The first negotiated prices take effect in 2026. Additionally, several major drugs are losing patent protection, which will bring cheaper generic competition.
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