The Top 200 Drugs of 2018

Top 200 Drugs of 2019 - The ClinCalc DrugStats Database

We’re proud to announce the annual update of the DrugStats database.  DrugStats provides free access to prescription drug utilization data estimates for the United States.  Using this data set, users can identify trends in prescribing practice and an official, reputable “top 200 drugs” list based on data provided by the U.S. Government.

Where does the DrugStats data come from?

All medication utilization data comes from the annual Medical Expenditure Panel Survey (MEPS), a survey conducted by the Agency for Healthcare Research and Quality (AHRQ) via the United States government. This data is publicly available on the MEPS website for free.  In order for the ClinCalc DrugStats database to implement the MEPS data, basic data sanitization and standardization measures are necessary to maintain an accurate and reliable data set.  Read more about the data set by clicking here.

What’s New in 2018?

The current DrugStats release (version 19.0) represents the MEPS data set from January through December 2016.  Each year, a number of medications or medication classes rises or falls in popularity due to changes in prescribing patterns.  For example, in an article reviewing the 2018 data set, SGLT2 inhibitors (such as canagliflozin) and direct-acting oral anticoagulants (such as rivaroxaban and apixaban) made major gains in the market.

The following drug or drug classes have made major changes in the market in the DrugStats 2018 data set:

Lisinopril Is No Longer King

Since 2012, lisinopril (Prinivil, Zestril) has held the commanding position as the most prescribed medication in the United States (rank #1).  As of this year; however, it has now decreased to rank #2, with levothyroxine (Synthroid) taking the throne.

Even though it isn’t ranked #1 anymore, lisinopril still maintains a huge monopoly of the ACE inhibitor market.  In fact, between lisinopril and its combination produce (lisinopril/HCTZ), it makes up more than 80% of all ACE inhibitors prescribed:

ACE inhibitors by market share

ACE inhibitors by market share (2016 data, DrugStats 2018)

Direct-Acting Oral Anticoagulants

Like last year, both rivaroxaban (Xarelto) and apixaban (Eliquis) made major strides in increasing their market share.  Apixaban rose in rank by +62 positions from 185 to 123, and rivaroxaban rose +26 from 131 to 105th position in the top 200 drug list.

Perhaps more interestingly, the market for dabigatran (Pradaxa) is slowly losing steam in favor of the aforementioned DOACs.  In 2015, it lost 22 positions and this year lost another 58 positions to now sit at #268:

Dabigatran - Number of Prescriptions Over Time 2006 - 2016

Dabigatran – Number of Prescriptions Over Time 2006 – 2016

The Setting Sun of Ezetimibe

With the publication of the 2013 ACC/AHA Lipid Guidelines emphasizing statins over all other agents for dyslipidemia, the role of ezetimibe (Zetia) has been steadily diminishing.  In 2016, its rank fell from 103 to 144 (a change of 41) with only about 4.5 million prescriptions filled.  Compared to about a decade earlier, with more than 16 million prescriptions in 2006, this decline is quite substantial:

Ezetimibe - Number of Prescriptions Over Time 2006 - 2016

Ezetimibe – Number of Prescriptions Over Time 2006 – 2016

Levetiracetam is Growing in Popularity

With its favorable adverse effect profile and reliable kinetic profile, it’s no surprise to see levetiracetam (Keppra) surpass older antiepileptics.  Levetiracetam has increased in rank by +29 to enjoy the status of the 89th most prescribed medication in the US.  With about 8.5 million prescriptions, levetiracetam has now easily surpassed other antiepileptics on the market such as oxcarbazepine (Trileptal), carbamazepine (Tegretol, Carbatrol), phenytoin (Dilantin), and valproic acid (Depakote).

Levetiracetam prescribing

Levetiracetam – Number of Prescriptions Over Time 2006 – 2016

In fact, the only other agents that are commonly used for epilepsy (and not other indications, such as is the case with gabapentin) that are more prescribed than levetiracetam are lamotrigine (Lamictal) with 11 million prescriptions and topiramate (Topamax) with about 9 million prescriptions.

Many, Many Other Data Trends and Interesting Facts

Between the 3 billion prescriptions and about 500 unique drug compounds covering more than a decade of prescribing patterns in the United States, the ClinCalc DrugStats database has plenty of other interesting data trends and facts to explore.

Explore DrugStats 2018


Flickr photo by Mike Mozart

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