Loss-of-Exclusivity Exposure

Which drug patent and exclusivity expiries actually matter — ranked by the Medicare Part D spending behind them, not by date.

$209.3bn of Medicare Part D spending sits on drugs whose listed protection lapses in the next 24 months

Apixaban alone accounts for 15.4% of it — $32.2bn, with its earliest listed date 2026-11-21.

The top five carry 46.5% of the total. This is exposure, not forecast savings.

Of the 25 drugs ranked, 1 already have a marketed generic.

$154.7bn of this spending is on drugs with no marketed generic today. $2.5bn is on drugs where competition has already arrived — the listed date is not the start of competition for those.

Ranked by Part D spending (2024, gross of rebates)

#	Drug	Part D spending	Earliest listed date	Generic today?	Applications
1	Apixaban ELIQUIS, ELIQUIS SPRINKLE	$32.2bn	2026-11-21	Approved, not marketed	4 approved
2	Semaglutide OZEMPIC, RYBELSUS	$24.2bn	2027-02-27	Brand only	0 approved
3	Empagliflozin JARDIANCE	$18.5bn	2026-09-21	Brand only	0 approved
4	Tirzepatide Mounjaro, ZEPBOUND	$12.3bn	2026-11-08	Brand only	0 approved
5	Lenalidomide Revlimid	$10.1bn	2027-04-27	Approved, not marketed	110 approved
6	Enzalutamide Xtandi	$5.8bn	2026-11-17	Brand only	0 approved
7	Sitagliptin JANUVIA, ZITUVIO	$4.9bn	2026-11-24	Approved, not marketed	9 approved
8	Tafamidis Vyndamax	$4.7bn	2026-12-19	Brand only	0 approved
9	Ibrutinib Imbruvica	$3.5bn	2026-12-28	Brand only	0 approved
10	Ruxolitinib JAKAFI, OPZELURA	$3.4bn	2026-11-24	Brand only	0 approved
11	Palbociclib Ibrance	$3.3bn	2027-03-05	Brand only	0 approved
12	Pomalidomide Pomalyst	$3.3bn	2027-05-14	Approved, not marketed	20 approved
13	Linaclotide Linzess	$3.1bn	2027-02-28	Brand only	0 approved
14	Valbenazine INGREZZA, INGREZZA Sprinkle	$3.0bn	2027-11-08	Approved, not marketed	2 approved
15	Zanubrutinib BRUKINSA	$2.9bn	2026-11-14	Brand only	0 approved
16	Acalabrutinib CALQUENCE	$2.9bn	2026-11-21	Brand only	0 approved
17	Osimertinib TAGRISSO	$2.7bn	2027-02-16	Brand only	0 approved
18	Cyclosporine CEQUA, Gengraf	$2.5bn	2027-11-03	Generic already marketed	28 approved
19	Upadacitinib Rinvoq	$2.4bn	2027-04-26	Brand only	0 approved
20	Apalutamide ERLEADA	$2.3bn	2027-03-27	Approved, not marketed	1 approved
21	Tiotropium Spiriva	$2.0bn	2026-10-10	Approved, not marketed	1 approved
22	Darolutamide NUBEQA	$1.9bn	2028-06-03	Brand only	0 approved
23	Macitentan OPSUMIT	$1.9bn	2026-12-03	Approved, not marketed	5 approved
24	Rifaximin XIFAXAN	$1.8bn	2027-09-02	Brand only	0 approved
25	Apremilast Otezla	$1.7bn	2027-01-19	Approved, not marketed	15 approved

Showing the top 25 of 434 drugs with a listed event in this window.

How to read this

This is EXPOSURE, not forecast savings. It is the Medicare Part D spending recorded against drugs whose listed protection lapses in the window. Whether anything is actually saved depends on a generic launching, at what price, and how fast it takes share — none of which is in this data.
The spending figures are GROSS, before manufacturer rebates. CMS publishes Part D spending before rebates are applied, so the net cost to the programme is lower — materially lower on heavily-rebated brands — and these figures should not be read as net.
This ranks Orange Book drugs only: small molecules approved under an NDA or ANDA. Biologics are licensed under BLAs, appear in the FDA Purple Book, and are among the largest Part D line items. They are absent from this ranking, so it is not a complete picture of drug spending.
An expiry date is not a launch date, and a Paragraph IV settlement can let a generic arrive earlier than the date shown. Those agreements are private and are not in this data.
A drug that already has a marketed generic appears here too, because a listed protection is still lapsing — but its spending is already open to competition. The market-status column separates the two.
Spending is CMS Part D data for 2024. CMS publishes it annually in arrears, so it describes that year rather than today.

FDA Orange Book listings and CMS Medicare Part D Spending by Drug — informational, not legal, investment or medical advice, and not a forecast of generic entry or savings.

Data: FDA Orange Book patent/exclusivity listings and CMS Medicare Part D Spending by Drug — Orange Book snapshot ingested 2026-09-13 · CMS Part D spending for 2024 · source

Machine access — this tool is available as structured data for AI assistants and agents:
GET https://rxfinder.ai/tools/loe-exposure/data.json?window=…&limit=…