The trend: Spending on prescription drugs in the US grew 11.4% in 2024, from $437 billion to $487 billion at net manufacturer prices, according to a new report from IQVIA.

• The 11.4% jump in drug spending represents “historic growth,” per IQVIA, and was only topped in recent years by 2021 due to the first year of COVID-19 vaccines and treatments.
• Prescription drug spending in the US is projected to increase between 5% and 8% through 2029, the report found.

What’s driving the trend: The bulk of higher drug spending was driven by 31 medicines— each with over $500 million in year-over-year growth.

• GLP-1 drugs accounted for 29% of the YoY jump in drug spending.
• Products with label expansions, such as new indications and earlier lines of therapy, accounted for 24% of the growth in drug spending. These drugs range across oncology, immunology, hematology, and other therapy areas.
• COVID-19 vaccines and therapeutics made up 14%.

Yes, and: Consumers are paying more for their medications out-of-pocket.

• Patient out-of-pocket costs reached $98 billion in 2024 across all payer types, an increase of $6 billion.
• While 90% of prescriptions cost patients less than $20, 79 million prescriptions had an out-of-pocket cost of $125 or more last year.
• The number of prescriptions costing more than $125 out-of-pocket increased 10% annually over the last five years on average. Medicare has seen the most growth in high-cost prescriptions in the last five years, with an annual 23% increase.

But wait, there’s more: Consumers are also taking more medications than they used to. Based on defined daily doses, prescription medicine use has spiked 14% since 2019.

Prescriptions for Medicare beneficiaries have grown the most over the last five years, up 25%, and nearly triple the growth in the number of program enrollees. Prescriptions per Medicare enrollee reached 36 in 2024, also a new high. Related, we forecast Medicare prescription drug spending to eclipse $343 billion this year, up 34% from 2021.