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It’s no secret that prescription medications are more expensive than ever before. This rise in costs affects nearly everyone in the United States and has led government officials to search for a solution. One of their most controversial proposals is cutting costs by encouraging people to take fewer medications.
Building on the Biden administration’s efforts, the Trump administration is looking to address the skyrocketing costs of prescription medications that impact everyone in the U.S. President Trump hopes to lower prescription costs for seniors and those in the most vulnerable communities and has signed an executive action as of April of 2025.
A report by Patients for Affordable Drugs states that pharmaceutical companies hiked the prices of at least 1,000 prescription drugs in 2024. These price increases go beyond the rate of inflation and have led to one in three Americans no longer being able to afford their medications. Many now have to choose between putting food on the table and getting their prescriptions.
It’s no secret that prescription medications in the United States are more expensive than in most countries worldwide. These costs impact many Americans who must decide whether to pay for the medicines they need or put food on the table.
The Centers for Disease Control and Prevention states that approximately 58.5 million adults in the United States suffer from some form of arthritis. This is a debilitating condition that can impact your life in a variety of ways, including preventing you from pursuing hobbies you love or working in your chosen career.
In 2024, an influx of new medications took center stage at doctors’ offices and pharmacies. Some options were consistently prescribed throughout the year, from cancer treatment drugs to cardiovascular medications. Learn all about the top drugs in 2024 and why they were so popular.
Each year, some prescription medications make it to the top of the best-selling list in pharmacies around the country. Knowing the top sellers can help patients understand which treatments are most commonly used for which conditions. However, individual treatment decisions should always be personalized via a healthcare professional. Let’s look closer at the prescription drugs that are on their way to being the most popular in 2025.
Certain medications use the body’s powerful immune system to combat cancer cells, one of these medications is pembrolizumab. This drug, which has the brand name Keytruda, blocks a crucial protein that cancerous cells rely on.
The PD-1 protein allows tumors to go unnoticed by the immune system, and that makes it easier for them to replicate. If pembrolizumab can block the protein, cancer cells become “visible” to the immune system. It’s a drug that can treat melanoma, stomach cancer, lung cancer, and others.
Nivolumab, marketed as Opdivo, is also an immunotherapy drug that enhances the body’s immune response against cancer cells. It functions by inhibiting the PD-1 protein, allowing T-cells to recognize and attack cancer cells more effectively.
Opdivo is approved for treating various cancers, including non-small cell lung cancer, melanoma, renal cell carcinoma, and Hodgkin lymphoma.
Ozempic earned its place near the top of the best-selling drugs last year, and it’s poised to do the same this year. Semaglutide is a treatment for Type 2 diabetes that can help control blood sugar levels. It prevents the release of sugars from the liver and slows down how food makes it through your digestive system.
Despite being created for treating diabetes, semaglutide is commonly used for weight loss. The drug mimics a natural hormone called glucagon-like peptide-1, which can help regulate your digestion and appetite. It slows down how quickly your body breaks food down, prompting you to feel fuller for longer.
Tirzepatide is similar to semaglutide and appears to be the latter’s competition for the top diabetes and weight loss drug this year. Mounjaro, which is tirzepatide’s brand name, is an injection that treats Type 2 diabetes by controlling blood sugar levels. It’s a glucose-dependent insulinotropic polypeptide (GIP) receptor as well as a glucagon-like peptide-1 receptor agonist.
Because it impacts the hormones that manage your appetite, tirzepatide is an effective weight loss option. Additionally, it can treat moderate to severe obstructive sleep apnea.
Dupilumab is a biologic drug that helps to moderate inflammatory responses that cause conditions like eczema, chronic rhinosinusitis that presents with nasal polyps, and asthma. It’s an effective medication because it targets and blocks two important proteins that cause these inflammatory responses: IL-4 and IL-13.
Dupilumab can reduce the chest tightness and wheezing associated with asthma and can assist in treating eosinophilic esophagitis, a condition in which there are high levels of blood cells in the esophagus. It’s also a good treatment option for prurigo nodularis, which is a skin condition that causes very itchy and hard bumps.
Another medication that focuses on moderating the body’s inflammatory response is risankizumab, which goes by the brand name Skyrizi. This is an injection that is often prescribed for the treatment of plaque psoriasis, Crohn’s disease, and psoriatic arthritis.
The medication is made from living organisms or their products, making it a biologic drug. It inhibits the IL-23 protein, which plays a role in how the body’s immune system functions as well as in its inflammatory response. By blocking this protein, the drug can reduce swelling and other symptoms.
Yet another medication is ustekinumab, sold under the brand name Stelara, a monoclonal antibody doctors prescribe to treat autoimmune conditions such as psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
It targets interleukins IL-12 and IL-23, cytokines involved in inflammatory and immune responses. By inhibiting these cytokines, Stelara reduces inflammation and alleviates symptoms of these difficult conditions.
Apixaban is an anticoagulant, which means it thins the blood. It’s a medication that can help prevent blood clots and strokes. Eliquis is its brand name, and it’s prescribed for people with atrial fibrillation or deep vein thrombosis. It can also be a treatment option for those with pulmonary embolisms.
The medication functions by blocking factor Xa, which is an essential ingredient in the formation of a clot. Apixaban slows down the clotting process. It’s often prescribed for people right after they’ve had a knee replacement because this surgery increases the risk of clots.
Aflibercept, known commercially as Eylea, is an anti-angiogenic agent that patients use to treat age related macular degeneration, diabetic macula edema, retinal vein occlusion, and other eye diseases.
It inhibits vascular endothelial growth factor (VEGF), which is a protein that promotes the growth of abnormal blood vessels in the eye. By blocking VEGF, Eylea helps prevent vision loss and has even become a leading therapy in ophthalmology.
Biktarvy is a combination antiretroviral medication used for the treatment of HIV-1 infection. It combines three main ingredients: bictegravir, an integrase strand transfer inhibitor; emtricitabine; and tenofovir alafenamide, both nucleoside reverse transcriptase inhibitors.
This once-daily tablet offers people living with HIV an effective treatment option. Although it’s not a cure, it can help those with HIV gain some normalcy.
Simplefill is a full-service prescription assistance company that researches, qualifies, and maintains patients’ enrollment in all sources of assistance available to them.
Apply today by calling 877-386-0206. A caring Simplefill representative will contact you within 24 hours to discuss your application and, if qualified, enroll you in the program.
According to the health policy organization KFF, 61% of all adults in the United States currently take at least one prescription drug. For many, getting access to medications has become more difficult because so many drugs are regularly out of stock.
One of the most serious concerns people on Medicare have is prescription drug costs. As of January 1, 2025, this issue is being directly addressed through a new annual out-of-pocket cap of $2,000 on prescription drug expenses.
The Medicare Drug Price Negotiation Program marks a major change in the way that prices are determined for certain medications commonly prescribed for Medicare enrollees. It was established by the passage of the Inflation Reduction Act, signed into law by President Biden on August 16, 2022. The program represents one of the most substantial changes to Medicare since its inception.
Many think of Medicare only as the federal health insurance program for people who are 65 or older. But it also provides coverage for younger individuals with End Stage Renal Disease (ESRD) and other qualifying disabilities. In 2024, approximately 65 million people enrolled in Medicare, roughly half of them in traditional Medicare and the other half in Medicare Advantage programs.
The Center for Medicare & Medicaid Services (CMS) historically was not allowed to leverage the full buying power of its vast enrollee population to negotiate lower drug prices. Only private insurance companies administering Medicare Advantage or Medicare Part D (prescription coverage) plans were allowed to negotiate prices.
The push for Medicare to negotiate drug prices directly with pharmaceutical companies gained momentum as part of broader healthcare reform and cost-reduction efforts.
The Medicare Drug Price Negotiation Program tackles three key goals head-on:
The Medicare Drug Price Negotiation Program was carefully designed to achieve the desired outcomes. Here are the steps in the process:
Each year, a specific number of high-cost, single-supplier drugs are targeted for negotiation based on such factors as:
Certain orphan drugs, plasma-derived products, and drugs that are a low-spend for Medicare are excluded from consideration.
The first stage of selection results in an initial list of 50 negotiation-eligible drugs, ranked according to total Part D gross covered prescription drug costs. Two additional considerations may eliminate some of the drugs on that list:
From the initial list of negotiation-eligible drugs, CMS will then select the drugs for price negotiation.
Selecting the drugs to consider for negotiation is a complex and painstaking process. And for the manufacturers of the selected drugs, it’s not exactly optional, at least not without penalty.
Pharmaceutical companies that refuse to negotiate or fail to reach an agreement with Medicare may have to pay a sizeable financial penalty. Most choose to participate, particularly when they can see some reasonable basis for engaging in fruitful price negotiation discussions.
The negotiation process engages both drug companies and the public through:
During the first round of price negotiations, CMS may invite each drug company to participate in up to three negotiation meetings before August 1, 2024.
Negotiation is considered successful when Medicare and a particular pharmaceutical company arrive at agreement on a drug’s price—one that is a fair reflection of value and meets Medicare’s cost reduction objective.
The new price arrived at through negotiation becomes the price that Medicare pays the pharmaceutical company for the drug moving forward, including reimbursements under Medicare Part D plans.
The first round of negotiation, which took place between June 1, 2022 and May 31, 2023, resulted in new pricing for the following 10 medications, effective beginning in 2026:
According to CMS, these 10 drugs account for $50.5 billion (about 20%) of total Part D gross covered prescription drug costs during the time period June 1, 2022 through May 31, 2023.
The first round of drug price negotiation was for price applicability year 2026. The milestones and schedule will be announced in advance of the drug selection and price negotiation for price applicability year 2027 and each subsequent year. And future negotiations may target more than 10 prescription medications.
The Congressional Budget Office has estimated that the Medicare drug price negotiation program will lower what Medicare pays for prescription drugs and reduce the budget deficit by $25 billion by 2031.
