Ranked: The Most Prescribed Drugs in the U.S.
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Ranked: The Most Prescribed Drugs in the U.S.

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Ranked: The Most Prescribed Drugs in the U.S.

Every day, millions of people in the U.S. take prescribed drugs to help them live their lives.

As our understanding of medicine has evolved, we’ve been able to develop drugs to aid with some of the most common medical conditions—from pain and blood pressure drugs to asthma medication, thyroid treatments, and antidepressants.

This graphic uses prescribed medicines data from the U.S. Agency for Healthcare Research and Quality, released in 2021 for the 2019 calendar year. It also uses supporting drug and health information from MedlinePlus.

What are the Most Prescribed Drugs in America?

Sorting the annual prescribed medicines data by the total number of patients highlights how important and prevalent some drugs are in America.

The most prescribed drug, atorvastatin (sold under brand Lipitor), was prescribed to 24.5 million people in the U.S. in 2019, or 7.5% of the population. It was one of many statin medications listed, which are used to prevent cardiovascular disease and treat abnormal lipid levels.

In fact, a majority of the most prescribed drugs in the U.S. are used to treat high blood pressure or symptoms of it. That’s because 108 million or nearly half of adults in the U.S. have hypertension or high blood pressure.

Drug NameTotal U.S. Patients (2019)Brand NamePrimary Use
Atorvastatin24,493,971LipitorCholesterol
Amoxicillin20,368,921Amoxil, TrimoxAntibiotic
Lisinopril19,990,170Prinivil, ZestrilBlood Pressure
Levothyroxine19,698,087Synthroid, LevoxylThyroid
Albuterol19,085,418Ventolin, ProventilBreathing
Metformin17,430,765Glucophage, FortametDiabetes
Amlodipine16,419,181NorvascBlood Pressure
Metoprolol15,177,787Lopressor, Toprol XLBlood Pressure
Omeprazole12,869,290Losec, PrilosecStomach Acid
Losartan11,760,646CozaarBlood Pressure
Azithromycin11,577,286Zithromax, AzithrocinAntibiotic
Prednisone10,999,246Deltasone, OrasoneInflammation
Ibuprofen10,951,995Advil, MotrinPain
Hydrocodone/Acetaminophen10,409,764Vicodin/NorcoPain (Opioid)
Gabapentin9,818,634NeurontinSeizures
Fluticasone9,564,147Flovent, FlonaseBreathing
Hydrochlorothiazide9,358,879Apo-Hydro, MicrozideDiuretic
Simvastatin8,543,612ZocorCholesterol
Sertraline7,723,122Zoloft, LustralAntidepressant
Montelukast7,429,725SingulairBreathing
Pantoprazole6,777,996ProtonixStomach Acid
Furosemide6,640,042Lasix, FrusemideDiuretic
Meloxicam6,484,210Mobic, MetacamPain
Amoxicillin; Clavulanate6,468,086Augmentin, ClavulinAntibiotic
Cephalexin6,267,878Keflex, CeporexAntibiotic
Rosuvastatin6,129,254Crestor, RosulipCholesterol
Escitalopram5,544,406Cipralex, LexaproAntidepressant
Bupropion5,520,278Wellbutrin, ZybanAntidepressant
Tramadol5,496,843Ultram, ZytramPain (Opioid)
Pravastatin5,420,488Pravachol, SelektineCholesterol

Other common prescriptions include antibiotics like amoxicillin and azithromycin, used to treat bacterial infections, as well as levothyroxine, which was used by 19.7 million Americans to treat thyroid hormone deficiency.

Asthma medication albuterol (usually prescribed through an inhaler) rounded out the top five prescribed drugs with the most patients, followed closely by Type 2 diabetes medication glucophage.

The Top Medical Conditions Treated by Prescription Drugs

The prevalence of cardiovascular-related medication becomes clear when combining the total patients for each type of medication.

The total number of patients with prescribed medication for blood pressure or cholesterol combined for 33% of the U.S. population.

Compared to that, medication for pain or inflammation were the most frequent on the top 30 list with five occurrences, but were only prescribed to 13.6% of people. That includes hydrocodone (known by the brand name Vicodin) and tramadol (known by the brand name Ultram), two opioid medications.

Primary Use of Prescribed DrugU.S. Patients as % Pop (2019)
Blood Pressure19.4%
Antibiotic13.7%
Cholesterol13.6%
Pain/Inflammation13.6%
Breathing11.0%
Thyroid6.0%
Stomach Acid6.0%
Antidepressant5.7%
Diabetes5.3%
Diuretic4.9%
Seizures3.0%

Most of the top 30 prescribed medications for specific conditions saw patients total less than 6% of the U.S. population. They include thyroid issues, gastrointestinal conditions, and mental conditions treated by antidepressants (including panic disorder, anxiety disorders, and PTSD).

But it’s important to remember that some patients have multiple prescriptions for serious conditions with multiple symptoms, or comorbid conditions—when more than one disease or condition is present at the same time.

Drug Spending in the U.S.

A prescribed drug’s total number of patients doesn’t necessarily reflect how important it is, or how expensive it is for the end user.

Levothyroxine is the fourth-most prescribed drug by total patients, but the second-most prescribed drug by total prescriptions with 102.6 million in 2019 at an average cost of $25.10 per prescription.

More specialized medication like fluticasone had significantly less total prescriptions with 27.9 million, but an average cost of $97.68 per prescription.

Prices are influenced by a drug’s demand, whether or not it’s patented or available in generic form, and a country’s healthcare system. As far as OECD countries go, the U.S. ranks as the most costly almost across the board.

Since the current rankings look at the U.S. pre-COVID, next year’s prescription data will be illuminating as to the state of American health (and healthcare).

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Science

Visualizing the Relationship Between Cancer and Lifespan

New research links mutation rates and lifespan. We visualize the data supporting this new framework for understanding cancer.

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Cancer and lifespan

A Newfound Link Between Cancer and Aging?

A new study in 2022 reveals a thought-provoking relationship between how long animals live and how quickly their genetic codes mutate.

Cancer is a product of time and mutations, and so researchers investigated its onset and impact within 16 unique mammals. A new perspective on DNA mutation broadens our understanding of aging and cancer development—and how we might be able to control it.

Mutations, Aging, and Cancer: A Primer

Cancer is the uncontrolled growth of cells. It is not a pathogen that infects the body, but a normal body process gone wrong.

Cells divide and multiply in our bodies all the time. Sometimes, during DNA replication, tiny mistakes (called mutations) appear randomly within the genetic code. Our bodies have mechanisms to correct these errors, and for much of our youth we remain strong and healthy as a result of these corrective measures.

However, these protections weaken as we age. Developing cancer becomes more likely as mutations slip past our defenses and continue to multiply. The longer we live, the more mutations we carry, and the likelihood of them manifesting into cancer increases.

A Biological Conundrum

Since mutations can occur randomly, biologists expect larger lifeforms (those with more cells) to have greater chances of developing cancer than smaller lifeforms.

Strangely, no association exists.

It is one of biology’s biggest mysteries as to why massive creatures like whales or elephants rarely seem to experience cancer. This is called Peto’s Paradox. Even stranger: some smaller creatures, like the naked mole rat, are completely resistant to cancer.

This phenomenon motivates researchers to look into the genetics of naked mole rats and whales. And while we’ve discovered that special genetic bonuses (like extra tumor-suppressing genes) benefit these creatures, a pattern for cancer rates across all other species is still poorly understood.

Cancer May Be Closely Associated with Lifespan

Researchers at the Wellcome Sanger Institute report the first study to look at how mutation rates compare with animal lifespans.

Mutation rates are simply the speed at which species beget mutations. Mammals with shorter lifespans have average mutation rates that are very fast. A mouse undergoes nearly 800 mutations in each of its four short years on Earth. Mammals with longer lifespans have average mutation rates that are much slower. In humans (average lifespan of roughly 84 years), it comes to fewer than 50 mutations per year.

The study also compares the number of mutations at time of death with other traits, like body mass and lifespan. For example, a giraffe has roughly 40,000 times more cells than a mouse. Or a human lives 90 times longer than a mouse. What surprised researchers was that the number of mutations at time of death differed only by a factor of three.

Such small differentiation suggests there may be a total number of mutations a species can collect before it dies. Since the mammals reached this number at different speeds, finding ways to control the rate of mutations may help stall cancer development, set back aging, and prolong life.

The Future of Cancer Research

The findings in this study ignite new questions for understanding cancer.

Confirming that mutation rate and lifespan are strongly correlated needs comparison to lifeforms beyond mammals, like fishes, birds, and even plants.

It will also be necessary to understand what factors control mutation rates. The answer to this likely lies within the complexities of DNA. Geneticists and oncologists are continuing to investigate genetic curiosities like tumor-suppressing genes and how they might impact mutation rates.

Aging is likely to be a confluence of many issues, like epigenetic changes or telomere shortening, but if mutations are involved then there may be hopes of slowing genetic damage—or even reversing it.

While just a first step, linking mutation rates to lifespan is a reframing of our understanding of cancer development, and it may open doors to new strategies and therapies for treating cancer or taming the number of health-related concerns that come with aging.

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Misc

Explainer: What to Know About Monkeypox

What is monkeypox, and what risk does it pose to the public? This infographic breaks down the symptoms, transmission, and more.

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Explainer: What to Know About Monkeypox

The COVID-19 pandemic is still fresh in the minds of the people around the world, so it comes as no surprise that recent outbreaks of another virus are grabbing headlines.

Monkeypox outbreaks have now been reported in multiple countries, and it has scientists paying close attention. For everyone else, numerous questions come to the surface:

  • How serious is this virus?
  • How contagious is it?
  • Could monkeypox develop into a new pandemic?

Below, we answer these questions and more.

What is Monkeypox?

Monkeypox is a virus in the Orthopoxvirus genus which also includes the variola virus (which causes smallpox) and the cowpox virus. The primary symptoms include fever, swollen lymph nodes, and a distinctive bumpy rash.

There are two major strains of the virus that pose very different risks:

  • Congo Basin strain: 1 in 10 people infected with this strain have died
  • West African strain: Approximately 1 in 100 people infected with this strain died

At the moment, health authorities in the UK have indicated they’re seeing the milder strain in patients there.

Where did Monkeypox Originate From?

The virus was originally discovered in the Democratic Republic of Congo in monkeys kept for research purposes (hence the name). Eventually, the virus made the jump to humans more than a decade after its discovery in 1958.

It is widely assumed that vaccination against another similar virus, smallpox, helped keep monkeypox outbreaks from occurring in human populations. Ironically, the successful eradication of smallpox, and eventual winding down of that vaccine program, has opened the door to a new viral threat. There is now a growing population of people who no longer have immunity against the virus.

Now that travel restrictions are lifting in many parts of the world, viruses are now able to hop between nations again. As of the publishing of this article, a handful of cases have now been reported in the U.S., Canada, the UK, and a number of European countries.

On the upside, contact tracing has helped authorities piece together the transmission of the virus. While cases are rare in Europe and North America, it is considered endemic in parts of West Africa. For example, the World Health Organization reports that Nigeria has experienced over 550 reported monkeypox cases from 2017 to today. The current UK outbreak originated from an individual who returned from a trip to Nigeria.

Could Monkeypox become a new pandemic?

Monkeypox, which primarily spreads through animal-to-human interaction, is not known to spread easily between humans. Most individuals infected with monkeypox pass the virus to between zero and one person, so outbreaks typically fizzle out. For this reason, the fact that outbreaks are occurring in several countries simultaneously is concerning for health authorities and organizations that monitor viral transmission. Experts are entertaining the possibility that the virus’ rate of transmission has increased.

Images of people covered in monkeypox lesions are shocking, and people are understandably concerned by this virus, but the good news is that members of the general public have little to fear at this stage.

I think the risk to the general public at this point, from the information we have, is very, very low.
–Tom Inglesby, Director, Johns Hopkins Center for Health Security

» For up-to-date information on monkeypox cases, check out Global.Health’s tracking spreadsheet

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