Most Expensive Prescription Medications in the US
2026 Edition — Updated with current pricing
The US has the highest prescription drug prices in the world. These are the most expensive — and what every patient needs to know about affording them.
$3.5M
Most expensive single drug
10x
Higher than next country
65%
Avg savings on Script Unlock
The 15 Most Expensive Prescription Drugs (2026)
1
Zolgensma (onasemnogene)
Spinal Muscular Atrophy
Gene therapy (one-time)$2,125,000
per year
2
Hemgenix (etranacogene)
Hemophilia B
Gene therapy (one-time)$3,500,000
per year
3
Skysona (elivaldogene)
Cerebral Adrenoleukodystrophy
Gene therapy (one-time)$3,000,000
per year
4
Bluebird bio (betibeglogene)
Beta-Thalassemia
Gene therapy (one-time)$2,800,000
per year
5
Imbruvica (ibrutinib)
Blood cancers
Oncology$181,000
per year
alternatives available
6
Revlimid (lenalidomide)
Multiple myeloma
Oncology$160,000
per year
alternatives available
7
Keytruda (pembrolizumab)
Various cancers
Immunotherapy$200,000
per year
8
Dupixent (dupilumab)
Eczema, asthma
Biologic$36,000
per year
alternatives available
9
Humira (adalimumab)
RA, psoriasis, Crohns
Biologic$84,000
per year
alternatives available
10
Ozempic (semaglutide)
Type 2 Diabetes / Weight Loss
GLP-1 Agonist$12,000
per year
alternatives available
11
Wegovy (semaglutide)
Chronic Weight Management
GLP-1 Agonist$16,000
per year
alternatives available
12
Mounjaro / Zepbound (tirzepatide)
Diabetes / Weight Loss
GLP-1/GIP Agonist$13,000
per year
alternatives available
13
Eliquis (apixaban)
AFib / Blood Clots
Anticoagulant$6,800
per year
alternatives available
14
Xarelto (rivaroxaban)
Blood Clots / AFib
Anticoagulant$6,500
per year
alternatives available
15
Jardiance (empagliflozin)
Type 2 Diabetes / Heart Failure
SGLT2 Inhibitor$6,600
per year
alternatives available
What To Do If Your Medication Is Too Expensive
Manufacturer PAP
Free medication for uninsured patients who qualify by income. Apply directly to the manufacturer.
Learn more →
Manufacturer Copay Cards
Reduces copay to $0-$10/month for insured patients. Find on manufacturer websites.
Learn more →
Biosimilar Alternatives
FDA-approved biosimilars for brand biologics — 40-65% lower cost.
Learn more →
Script Unlock Pricing
For eligible medications, pharmacy bidding finds the lowest cash price.
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FAQs
What is the most expensive prescription drug in the US?
Hemgenix (etranacogene dezaparvovec) for Hemophilia B is currently the most expensive drug in the US at approximately $3.5 million for a single one-time treatment. However, this is a gene therapy administered once. Among recurring medications, oncology drugs like Keytruda ($200,000/year) and Imbruvica ($181,000/year) are among the most expensive.
How can patients afford expensive medications?
Options for expensive medications: (1) Manufacturer PAP programs — many provide free medication for qualifying uninsured patients, (2) Manufacturer copay cards — can reduce copay to $0 for insured patients, (3) Non-profit foundations (HealthWell, CancerCare, Patient Advocate Foundation), (4) Biosimilars and generics where available, (5) Script Unlock for pharmacy price comparison on available medications.