The Most Popular Medications Among Medicare Recipients in 2023
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Last Updated July 24, 2026
Medicare beneficiaries account for a large share of U.S. prescription drug spending. According to the Centers for Medicare & Medicaid Services, total U.S. prescription drug expenditures reached about $370 billion in 2019, with roughly 41% flowing through federal health programs including Medicare Part B, Medicare Part D, and Medicaid. This article breaks down which drugs Medicare spends the most on, what they cost seniors out of pocket, and practical ways to lower your bill. For the latest program updates, see 2025 changes to the Medicare Part D prescription drug plan.
Understanding Medicare Drug Spending
When it comes to drug spending in the United States, Medicare beneficiaries play a significant role. According to the Centers for Medicare & Medicaid Services (CMS), prescription drug expenditures in the US totaled $370 billion in 2019. Of this total, spending through Department of Health and Human Services (HHS) programs accounted for 41 percent, or $151 billion. Recent legislation is changing the landscape — see 2025 changes to Medicare from the Inflation Reduction Act. These programs include Medicaid, Medicare Part B, and Medicare Part D.
Top-Spending Drugs in 2020
In 2020, one of the top-spending drugs for Medicare was Eliquis, a blood thinner. More than 2.6 million Medicare Part D enrollees were prescribed this medication, with a total cost of nearly $10 billion.
Does Medicare cover the cost of blood thinners?
Your Medicare Part D prescription drug plan will cover blood thinners. The most popular of these now is Eliquis and then here is the low-cost Warfarin which (unlike Eliquis) requires ongoing blood testing and here are a few more: dabigatran (Pradaxa), edoxaban (Lixiana) and rivaroxaban (Xarelto). Medicare Advantage plans include prescription drug coverage if they are MAPD (Medicare Advantage with Prescription Drug coverage) plans otherwise the standalone Part D insurance covers blood thinners, too.How to Find the Part D Plan That Covers the Most of Your Medications
Every Part D plan and Medicare Advantage prescription drug plan publishes its own formulary, which is the list of covered medications. Two plans in the same ZIP code can have very different formularies, so the cheapest premium doesn't always mean the best coverage for the drugs you actually take.
The most reliable way to check is to enter your medication list into a plan comparison tool. Both the official Medicare.gov Plan Finder and the free tool on Medicare Agents Hub will rank the plans in your area by how well they cover your specific prescriptions, including tier placement and estimated annual out-of-pocket cost. Running the same drug list through both tools once a year during Open Enrollment is one of the simplest ways to avoid overpaying.
Reducing the Cost of Drug Coverage
While the cost of drug coverage can be high for Medicare beneficiaries, there are ways to reduce these expenses. Some options include shopping around for the best prices, using generic medications when possible, and taking advantage of discounts or financial assistance programs. Low-income beneficiaries may also qualify for Medicare Extra Help, which can significantly reduce Part D premiums and copays. It is important to speak with a healthcare professional or insurance provider to explore the options available to you. Our article on how to save money on prescriptions with Medicare covers additional strategies.
How will the new 2025 Medicare Part D out-of-pocket cap impact seniors and prescription drug costs?
The $2,000 out-of-pocket cap is a major step forward for seniors. It provides a clear limit on how much you’ll spend on medications each year and ensures that those with high prescription drug costs won’t be burdened with endless out-of-pocket expenses. This cap will especially help those on expensive medications or those with chronic conditions who need a lot of prescriptions. It offers greater predictability, affordability, and peace of mind for seniors, making their medications more accessible and reducing financial stress.Ways to Lower Prescription Drug Costs for Medicare Beneficiaries
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Consider Medicare Advantage (Part C) plans that include prescription drug coverage. These plans have their own set of pros and cons, with costs and providers varying depending on your location. Learn more in our Medicare Advantage vs. Medicare Supplement comparison. It is highly recommended to speak to a local Medicare Advantage agent to explore the options available in your area. You can use our free Zip Code directory to find one in your area.
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Compare Medicare drug plans based on the specific drugs you take. Medicare Agents Hub provides access to a free tool that you can use without entering personal information. Simply enter your Zip Code and the drugs you take, and the tool will show the best plan for your area. You can also run the same comparison directly on the official Medicare.gov Plan Finder.
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Utilize discount drug plan codes, such as GoodRx. Even with the best Medicare drug plan, it can be beneficial to check the prices on discount plans like GoodRx. Many major pharmacies, such as CVS and Costco, accept these codes, so it pays to compare prices even with great Medicare Plan D coverage.
Top Medications Consumed by Medicare Recipients
We've compiled a list of the top 10 drugs that Medicare has spent the most on. The spending figures below reflect 2020 CMS data (the most recent full year with detailed per-drug data available at publication), while the price-increase percentages compare January 2022 pricing to 2021. Actual out-of-pocket costs vary significantly based on your specific Part D plan, coverage phase, and whether you qualify for Extra Help or the Low-Income Subsidy — the averages here are a starting point, not what every senior will pay.
Can Medicare Part D deny coverage for a brand-name drug if a generic isn't available?
Yes. Part D plans cover drugs based on their formulary, so a brand-name drug can be non-covered even if no generic exists (they may prefer a different brand or therapeutic alternative, or require prior auth/step therapy).Lack of a generic doesn’t guarantee coverage—it just means the plan can’t force you to take a generic of that exact drug.
If your prescriber says the brand is medically necessary and alternatives won’t work, you can request a coverage exception/appeal with supporting clinical notes.
There are also transition fills for new members and special protections for certain “protected classes” of drugs, which can help in the short term.
1. Eliquis
A blood thinning medication for people with atrial fibrillation, Eliquis is manufactured by Bristol-Myers Squibb. The cost of a 30-day supply without insurance was listed as $522 on the manufacturer's website in 2022.
Those who have prescription coverage through Medicare pay an average of $37 for Eliquis, according to the manufacturer.
In 2020, Medicare spending on Eliquis reached $9.9 billion, with 2,641,941 beneficiaries. The price of Eliquis increased by 6% in 2022 compared to the previous year.
2. Revlimid
Another commonly used drug among Medicare beneficiaries, Revlimid is primarily utilized as part of cancer treatment. According to a new analysis, there is a significant variation in spending for specialty drugs such as Revlimid among Medicare Part D plans.
The average annual out-of-pocket cost for Revlimid was $17,142, according to a report from GoodRx. However, the minimum price paid for the drug was $2,818, while the maximum out-of-pocket cost was $20,015, representing a difference of almost $18,000.
In 2020, Medicare spending on Revlimid amounted to $5.4 billion, with 43,747 beneficiaries. The price of Revlimid increased by 4.5% in 2022 compared to the previous year.
3. Xarelto
A medication commonly used as a blood thinner for those with atrial fibrillation, the cost of Xarelto without insurance in 2022 was estimated to be between $400-500 for a 30-day supply.
Individuals with prescription insurance through Medicare typically pay between $2-18 on average for a 30-day supply of Xarelto, with the final cost varying depending on factors such as the type of Medicare coverage.
In 2020, Medicare spent a total of $4.7 billion on Xarelto, with 1,184,718 beneficiaries. The price of Xarelto increased by 4.9 percent in 2022 compared to the previous year.
4. Januvia
A medication used to aid in the treatment of diabetes (for more on insulin and drug coverage, see Diabetes and Medicare: What You Need to Know About Insulin and Part D Coverage), the average cost for Medicare members ranges from $75 to $175 per month for a 30-tablet supply. This compares to a retail cost of over $450 per month for the same amount of Januvia.
In 2020, Medicare spent a total of $3.9 billion on Januvia, with 934,686 beneficiaries. The price of Januvia increased by 5 percent in 2022 compared to the previous year.
5. Trulicity
Trulicity is a medication used as part of diabetes treatment. According to the manufacturer, Lilly, the list price of Trulicity in 2022 is $886.36 per month without insurance. For those with prescription insurance through Medicare, approximately 70% pay between $0-100 per month, while the remaining individuals pay an average of $207 per month. Additionally, those with Medicare who qualify for Extra Help may expect to pay $4 to $9 for each Trulicity prescription.
In 2020, Medicare spending on Trulicity amounted to $3.3 billion and it had 497,327 beneficiaries. The price of Trulicity increased by 5 percent in 2022.
6. Imbruvica
Used as a treatment for cancer, Imbruvica costs $484 per capsule/tablet, regardless of the strength (70mg, 140mg, 280mg, 420mg, 560mg). This amounts to $13,546 for a supply of 28 tablets/capsules.
However, most people will not have to pay this full amount, as insurance plans and Medicare cover the cost of this medicine. 99% of Medicare Part D and Medicare Advantage plans cover Imbruvica.
2020 Medicare spending: $3 billion
Beneficiaries: 26,847
2022 price increase: 7.4 percent
7. Jardiance
Jardiance is commonly prescribed as part of diabetes treatment. For patients with Medicare Part D coverage, approximately 63% of patients will pay between $0-$50 a month, according to the company. The remaining 37% pay an average of $161 a month.
2020 Medicare spending: $2.4 billion
Beneficiaries: 594,859
2022 price increase: 4 percent
8. Humira (Cf) pen
This medication is used to treat conditions such as rheumatoid arthritis and plaque psoriasis. A month's supply of Humira can cost around $7,389.
2020 Medicare spending: $2.2 billion
Number of beneficiaries: 42,406
Price increase: 7.4 percent (2022 over 2021)
9. Ibrance
This drug is used as part of cancer treatment. The cash price for a supply of 21 capsules of Ibrance is around $13,000 to $13,500, with the manufacturer offering an online coupon. It is covered by 100% of Medicare Part D plans as of March 2019.
2020 Medicare spending: $2.1 billion
Number of beneficiaries: 21,394
Price increase: 6.9 percent (2022 over 2021)
10. Symbicort
Symbicort is a medication prescribed as part of asthma treatment. The list price for a 30-day supply of Symbicort is $303.42 (80/4.5 mcg) and $346.83 (160/4.5 mcg). According to the manufacturer, individuals with Medicare Part D coverage can expect to pay an average out-of-pocket cost of $31.03 per month. In 2020, Medicare spending on Symbicort totaled $2 billion and it had 1,017,530 beneficiaries. The price of Symbicort increased by 2 percent in 2022. For more on why prices fluctuate, see common reasons generic drug prices increase under Part D.