Unveiling the Answer: What is the most sold drug?

October 5, 2025 •

3 min read

In 2023, global pharmaceutical sales reached $60.12 billion for just one company, Merck [1.4.2]. Within this massive industry, what is the most sold drug? The answer depends on whether it's measured by global revenue or the number of prescriptions filled.

Quick Summary

A detailed look at the top-selling medications globally. This analysis breaks down the leading drugs by both sales revenue and total prescriptions, highlighting the current market leaders and the factors behind their success.

Key Points

Revenue vs. Volume: The 'most sold' drug differs significantly when measured by revenue (Keytruda, a high-cost cancer drug) versus prescription volume (Atorvastatin, a low-cost generic) [1.7.2].
Keytruda's Dominance: The cancer immunotherapy Keytruda became the world's top-selling drug by revenue in 2023, generating $25 billion [1.4.2, 1.4.4].
Humira's Decline: After nearly a decade at the top, sales of the autoimmune drug Humira fell 32% in 2023 due to the introduction of biosimilar competition [1.5.2].
GLP-1 Growth: Medications for diabetes and weight loss, like Ozempic and Wegovy, have seen explosive growth, placing them among the top global earners by revenue [1.6.7].
Generics Lead Prescriptions: Low-cost generic drugs for chronic conditions, such as Atorvastatin (high cholesterol) and Metformin (diabetes), are the most frequently prescribed medications in the U.S. [1.3.8].

A Tale of Two Metrics: Revenue vs. Volume

When asking "What is the most sold drug?", the answer is not as straightforward as it seems. The pharmaceutical industry measures a drug's success in two primary ways: total revenue generated and total prescription volume. The drugs that top these lists are often completely different [1.7.2]. High-revenue drugs are typically expensive, patent-protected specialty medications for complex diseases like cancer or autoimmune disorders. In contrast, the most-prescribed drugs are often low-cost, generic medications used to treat common, chronic conditions like high cholesterol or blood pressure [1.7.2].

The Reigning Champion by Revenue: Keytruda

As of 2023, the top-selling drug in the world by revenue is Keytruda (pembrolizumab) [1.4.4, 1.4.8]. This cancer immunotherapy from Merck generated an astounding $25 billion in sales in 2023 [1.4.2, 1.4.5]. Keytruda's success is driven by its effectiveness and its approval for treating a wide variety of cancers, including lung cancer, melanoma, and kidney cancer [1.3.4, 1.4.1]. This broad applicability, combined with a high price point characteristic of biologic therapies, has propelled it to the top of the sales charts, officially dethroning the long-time leader, Humira [1.4.4, 1.4.8]. Projections show its sales continuing to grow, potentially reaching over $29 billion in 2024 [1.2.2].

The Long-Standing Leader Dethroned: Humira

For nearly a decade, Humira (adalimumab) by AbbVie was the undisputed best-selling drug globally, treating autoimmune conditions like rheumatoid arthritis and plaque psoriasis [1.4.8, 1.5.2]. Its peak sales reached over $21 billion in 2022 [1.5.2]. However, the expiration of its main patents in the U.S. in January 2023 opened the floodgates for biosimilar competition [1.5.1, 1.5.2]. This influx of lower-cost alternatives caused Humira's sales to plummet by 32% in 2023 to around $14.4 billion [1.4.5, 1.5.2]. While still a blockbuster, its reign at the top has ended, showcasing the dramatic impact that patent cliffs and biosimilars have on the pharmaceutical market [1.5.4].

The Meteoric Rise of GLP-1 Agonists

The most significant disruption in the top-selling drug landscape comes from a class of medications known as GLP-1 receptor agonists, primarily Novo Nordisk's Ozempic and Wegovy (semaglutide) [1.6.7]. Originally for type 2 diabetes, their profound effectiveness in promoting weight loss has led to a massive surge in demand [1.6.1, 1.6.3]. In 2023, Ozempic alone generated nearly $14 billion in revenue, with the combined semaglutide franchise (including Wegovy and Rybelsus) reaching $21.1 billion [1.6.7]. This explosive growth has placed them firmly in the top 5 by revenue and signals a major shift in the pharmaceutical market towards metabolic diseases [1.4.7].

Measuring by Volume: The Most Prescribed Drugs

If we define "most sold" by the sheer number of prescriptions, the list looks very different. In the United States, the most prescribed drug is typically Atorvastatin, the generic version of the former blockbuster cholesterol medication Lipitor [1.3.8, 1.7.2]. In 2023, over 115 million prescriptions for Atorvastatin were dispensed in the U.S. [1.3.8].

Other drugs that consistently top the prescription charts include:

Levothyroxine: For treating hypothyroidism, with over 80 million prescriptions [1.3.8].
Lisinopril: A common ACE inhibitor for high blood pressure, with over 76 million prescriptions [1.3.8].
Metformin: A first-line treatment for type 2 diabetes, with over 85 million prescriptions [1.3.8].

These medications are the workhorses of modern medicine, treating widespread chronic conditions at a low cost to the healthcare system.

Comparison Table: Revenue vs. Prescriptions


Metric (Based on 2023 Data)	Drug Name (Generic)	Primary Use	Global Revenue / U.S. Prescriptions
Revenue	Keytruda (Pembrolizumab)	Cancer Immunotherapy	$25.0 Billion [1.4.2, 1.4.5]
Revenue	Humira (Adalimumab)	Autoimmune Disease	$14.4 Billion [1.4.5, 1.5.2]
Revenue	Ozempic (Semaglutide)	Diabetes / Weight Loss	$13.9 Billion [1.4.5, 1.6.7]
Prescriptions	Atorvastatin	High Cholesterol	115.2 Million [1.3.8]
Prescriptions	Metformin	Diabetes	85.6 Million [1.3.8]
Prescriptions	Levothyroxine	Hypothyroidism	80.9 Million [1.3.8]

Conclusion

So, what is the most sold drug? By the measure of pure financial power and revenue, the title currently belongs to the cancer-fighting immunotherapy, Keytruda [1.4.8]. However, by the measure of how many people rely on a medication daily, the honor goes to the generic cholesterol-lowering pill, Atorvastatin [1.3.8]. The pharmaceutical landscape is ever-changing, with the rapid ascent of GLP-1 drugs for diabetes and obesity poised to challenge the top revenue spots in the coming years [1.6.7].

For a comprehensive list of top-selling drugs, a reliable source is Fierce Pharma's annual report. https://www.fiercepharma.com/special-reports/top-20-drugs-worldwide-sales-2023 [1.4.8, 1.6.7]

Frequently Asked Questions

Humira (adalimumab) is considered the best-selling drug in history based on total lifetime sales, having generated over $200 billion since its approval in 2002 [1.5.1, 1.5.6]. It surpassed the previous record holder, Lipitor.

No, but it is one of the top contenders. In 2023, Ozempic was the third highest-grossing drug with nearly $14 billion in sales [1.4.5]. When combined with other semaglutide products from the same company, the franchise's total revenue is very close to the top spot [1.6.7].

The most prescribed drugs are typically older, generic medications with low price points used to treat very common conditions. The highest-selling drugs are often newer, patent-protected specialty drugs (biologics) with very high prices, so they generate more revenue per prescription [1.7.2].

A 'blockbuster' drug is a pharmaceutical product that generates more than $1 billion in annual sales. Many of the drugs on the top revenue lists, like Keytruda and Humira, are considered blockbusters [1.5.2].

Keytruda is manufactured by the pharmaceutical company Merck & Co. [1.4.2, 1.4.8].

Ozempic and Wegovy are both brand names for the same active ingredient, semaglutide, made by Novo Nordisk. However, they are approved for different indications and come in different dosages; Ozempic is primarily for type 2 diabetes, while Wegovy is for chronic weight management [1.6.1, 1.6.2, 1.6.7].

After losing patent exclusivity in the U.S. in 2023, the introduction of multiple biosimilar versions of Humira caused its annual revenue to drop by 32% as healthcare systems and insurers shifted to lower-cost alternatives [1.5.2, 1.5.4].