The biggest selling drug in the world currently is Merck's cancer immunotherapy Keytruda (pembrolizumab), reaching nearly $30 billion in sales in 2024, taking the top spot from AbbVie's Humira (adalimumab), which held the title for years but saw declining sales due to market competition.
Leading this surge was Merck's immuno-oncology therapy, Keytruda, which maintained its position as the world's best-selling drug with nearly $29.5 billion in sales. Following closely were Bristol Myers Squibb/Pfizer's Eliquis, Novo Nordisk's GLP-1 receptor agonist Ozempic and Sanofi/Regeneron's Dupixent.
Get facts about the most commonly misused and abused drugs.
For the second year in a row, Merck's blockbuster PD-1 inhibitor Keytruda tops the list of pharma's best-selling products. In 2024, Keytruda surged 18% year-on-year to hit $29.48 billion in sales.
A blockbuster drug is an extremely popular drug that generates annual sales of at least $1 billion for the company that sells it.
1. Zolgensma – $2,125,000. Zolgensma received FDA approval in May 2019. It has remained the most expensive drug in the U.S., with a one-time cost of $2.1 million for a course of treatment.
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By far, alcohol is the most commonly abused substance in the United States.
Eli Lilly is the largest pharma company in the world, with a market cap of $934.79 billion.
For example, the world's new most expensive drug, Lenmeldy, treats MLD, which only affects one in every 40,000 individuals in the U.S. This means that, even though they cost so much, selling gene therapies is potentially a risky business.
Opioid Abuse
8.9 million or 3.4% of Americans aged 12 and older misuse opioids at least once over a 12-month period. Usership has remained consistent from 2021 to 2023, with about 3.2% of Americans 12 or older misusing opioids.
Alcohol. Alcohol is the most regularly used addictive substance in America, with nearly 29 million people aged 12 or older having a past year alcohol use disorder in 2023.
25I-NBOMe, also known as 2C-I-NBOMe, Cimbi-5, and shortened to "25I", is a psychedelic drug of the phenethylamine, 2C, and NBOMe (25-NB) families. Since 2010, it has circulated in the recreational drug scene, often misrepresented as LSD.
The US has the highest death rates from opioids and illicit drugs. Opioids are responsible for the largest number of overdose deaths globally. Death rates from illicit drugs are the highest in the United States.
Top 10 Most Addictive Drugs List
All of the drugs on this list had a immense impact on the evolution of medicine and the evolution of mankind.
It is no surprise that the U.S. is the largest national pharmaceutical market worldwide. China has become one of the main players in the industry, and the annual growth rates of some emerging pharma markets have been strong in recent years.
The U.S. pharmaceutical wholesale distribution industry is an extremely concentrated oligopoly dominated by three firms: McKesson Corporation, AmerisourceBergen (now Cencora, Inc.), and Cardinal Health.
Dilip Shanghvi. This is the latest accepted revision, reviewed on 12 December 2025. Dilip Shanghvi (born 1 October 1955) is an Indian billionaire businessman. Shanghvi is the founder of Sun Pharmaceuticals, a pharmaceutical company.
Marijuana is by far the most used illicit drug in the United States, with over 64 million people using this drug in 2024.
Therefore, this article defines the most addictive substances as substances that greatly affect dopamine levels and are most likely to cause addiction.
A snowflake or diamond emoji represents cocaine, and a pill or chocolate bar emoji may be code for Xanax.
Cannabis: Marijuana, Grass, Dope, Pot, Puff, Weed. Cannabis is a cannabinoid. It is available as resin, dried flower, and less commonly, oil. The main active compound is tetrahydrocannabinol (THC).
The majority of students who enter college are under the age of 21 and, unsurprisingly, alcohol is the most common drug of choice.