In its first year on the market , the hepatitis C virus drug Sovaldi soared to the top of the Medicare part D spending list, the Centers for Medicare & Medicaid Services reported.

With innovative oral HCV drugs getting at least partial credit for a big jump in U.S. health expenditures in 2014, total part D spending for Sovaldi (sofosbuvir) was more than $3.1 billion, close to half a billion more than second-place Nexium (esomeprazole), which had almost $2.7 billion in spending for the year. Next on the list was Crestor (rosuvastatin) at $2.54 billion, followed by Abilify (aripiprazole) at $2.53 billion and Advair Diskus (fluticasone/salmeterol) at $2.3 billion, according to the Medicare drug spending dashboard.

Sovaldi’s spot at the top, however, was not a result of its popularity. Compared with the other top five drugs, it was used by the fewest people (33,000) and had the highest average per-unit cost ($1,017). Crestor was most commonly prescribed among the five, with 1.7 million users in 2014. Advair Diskus was used by 1.42 million part D beneficiaries, putting it just ahead of Nexium, which had 1.4 million users. Abilify was well behind those three with 405,000 users, but it did have the second-highest per-unit cost, $28.65. The per-unit costs were similar for Crestor ($6.07), Advair Diskus ($4.94), and Nexium ($7.82), the CMS data show.

In 2014 overall, 3,761 different prescription drug products were covered by Medicare part D, with total program spending of $121.5 billion. There were 115 drugs with spending over $250 million for the year, and combined spending for those 115 drugs was $76.7 billion, or 63% of the part D total, the CMS said.


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