America's 10 Biggest Selling Prescription Drugs

Drugs always prove to be a fascinating, if controversial, topic of conversation. Certainly the implications of prescription drugs today are complex - and yes, there are plenty of stories about prescription drug abuse. However, the ones on this list are all popular because they've proven successful in helping people with some of the most prevalent and trying diseases in the modern world.

While well known and widely prescribed drugs have certainly proven their worth, there's no doubt that America is becoming increasingly medicated each year. A recent study by the Mayo Clinic showed that around 70% of Americans are medicated with at least one prescription drug, and about 50% of Americans are on at least two prescription drugs. In the past few years, with statistics like this emerging, an open and sometimes contentious dialogue has begun regarding the alacrity with which people turn to medicine for mental disorders – most commonly, anxiety and depression – and medicate their children for conditions such as ADHD. Even medical professionals appear to be split on the issue of whether we are, as a country, too reliant on medication. And yet, despite the dissonance of these various opinions, it's important to acknowledge the incredible advances in science and medicine that have taken place over the past few decades. That researchers around the world are coming closer to finding cures for many disorders and increasingly powerful ways to ameliorate the suffering these diseases bring to the patients and the patients' families is a fact that can be neither disputed nor denounced.

This list is comprised of the latest information on the top 10 most lucrative prescribed medicines according to U.S. National Sales in the last quarter of 2013; figures include sales from both retail and hospital channels. The amount of money associated with each medication represents the sales value in U.S dollars. Many of the following ailments are as well-known as they are common; although the following list may not fill readers with joy, it certainly provides an insight into both the health of U.S. citizens and the state of the pharmaceutical industry in America today.

10 Copaxone ($851 million)

Copaxone is used to treat Multiple Sclerosis (MS) and to prevent relapses of MS. MS is a chronic disease that involves an immune system attack on the central nervous system, which is made up of the brain, spinal cord and optic nerves. Copaxone cannot cure MS, but it can help reduce the frequency with which relapses occur. The drug itself is a combination of four proteins that affect the immune system. A little more specifically, it works to block myelin-damaging T-cells; one function of myelin is to insulate nerve fibers in the brain and spinal cord. MS can vary from mild to severe; at its worst, it can cause paralysis or loss of vision. Symptoms and severity, however, tend to vary from patient to patient. Most people with MS are able to live satisfying lives; however, there is still a lot of work to be done to figure out the specific target of the immune attack involved in MS. Luckily, there are many clinical trials and charities working towards a cure for the disease. In fact, this month, researchers began recruiting subjects for a study of a blood test that may help to diagnose and monitor MS.

9 Neulasta ($854 million)

Neulasta is of a class of drugs known as colony stimulating factors. It is used to prevent neutropenia – a lack of certain white blood cells – which is caused by receiving chemotherapy treatment. Neulasta is a man-made form of a protein that stimulates the growth of white blood cells, which are crucial for helping the body fight infection. This medicine is usually administered once per chemotherapy cycle. Unfortunately, nearly everyone knows someone who has suffered from some form of cancer - in America, latest statistics show that men have just less than a 1 in 2 lifetime risk of developing cancer while a little more than 1 in 3 women are likely to develop cancer in their lifetime. While the disease can be devastating, there is hope; more and more research is being conducted each day to find ways to better combat the onset and progression of cancer. A positive statistic as of 2012; the United States has had 13,683,850 cancer survivors! Here’s to more research and to more unyielding strength and bravery.

8 Remicade ($994 million)

Remicade reduces inflammation in the body; it is used to treat arthritis, Crohn’s disease, and severe plaque psoriasis. That it is one of three arthritis drugs featured in the top 10 on this list demonstrates the prevalence of this disease in the modern world. In 2007, 1 in 5 adults in the United States reported that they had a form of arthritis – that’s 22% of adults! Another condition this medicine treats is Crohn’s Disease, which results chronic inflammation in the gastrointestinal tract. Crohn’s may affect as many as 700,000 Americans; it is most prevalent among people aged 15-35. While medications like this may help with Crohn’s, the actual causes of the disease are still largely unclear.

7 Cymbalta ($1.06 billion)

Cymbalta is used to treat major depression and general anxiety disorders. It is part of a family of drugs known as selective seratonin and norepinephren reuptake inhibitors (SSNRI). This means that it affects chemicals in the brain (namely, the concentration of seratonin) that can become unbalanced and cause depressive symptoms. Interestingly, it can also be used to treat fibromyalgia (a chronic pain disorder) or chronic muscle pain. According to the Center for Disease Control and Prevention, 1 in 10 U.S. adults report experiencing depression. Symptoms of major depression can include feelings of hopelessness, guilt, irritability, fatigue or helplessness. It has been noted that older adults are at an increased risk for depression. SSNRI’s like Cymbalta, however, have been successful in a number of cases. Many people find relief from serious depressive symptoms by taking a prescribed drug and/or using a resource like psychotherapy.

6 Enbrel ($1.19 Billion)

Enbrel is also used to treat various forms of arthritis and joint damage that those conditions can sometimes cause. In people with autoimmune disorders, the immune system can actually mistake the body’s own cells for invaders and respond by attacking them. Enbrel works by decreasing a certain protein produced by the immune system so that this doesn’t happen. The most common form of Enbrel is an injection under the skin rather than a pill. As its high ranking on this list suggests, patients have had a significant degree of success with this medicine.

5 Advair Diskus ($1.25 Billion)

The Advair Diskus is a handy contraption that contains a steroid called fluticasone and something called salmetrol, which is a bronchodialator (relaxes airways to aid breathing). Fluticasone is a steroid. In tandem, these two substances work to prevent asthma attacks, and prevent flare-ups of chronic obstructive pulmonary disease, which is often associated with chronic bronchitis or emphysema. According to the American Academy of Allergy, Asthma, and Immunology, 1 in 12 people (that’s around 8% of the U.S. population) had asthma in 2009, compared with 7% in 2001. An estimated 300 million people worldwide suffer from asthma. Luckily, the disease can be treated effectively. The challenge we face is the medical accessibility and funds necessary to keep the disease at bay. Approximately 250,000 people die prematurely from asthma internationally, and nearly all of those deaths are avoidable.

4 Crestor ($1.33 Billion)

Crestor works to treat high cholesterol in adults. It is also used to lower the risk of stroke, heart attack, coronary heart disease, and other heart complications in diabetes patients. It is part of a group of drugs called “HMG CoA reductase inhibitors.” In simpler terms, the drug targets “bad” cholesterol and works to decrease its concentration in the body, while increasing levels of “good” cholesterol. That being said, Crestor is only maximally effective if the patient sticks to a reasonable diet low in fat, cholesterol, and alcohol. The Center for Disease Control and Prevention reported that only 1 out of every 3 people with high cholesterol are able to keep it under control. Less than half of adults with high “bad” cholesterol get treatment. Thankfully, it is quite possible to combat high cholesterol without medication. Simply eating well, exercising regularly, and refraining from smoking are three ways to keep one’s cholesterol levels healthily low.

3 Humira ($1.46 Billion)

Humira is yet another medication used to treat various forms of arthritis. It is also used to treat Crohn’s disease if other drugs have been ineffective. Startlingly, by 2030, an estimated 67 million Americans aged 18 or over are projected to have some form of doctor-diagnosed arthritis. However there are ways to keep symptoms at bay; exercise, pain management, and medication therapy are all available options. Humira and Enbrel (mentioned earlier) have both been effective in 70% of patients, certainly a step in the right direction. There are a few leading orthopedic researchers – for example, Dr. Christian Lattermann – in the field who hope to study the disease and evaluate new treatment options in the future. 

2 Nexium ($1.54 Billion)

Nexium is a drug used to treat symptoms of acid reflux and other conditions involving excessive stomach acid. (If you’re eating a meatball sub while reading this, pause). It is part of a group of medications called proton pump inhibitors. For those who haven’t taken bio since senior year of high school (me), this means that it acts to decrease the amount of stomach acid in the body, thereby helping with mild to more severe indigestion. Nexium can also help promote healing of the esophagus and may be given to help prevent gastric ulcer as well. Studies have shown that the problem of gastro- esophageal reflux disease is increasing; approximately 20% of Americans suffer from reflux at least once a week as according to the National Digestive Diseases Information Clearinghouse. The variety and increasing availability of food that may be hard on the stomach could be one reason for this incline.

1 Abilify ($1.60 Billion)

Abilify is a medication that treats the symptoms of conditions such as schizophrenia and bipolar disorder (manic depression), and can be used in conjunction with other medications to treat major depression in adults. It can also be helpful when treating severe mood swings and aggression associated with autism in children over 6 years of age. Bipolar disorder affects approximately 5.7 million American adults; the median age of the onset is 25 years of age.  Additionally, about 2.4 million American adults - approximately 1.1% of the population over 18 – suffer from schizophrenia. Abilify is part of a class of medications known as “antipsychotics.” However, recently there have been efforts to refer to these medications by a different name (for example, neuroleptics) to help avoid the stigmatization of the concept of ‘psychosis,’ as well as of mental illness in general.



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