U.S. prescription drug spending is projected to exceed $1 trillion in 2026, up from $915 billion in 2025, according to the American Society of Health-System Pharmacists. The 12.7% growth rate in 2025 represents one of the fastest increases in two decades, driven primarily by GLP-1 weight-loss medications like tirzepatide and semaglutide, which each generated approximately $60 billion in sales and accounted for nearly one-third of all spending growth. Cancer drugs remain the largest category, with clinic spending growing 19% due to precision oncology and immune checkpoint inhibitors. The organization attributes the surge to increased medication utilization rather than rising prices, warning that institutions focused on specialty care will face far higher cost pressures than those providing routine care. While Medicare drug price negotiations may reduce patient out-of-pocket costs, this could paradoxically increase overall system spending through higher utilization.
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