Table 1. Descriptive Characteristics of 150 Top-Selling Drugs as Measured by 2020 US Drug Sales.
| Spending and market variables | Median (IQR) |
|---|---|
| Proportion of total promotional spending allocated to direct-to-consumer advertising, % | 13.5 (1.96-36.6) |
| Total promotional spending, millions, $ | 20.9 (2.72-131) |
| Total product sales, billions, $ | 1.51 (0.97-2.26) |
| Medicare spending per beneficiary, thousands, $ | 17.9 (3.41-46.2) [n = 147] |
| Proportion of manufacturer sales attributable to the drug product, % | 7.9 (4.2-17.7) |
| Market size, billions, $a | 17.0 (5.68-31.1) |
| Drug variables | No. (%) (n = 150) |
| Added clinical benefit (low vs high)b | 92 (68) [n = 135 assessed] |
| Approval year (since 2012 vs earlier) | 76 (51) |
| Administration (clinician administered vs self-administered) | 43 (29) |
| Market competitivenessc | [n = 146] |
| Competitive | 79 (54) |
| Oligopolistic | 58 (40) |
| Monopoly or near monopoly | 9 (6) |
| Molecule type (biologic or biosimilar products vs small molecule) | 59 (39) |
| Single indication (yes vs no) | 63 (42) |
| Off-label use (yes vs no) | 65 (43) |
| Generic availability (yes vs no) | 28 (19) |
| Conditions targetedc | [n = 149] |
| Chronic | 76 (51) |
| Chronic or acute | 44 (30) |
| Acute | 29 (19) |
| Anatomical group | |
| Alimentary tract and metabolism | 25 (17) |
| Anti-infectives for systemic use | 14 (9) |
| Antineoplastic and immunomodulating agents | 53 (35) |
| Nervous system | 15 (10) |
| Respiratory system | 16 (11) |
| Otherd | 27 (18) |
Market size for each drug was calculated as the sum of all sales in the drug’s class defined using level 3 of IQVIA’s Uniform System of Classification (eg, nonnarcotic analgesics).
Added clinical benefit was identified using assessments from health technology assessment agencies in France and Canada. See the Box, Methods section, and Table 2 footnotes for details. Canada’s ratings for 27 drugs were used when there was no French rating available.
Data were not available in the sources used.
World Health Organization anatomical chemical classification system categories: blood and blood forming agents (n = 8), systemic hormonal preparations (n = 6), cardiovascular system (n = 4), musculoskeletal system (n = 3), sensory organs (n = 3), genitourinary system and sex hormones (n = 2), and dermatological conditions (n = 1).