Specialty medications, which can cost between $10,000 and upward of $5 million, now account for 52% of U.S. pharmaceutical sales, according to a Dec. 30 report from the Healthcare Distribution Alliance, which represents pharmaceutical distributors.
These therapies pose significant logistics challenges due to shorter shelf lives than traditional biologics, the need in some cases for ultra-cold or cryogenic storage and transport, and their extraordinarily high cost, which raises the financial stakes of any delay, mishandling or waste, the report said.
In a survey of specialty distributors, companies attributed 38.3% of sales to independent physician-owned and -operated clinics in 2024, according to the report. Hospitals were a close second at 36.2%. Other customer groups were specialty pharmacies (15.6% of sales), retail pharmacies (3.1%) and hospital clinics (1.9%).
Immunology made up the largest therapeutic area in 2024, accounting for 36% of U.S. specialty pharmaceutical sales. Oncologics accounted for 28%, HIV antivirals for 8%, multiple sclerosis for 4% and all other areas for 24%.
The five top-selling brand-name specialty medications in 2024 were:
1. Humira — $26.9 billion in U.S. sales
2. Keytruda — $18 billion
3. Stelara — $17 billion
4. Skyrizi — $16.1 billion
5. Dupixent — $15.6 billion
Sponsors of the report include Eisai, Johnson & Johnson, Regeneron, Takeda Pharmaceuticals and Two Labs Pharma Services.
Access the report here.
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