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Healthcare transparency

Where money moves through U.S. healthcare — federal spending (HHS, Medicare, Medicaid), drug spending, lobbying, and congressional trades in health stocks. Coverage-honest: figures we don't have yet show "—"; Medicaid is state-administered and partial. New to the topic? Start with the healthcare primer.

HHS outlays (FY2025)$2,794,349,803,089
Medicare Part D drugs (2024)$288,377,933,622

Federal health spending over time

HHS agency outlays and the Medicare & Health budget functions, by fiscal year (USAspending). Gross by-function figures differ from Treasury net totals.

Federal health spending by fiscal year
FYDepartment of Health and Human ServicesMedicareHealth
2017$1,646,989,531,124$1,046,629,647,350$668,798,313,890
2018$1,679,128,003,254$1,059,508,772,650$696,461,718,451
2019$1,814,270,463,757$1,166,775,735,190$729,669,451,777
2020$2,198,882,208,892$1,326,920,207,561$948,669,160,297
2021$2,355,524,286,884$1,382,370,688,566$1,004,083,682,015
2022$2,452,969,781,323$1,484,160,985,812$1,075,778,623,838
2023$2,475,673,980,553$1,554,762,388,110$1,039,243,879,971
2024$2,518,647,728,971$1,582,650,103,296$1,098,419,579,301
2025$2,794,349,803,089$1,836,688,276,390$1,145,485,923,480

HHS-outlays figure from USAspending (agency & budget function); drug-spending figure from CMS. Fuller breakdowns on the funding page.

Top drugs by Medicare Part D spending

Top 25 drugs by total Medicare Part D spend in 2024, with the primary manufacturer and year-over-year change. Medicare Part D covers outpatient prescription drugs. Data from CMS.gov

DrugManufacturerTotal spendPer unitClaimsYoY
EliquisApixaban BMS Primarycare $20,774,929,225 $9.64 24,061,332 +13.7%
OzempicSemaglutide Novo Nordisk $12,970,296,347 $306.48 10,417,182 +41.1%
JardianceEmpagliflozin Boehringer Ing. $11,435,997,421 $18.94 11,368,280 +29.4%
MounjaroTirzepatide Eli Lilly & Co. $6,336,942,641 $511.63 5,105,397 +168.4%
XareltoRivaroxaban Janssen Pharm. $6,232,231,840 $17.68 6,660,246 -1.2%
TrulicityDulaglutide Eli Lilly & Co. $5,454,134,725 $467.75 4,305,141 -25.9%
Trelegy ElliptaFluticasone/Umeclidin/Vilanter Glaxosmithkline $5,294,401,777 $10.52 6,250,872 +18.8%
FarxigaDapagliflozin Propanediol Astrazeneca $5,290,548,963 $18.31 5,634,650 +21.8%
Humira(Cf) PenAdalimumab Multiple manufacturers (2) $4,328,698,864 $3,531.42 490,303 -2.1%
RevlimidLenalidomide Celgene/BMS $4,179,511,486 $854.82 239,843 +8.3%
EntrestoSacubitril/Valsartan Novartis $4,020,321,686 $11.04 3,898,804 +17.2%
JanuviaSitagliptin Phosphate Merck Sharp & D $3,807,854,662 $17.97 4,027,317 -6.9%
BiktarvyBictegrav/Emtricit/Tenofov Ala Gilead Sciences $3,456,061,331 $131.33 840,772 +9.6%
XtandiEnzalutamide Astellas Pharma $3,400,769,229 $150.09 255,669 +30.7%
Stelara*Ustekinumab Janssen Biotech* $3,378,017,374 $26,534.27 132,865 +13.1%
VyndamaxTafamidis Pfizer US Pharm $2,830,811,857 $743.93 109,373 +109.7%
Lenalidomide Multiple manufacturers (10) $2,640,854,800 $655.88 198,067 +57.1%
Enbrel SureclickEtanercept Amgen $2,337,152,869 $1,821.23 296,022 +13.7%
MyrbetriqMirabegron Astellas Pharma $2,297,067,834 $14.95 3,453,189 -8.5%
ImbruvicaIbrutinib Pharmacyclics, $2,266,252,032 $478.65 146,416 -4.5%
PomalystPomalidomide Celgene/BMS $2,150,231,815 $1,094.75 98,648 +25.8%
OfevNintedanib Esylate Boehringer Ing. $2,086,398,979 $216.45 161,717 +13.6%
JakafiRuxolitinib Phosphate Incyte Corporat $2,082,741,189 $283.65 130,891 +7.3%
IbrancePalbociclib Pfizer US Pharm $2,035,022,061 $744.24 131,537 +0.7%
LinzessLinaclotide Allergan Inc. $1,981,958,629 $17.69 2,506,531 +8.6%