Person entering Gilead building Leading the pack is Gilead Sciences’ HIV medication Biktarvy, which had U.S. sales revenue five times greater than the rest of the world. (Photo: David Paul Morris/Bloomberg)

Americans spent nearly twice as much on the 20 top-selling pharmaceuticals as the rest of the world combined last year, according to an analysis by the interest group Public Citizen.

“Americans spend far too much on prescription drugs,” according to the report. “Earlier studies have identified that the United States spends more per capita for prescription drugs than any other industrialized nation. In this analysis, we attempted to quantify the spending disparity by analyzing the sources of revenue for the 20 top-selling drugs globally in 2020.”

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Among the key findings:

  • U.S. sales of the 20 top-selling drugs worldwide totaled $101.1 billion, while sales to the rest of the world totaled nearly $57 billion.
  • For 17 of the 20 top-selling drugs worldwide in 2020, pharmaceutical corporations made more money from U.S. sales than from sales to all other countries combined.
  • For 11 of the 20 top-selling drugs worldwide, U.S. sales revenue was double or more the revenue from sales to the rest of the world.
  • Eleven of the 13 pharmaceutical companies selling these top drugs made more money in the United States from these drugs than they did in the rest of the world combined.

Drugs with significant sales revenue disparities between the United States and the rest of the world include:

  • Gilead Sciences’ HIV medication Biktarvy, which had U.S. sales revenue five times greater than the rest of the world;
  • AbbVie’s autoimmune disease drug Humira, which had U.S. sales revenue four times greater than the rest of the world; and
  • Eli Lily’s type 2 diabetes drug Trulicity, Roche’s multiple sclerosis drug Ocrevus and Amgen and Pfizer’s autoimmune disease drug Enbrel, all three of which had U.S. sales revenue more than triple the rest of the world.

Although differences in revenue may reflect differences in volumes of drugs consumed, previous research indicates that Americans consume comparable amounts of drugs as people in other high-income countries. Public Citizen supports proposed legislation that would empower Medicare to negotiate drug prices.

“Granting Medicare the authority to push back against pharmaceutical company profiteering would mean an end to decades of overpaying for medicines,” the report said, “and the beginning of billions in cost-savings that could be used to improve and expand Medicare, including increasing access to treatments as well as to dental, hearing and visual care. Congress should allow Medicare to negotiate without delay.”

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