Americans pay more for 20 top drugs than rest of the world combined, study shows

U.S. sales for the 20 top-selling drugs worldwide in 2020 was nearly double the amount the rest of the world paid for the same drugs, according to a report released Sept. 30 by consumer rights advocacy group Public Citizen.

For all 20 top-selling drugs worldwide in 2020, Public Citizen compared their drugmakers' U.S. sales revenue to global sales revenue as reported in annual filings with the U.S. Securities and Exchange Commission (or analogous annual reports for drugmakers based outside the U.S.).

Five things to know:

  1. U.S. sales for the 20 top-selling drugs worldwide totaled $101.1 billion in 2020, whereas these drugs' sales in the rest of the world totaled nearly $57 billion.

  2. For 17 of the 20 top-selling drugs worldwide, drugmakers made more money from U.S. sales than from sales to all other countries in the rest of the world combined.

  3. For 11 of the 20 top-selling drugs worldwide, U.S. sales revenue was double or more the revenue for sales in the rest of the world.

  4. Eleven of the 13 drugmakers who produced the 20 top-selling drugs worldwide made more money in the U.S. from these drugs than they did in the rest of the world combined.

  5. Drugs with significant sales revenue disparities between the U.S. and the rest of the world include: Gilead's HIV drug Biktarvy (U.S. sales revenue five times greater), AbbVie’s autoimmune disease drug Humira (four times greater), Eli Lilly’s type 2 diabetes drug Trulicity (three times greater), Roche’s multiple sclerosis drug Ocrevus (three times greater), and Amgen and Pfizer’s autoimmune disease drug Enbrel (three times greater).

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