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Cambridge MedChem Consulting

Medicines Used

We often see news stories about the "biggest" drugs based on sales, however this way of looking at drug sales is somewhat skewed by the high cost of some therapeutics, particularly biologics. It is also noteworthy that the majority of the drugs are indicated for cancer.

Drug Indication Worldwide Sales 2018
Humira Rheumatoid Arthritis $19.936 billion
Eliquis Anticoagulant  $9.872 billion
Revlimid Cancer $9.685 billion
Opdivo Cancer $7.570 billion
Keytruda Cancer $7.171 billion
Enbrel Rheumatoid Arthritis $7.126 billion
Herceptin Cancer $6.981 billion
Avastin Cancer $6.847 billion
Rituxan Cancer $6.750 billion
Xarelto Anticoagulant 6.589 billion
Eylea Cancer/AMD $6.551 billion
Remicade Crohn's Disease $5.908 billion
Prevnar 13 Pneumonia $5.802 billion
Stelara Psoriasis  $5.156 billion
Lyrica Epilepsy/Pain $4.970 billion

I can't help but think that a better metric might be the number of patients treated. Whilst I don't have access to worldwide prescriptions the NHS in the UK does provide some information as part of the Prescription cost analysis for 2018. Whilst the number of prescriptions does correspond exactly with the number of patients treated I suspect it gives a very good indication.

Looking at the categories of drugs it is interesting to note that cancer does not figure in the top 20 categories. As you might expect lipid-lowering drugs, gastric ulcer treatment, treatments for cardiovascular disease, anti-depressants and analgesics are the most prescribed.

Drug Category Number of items
Lipid-Regulating Drugs 74,289,246
Proton Pump Inhibitors 60,024,837
Angiotensin-Converting Enzyme Inhibitors 44,159,042
Calcium-Channel Blockers 41,102,081
Beta-Adrenoceptor Blocking Drugs 38,617,728
Selective Serotonin Re-Uptake Inhibitors 38,216,924
Non-Opioid Analgesics And Compound Prep 35,998,332
Antiplatelet Drugs 34,139,843
Thyroid Hormones 32,253,535
Control Of Epilepsy 27,989,893
Vitamin D 24,559,380
Opioid Analgesics 23,393,193
Selective Beta(2)-Agonists 22,900,805
Biguanides 21,806,787
Corticosteroids (Respiratory) 20,879,110
Angiotensin-II Receptor Antagonists 20,499,156
Oral Anticoagulants 17,613,257
Tricyclic & Related Antidepressant Drugs 16,704,980
Other Antidepressant Drugs 15,911,182
Thiazides And Related Diuretics 14,628,130
Antihistamines 13,626,254

Looking at the top most prescribed drugs, small molecule drugs dominate for all indications.

Chemical Name Indication Items
Atorvastatin Lipid-Regulating Drugs 41,820,664
Levothyroxine Sodium Thyroid Hormones 32,187,950
Omeprazole Proton Pump Inhibitors 31,038,076
Amlodipine Calcium-Channel Blockers 29,052,338
Ramipril Angiotensin-Converting Enzyme Inhibitors 28,605,025
Lansoprazole Proton Pump Inhibitors 25,461,167
Simvastatin Lipid-Regulating Drugs 24,303,261
Bisoprolol Fumarate Beta-Adrenoceptor Blocking Drugs 23,625,562
Colecalciferol Vitamin D 23,609,903
Aspirin Non-Opioid Analgesics And Compound Prep 23,397,042
Metformin Hydrochloride Diabetes 21,806,787
Salbutamol Selective Beta(2)-Agonists 21,577,054
Paracetamol Non-Opioid Analgesics And Compound Prep 18,516,491
Co-Codamol (Codeine Phos/Paracetamol) Opioid Analgesics 15,179,951
Sertraline Hydrochloride Selective Serotonin Re-Uptake Inhibitors 14,815,719
Citalopram Hydrobromide Selective Serotonin Re-Uptake Inhibitors 14,136,645
Amitriptyline Hydrochloride Tricyclic & Related Antidepressant Drugs 13,532,567
Furosemide Thiazides And Related Diuretics 11,945,445
Beclometasone Dipropionate Corticosteroids (Respiratory) 10,671,698

Also of note is the number of prescriptions for drugs that are readily available over the counter.