Net spending on medicines in the U.S. climbed $58 billion, or 10.6%, from 2024 to 2025, reaching $606 billion, according to an April 28 IQVIA Institute report.
Here are five things to know from the report:
- Total prescription drug use, measured in days of therapy, has grown 13% over the last five years to 210 billion days, though growth has slowed since 2024.
- GLP-1 and GIP agonists for diabetes and obesity accounted for $14 billion of 2025’s spending growth, with $9.6 billion tied to obesity indications specifically.
- Patient out-of-pocket costs hit a record $110 billion in 2025. Medicare beneficiaries saw costs decline thanks to the new Part D out-of-pocket cap, but commercial insurance out-of-pocket costs — 52% of the total — rose 5% in 2025 and 37% over five years.
- Access remains a persistent barrier. For newly launched drugs, 65% of first-year prescriptions go unfilled, with 49% rejected by payers and 17% abandoned by patients after approval, often due to cost.
- The report projects spending will keep climbing but at a slower pace, 4.5% to 7.5% annually through 2030 at net prices, as patent expirations offset continued uptake of new therapies.
