In 2025, 33 health benefit plan (HBPs) issuers reported the 25 most frequently prescribed drugs and some aspects of their prescription drug spending. TDI collected the data under Texas Insurance Code 1369.502 and 1369.503. TDI reports only what the HBPs supplied and doesn’t audit it.
25 Most frequently prescribed drugs
The table below shows how many issuers reported each drug. Of 75 drugs reported, at least 16 responding issuers prescribed these 25 drugs.
We asked issuers to remove duplicates and combine data for brand and generic names, different dosages, and standard and extended-release versions of drugs.
A drug’s score reflects its position in issuers’ reporting. A drug reported as the most prescribed drug received a score of 25 and the twenty-fifth most prescribed drug scored as one. The score column aggregates those scores. For example, 30 issuers reported Atorvastatin in any position. Of those, 19 issuers reported it as the most prescribed drug and three reported it as the second.
| Drug name | Class | Condition | Total issuers | Score [1] | Percent of total issuers |
|---|---|---|---|---|---|
|
Atorvastatin |
statins |
high cholesterol |
30 |
691 |
93.8% |
|
Levothyroxine |
thyroid drugs |
hypothyroidism |
31 |
614 |
96.9% |
|
Amlodipine |
calcium channel blockers |
high blood pressure; angina |
30 |
551 |
93.8% |
|
Metformin |
antidiabetic agents |
type 2 diabetes |
30 |
551 |
93.8% |
|
Lisinopril |
ACE inhibitors |
high blood pressure |
29 |
537 |
90.6% |
|
Losartan |
angiotensin receptor antagonists |
high blood pressure |
30 |
524 |
93.8% |
|
Rosuvastatin |
statins |
high cholesterol |
29 |
505 |
90.6% |
|
Gabapentin |
anticonvulsants |
seizures; shingles pain; restless leg syndrome |
28 |
455 |
87.5% |
|
Albuterol |
bronchodilators |
asthma |
28 |
437 |
87.5% |
|
Amoxicillin |
antibiotics |
bacterial infection |
28 |
389 |
87.5% |
|
Amphetamine And Dextroamphetamine |
stimulants |
ADHD; narcolepsy |
21 |
325 |
65.6% |
|
Prednisone |
corticosteroids |
inflammation |
30 |
298 |
93.8% |
|
Tirzepatide |
incretin mimetics |
type 2 diabetes |
19 |
291 |
59.4% |
|
Bupropion |
antidepressants |
depression |
21 |
265 |
65.6% |
|
Amoxicillin And Clavulanate Potassium |
antibiotics |
bacterial infection |
27 |
253 |
84.4% |
|
Sertraline |
SSRIs |
depression; panic; anxiety; or obsessive-compulsive symptoms |
23 |
253 |
71.9% |
|
Ibuprofen |
NSAIDs |
mild to moderate pain; fever; and inflammation |
17 |
250 |
53.1% |
|
Pantoprazole |
proton pump inhibitors |
gastroesophageal reflux disease |
24 |
246 |
75.0% |
|
Azithromycin |
antibiotics |
bacterial infection |
26 |
245 |
81.3% |
|
Escitalopram |
SSRIs |
depression |
23 |
245 |
71.9% |
|
Fluticasone |
steroids |
asthma |
16 |
219 |
50.0% |
|
Semaglutide |
incretin mimetics |
type 2 diabetes |
18 |
202 |
56.3% |
|
Ondansetron |
5HT3 receptor antagonists |
nausea |
22 |
150 |
68.8% |
|
Metoprolol |
beta blockers |
high blood pressure |
15 |
131 |
46.9% |
|
Trazodone |
SARIs |
depression |
22 |
122 |
68.8% |
[1] Score is a new metric made possible by issuers reporting combined data and not different formulations separately.
Premium reductions due to utilization management
The issuers reported savings of $569 million due to specialty drug utilization management, $194 million more than the previous year.
Drug spending data
These tables show HBPs responses on prescription drug spending. In each case, “Number reporting this amount” is how many respondents reported changes in the ranges indicated.
| Net spending change on prescription drugs | Number reporting this amount |
|---|---|
|
-56.8% |
1 |
|
-49.0% |
1 |
|
-25.4% |
1 |
|
-13.9% |
1 |
|
-12.6% |
1 |
|
-10.9% |
1 |
|
-2.8% |
1 |
|
-1.6% |
1 |
|
0.0% |
3 |
|
2.1% |
1 |
|
8.9% |
1 |
|
10.0% |
2 |
|
10.7% |
1 |
|
13.2% |
1 |
|
15.3% |
1 |
|
16.9% |
2 |
|
19.0% |
1 |
|
20.4% |
1 |
|
20.5% |
1 |
|
21.0% |
1 |
|
31.0% |
1 |
|
34.3% |
1 |
|
35.4% |
1 |
|
50.7% |
1 |
|
51.0% |
1 |
|
56.0% |
1 |
|
63.0% |
1 |
|
64.6% |
1 |
|
68.1% |
1 |
| Premium change due to prescription drugs | Number reporting this amount |
|---|---|
|
-2515.5% [2] |
1 |
|
-7.2% |
1 |
|
-2.7% |
1 |
|
-1.5% |
1 |
|
-0.4% |
1 |
|
-0.4% |
1 |
|
0.0% |
6 |
|
0.2% |
1 |
|
0.3% |
2 |
|
1.4% |
1 |
|
2.4% |
1 |
|
3.2% |
2 |
|
3.3% |
2 |
|
5.3% |
1 |
|
11.7% |
1 |
|
13.8% |
1 |
|
19.0% |
1 |
|
20.0% |
1 |
|
24.4% |
1 |
|
26.0% |
1 |
|
26.8% |
1 |
|
27.0% |
1 |
|
31.0% |
1 |
|
64.0% |
1 |
[2] The issuer confirmed their submission was not an error.
| Specialty drugs under use management | Number reporting this amount |
|---|---|
|
0.0% |
3 |
|
18.0% |
1 |
|
25.0% |
1 |
|
26.0% |
1 |
|
27.0% |
1 |
|
35.0% |
2 |
|
37.0% |
1 |
|
60.8% |
2 |
|
61.0% |
1 |
|
61.2% |
2 |
|
61.3% |
1 |
|
79.0% |
1 |
|
79.3% |
1 |
|
83.0% |
2 |
|
84.4% |
1 |
|
85.0% |
2 |
|
86.0% |
1 |
|
88.0% |
1 |
|
89.0% |
2 |
|
89.8% |
1 |
|
91.0% |
2 |
|
92.9% |
1 |
|
95.8% |
2 |