Every year, Americans spend over $700 billion on prescription drugs. But here’s the thing: generic drugs are the reason that number isn’t even higher. In 2024, generics made up 90% of all prescriptions filled in the U.S.-3.9 billion pills, patches, and inhalers. Yet they only cost $98 billion. Meanwhile, brand-name drugs, which made up just 10% of prescriptions, ate up $700 billion. That’s not a typo. The same number of people are getting treated, but one type of drug costs nearly seven times more per prescription. The difference? $482 billion in savings-just from generics alone.
How Generic Drugs Save So Much Money
Generic drugs aren’t cheaper because they’re low quality. They’re cheaper because they don’t need to pay back billions in research and marketing costs. When a brand-name drug’s patent expires, other companies can make the exact same medicine. The FDA requires them to prove they work the same way, deliver the same dose, and have the same safety profile. That’s it. No need for expensive clinical trials. No need to advertise on TV. No need to pay executives $20 million a year.
Take albuterol, a common asthma inhaler. The brand version might cost $60 per refill. The generic? Around $15. That’s a $45 monthly saving for one patient. Multiply that by millions of people, and you’re talking about billions. One Reddit user shared that switching to generic albuterol cut their monthly cost by $300. That’s not unusual. GoodRx’s 2025 report found that nearly one in twelve Americans have medical debt because they couldn’t afford their meds. Generics are often the line between taking your medicine and skipping it.
Biosimilars: The Next Big Wave of Savings
Generics work for pills and injections. But what about complex biologic drugs-like Humira, Enbrel, or Stelara? These are made from living cells, not chemicals. Until recently, no one could copy them. That changed with biosimilars. These aren’t exact copies, but they’re close enough to work the same way-and cost 80% less.
In 2024, Humira biosimilars went from being used in just 3% of cases to 28%. Why? Because health plans started pushing them. They stopped paying extra for the brand. They reimbursed pharmacies fairly for switching patients. They simplified the paperwork. The result? Billions saved. Stelara, a $6 billion-a-year drug, now has seven biosimilar versions coming online in 2025. Once fully adopted, those biosimilars could save $4.8 billion per year.
But here’s the problem: 90% of biologics losing patent protection in the next ten years have no biosimilar in development. That’s a $234 billion missed opportunity. If you think generics saved a lot, wait until biosimilars hit their stride-if we let them.
Why Brand Drugs Cost So Much
Why do brand-name drugs cost so much? It’s not because they’re better. It’s because they’re protected.
Big Pharma uses legal tricks to delay generics. One common tactic is called “pay for delay.” A brand-name company pays a generic maker to stay off the market. In 2024, these deals cost the system an estimated $1.2 billion per year in lost savings. The Federal Trade Commission has been trying to stop this for years. So far, it’s been slow going.
Another reason? Americans pay three times more for the same brand-name drugs than people in other developed countries. A 2025 White House fact sheet showed that the U.S. pays the highest prices in the OECD. Why? Because we don’t negotiate drug prices at the federal level-until now.
What’s Changing: Medicare Negotiation and Price Caps
The Inflation Reduction Act changed the game. For the first time, Medicare can negotiate prices for some of the costliest drugs. In 2024, insulin prices dropped from $275 to $25 per vial after public pressure and policy changes. That’s not a fluke. It’s a model.
Starting in 2025, Medicare beneficiaries pay no more than $35 a month for insulin. By 2027, that cap will extend to commercial plans. The Congressional Budget Office estimates that expanding Medicare negotiations to 30 drugs per year could save $500-550 billion over ten years. If those same rules applied to Medicaid and private insurers? We’re looking at over $1 trillion in savings.
And it’s working. Eli Lilly and Novo Nordisk agreed to cut the price of Ozempic and Wegovy from over $1,000 to $350 a month under a new federal pricing deal. That’s not because they suddenly became charitable. It’s because the government finally had the power to say: “We won’t pay this.”
Who Benefits? Patients, Payers, and the System
Generics don’t just help patients pay less. They help insurance companies, employers, and taxpayers too.
Blue Cross Blue Shield found that switching to generics reduced their total drug spend by 15% in just two years. Employers with self-funded plans saved millions. Medicare Part D saw a 20% drop in out-of-pocket costs for seniors-mostly because more people were on generics.
The U.S. generic drug industry supports 350,000 jobs across 46 states. It’s not a side business. It’s a backbone of the healthcare economy. Yet, despite all this, the industry still faces hurdles. In 2024, the FDA issued 1,247 warnings about manufacturing quality at generic drug plants. That’s a red flag. We can’t afford to cut corners on safety just to save money.
The Road Ahead: What Needs to Happen
Generics and biosimilars are the most proven way to lower drug costs without sacrificing care. But we’re not using them to their full potential.
Here’s what needs to change:
- Stop “pay for delay” deals. The FTC needs more power to block them.
- Speed up biosimilar approvals. The FDA is doing better, but it’s still too slow.
- Require insurers to cover biosimilars at the same cost-sharing level as brands.
- Expand Medicare price negotiation to all payers. Private insurers should get the same leverage.
- Invest in patient education. Too many people think generics are “weaker.” They’re not.
Every time a pharmacist switches a patient from a brand to a generic, they’re saving money-sometimes hundreds of dollars a month. That’s not just good for budgets. It’s good for health. People who can afford their meds take them. People who can’t, don’t. And that leads to hospital visits, emergency care, and worse outcomes.
Final Thought: It’s Not Magic. It’s Math.
There’s no secret formula. No miracle cure. Just simple economics: if you can make the same drug for less, you should. And when you do, the whole system benefits.
The U.S. spends more on drugs than any country in the world. But we don’t get better results. We just pay more. Generics and biosimilars fix that. They’re not the whole solution-but they’re the most powerful tool we already have. The question isn’t whether we can afford to use them. It’s whether we can afford not to.