Patient Rights Treatment Decisions & Safety Top 10 Biologic Medications in the United States These drugs are changing the way illnesses are treated By Kathlyn Stone Updated on December 27, 2023 Medically reviewed by Do-Eun Lee, MD Fact checked by James Lacy Print Biologics are drugs made from complex molecules manufactured using living microorganisms, plants, or animal cells. Many are produced using recombinant DNA (rDNA), a technology that involves joining DNA molecules in a laboratory to produce new genetic combinations. Biologics are sometimes referred to as biopharmaceuticals or biological drugs. Biologics are changing the way healthcare providers treat common conditions. For certain conditions, biologics are becoming more commonly prescribed than traditional drugs. Rheumatoid arthritis, certain cancers, and diabetes have the greatest numbers of dedicated biologic treatments. This article discusses the top 10 biologic drugs in the United States and what they are used for. How Biologic Medications Work Biologic drugs target specific proteins or cells in your body. For example, biologic drugs designed to treat rheumatoid arthritis block certain inflammatory proteins or pro-inflammatory cells. Biologic cancer treatments help the body's own immune system identify and destroy cancer cells. Biologics don't always work for everyone, and it can be challenging to find the right biologic medication. They can also have severe, sometimes life-threatening side effects. Generic Biologics While most drugs are chemicals synthesized from other chemicals, biologics are much more expensive due to their complex manufacturing process. Because of their high cost, there is a great demand for generic versions of biologic medications. Several pharmaceutical companies are lobbying for the right to manufacture generic versions. However, because they are so difficult to manufacture, there are concerns about the ability to manufacture generics both safely and reliably. They're not exactly generics, but in recent years, numerous biosimilars have come on the market, usually at a much lower cost than the original biologic they're based on. Biosimilars vs. Biologics for Treating Psoriatic Disease Top 10 Biologics The top 10 biologic drugs all have exceeded the monetary definition of a "blockbuster," meaning they've generated more than $1 billion in annual sales, according to 2017 sales data reported by drug manufacturers. 1 Humira Jose Luis Pelaez Inc / Blend Images / Getty Images The anti-inflammatory drug Humira (adalimumab) is not only the best-selling biologic, it's one of the best-selling drugs worldwide, regardless of class. Humira is approved for: Rheumatoid arthritis Plaque psoriasis Crohn's disease Ulcerative colitis Ankylosing spondylitis Psoriatic arthritis Polyarticular juvenile idiopathic arthritis Hidradenitis suppurativa Uveitis Manufacturer: AbbVie, an Abbott Laboratories spinoff Global Sales in 2017: $18.4 billion Generic name: Adalimumab Launch date: 2002 Side Effects Humira has risks and can cause serious side effects in some people. Discuss these risks with your healthcare provider before you start taking Humira. Some of these side effects include: Serious infections including tuberculosis, bacterial sepsis, and invasive fungal infectionsAn increased risk of developing certain cancers such as lymphoma and basal or squamous cell skin cancers Other, less serious side effects may include: Pain, rash, swelling, or itching at the injection siteUpper respiratory infectionHeadachesNauseaRash 2 Rituxan BURGER/PHANIE / Canopy / Getty Images Rituxan (rituximab) was developed by IDEC Pharmaceuticals. It's currently co-marketed in the United States by Biogen Idec and Roche subsidiary Genentech. Rituxan is approved for: Non-Hodgkin's lymphoma Chronic lymphocytic leukemia Rheumatoid arthritis Granulomatosis with polyangiitis Pemphigus vulgaris Manufacturer: Roche Global Sales in 2017: $9.2 billion Generic name: Rituximab Launch date: 1997 Side Effects It is possible to experience serious side effects while taking Rituxan. These may include: Severe skin reactions including sores and ulcers, blisters, rash, and peeling skin, which may occur on your lips and mouth or on other parts of your bodyReactivation of hepatitis B virus in people who are carriers or who have recovered from hepatitis BProgressive multifocal leukoencephalopathy, a serious brain infection that can cause death or severe disabilityTumor lysis syndrome, a condition caused by the rapid breakdown of cancer cells that can lead to kidney failureHeart problems such as irregular heartbeat, chest pain, and heart attackBowel blockage or tears in people taking Rituxan with chemotherapy medicationsSevere allergic reaction (anaphylaxis) Other side effects of Rituxan include infusion-related reactions such as nausea, fever or chills, headache, flushing, and shortness of breath. 3 Enbrel DAM GAULT / SPL / Science Photo Library / Getty Images Enbrel (etanercept) was developed by researchers at Immunex. Today the drug is co-marketed in North America by Amgen and Pfizer, by Takeda Pharmaceuticals in Japan, and by Wyeth in the rest of the world. Enbrel is approved for: Rheumatoid arthritisPlaque psoriasisPsoriatic arthritisPolyarticular juvenile idiopathic arthritisAnkylosing spondylitis Manufacturer: Pfizer/Amgen Global Sales in 2017: $7.9 billion Generic name: Etanercept Launch date: 1998 Side Effects Enbrel can cause serious side effects such as: New infections or worsening of existing infections, including hepatitis B reactivationNew or worsening heart failureNervous system problems, including multiple sclerosis and seizuresLife-threatening blood problemsNew or worsening psoriasisSevere allergic reaction (anaphylaxis)Autoimmune reactions including autoimmune hepatitis or a condition that causes lupus-like symptoms Less serious side effects include: Upper respiratory infectionPain, swelling, itching, or rash at the injection site 4 Herceptin Echo / Cultura / Getty Images Herceptin (trastuzumab) was developed by Genentech, now a Roche subsidiary, and UCLA's Jonsson Comprehensive Cancer Center. Herceptin is approved for: HER2+ breast cancer HER2+ metastatic gastric or gastroesophageal junction adenocarcinoma Manufacturer: Roche Global Sales in 2017: $7.4 billion Generic name: Trastuzumab Launch date: 1998 Side Effects Herceptin can cause serious side effects, including infusion reactions that may be fatal. These can include: Increased risk of infectionRespiratory distressSevere allergic reaction (anaphylaxis)Low blood pressure Other serious side effects may include: Damage to the heart or lungsIn pregnant women, Herceptin may harm the developing fetus Less serious side effects include: FeverNausea and vomitingDiarrheaCoughHeadacheFatigueRashMuscle painAnemia 5 Avastin Echo / Cultura / Getty Images When launched in 2004, Genentech's Avastin (bevacizumab) was one of the most expensive drugs on the market, with a $4,400 monthly price tag. Avastin is approved for: Cervical cancer Hepatocellular cancer Metastatic colorectal cancer Metastatic renal cell carcinoma Epithelial ovarian, fallopian tube, or peritoneal cancer Glioblastoma Non-squamous non−small cell lung cancer Manufacturer: Roche Global Sales in 2017: $7.1 billion Generic name: Bevacizumab Launch date: 2004 Side Effects Serious side effects of Avastin may include: Bowel or stomach perforationProblems with wound healingCoughing up bloodGastrointestinal, brain, vaginal, or spinal cord bleedingSevere high blood pressureStroke or heart attackKidney problemsSerious or fatal infusion reactionsNervous system or vision problems including seizure, confusion, and blindnessFistula, an abnormal passage that forms between one part of the body and another Some less serious side effects may include: Dry skinWatery eyesChange in tasteNosebleedsHeadache 6 Remicade BURGER / PHANIE / Canopy / Getty Images Remicade (infliximab) was originally developed by Centocor Ortho Biotech, which is now Janssen Biotech, a Johnson & Johnson subsidiary. Remicade is approved for: Rheumatoid arthritisCrohn's diseaseAnkylosing spondylitisPsoriatic arthritisPlaque psoriasisUlcerative colitis Manufacturer: Johnson & Johnson/Merck & Co. Global Sales in 2017: $7.1 billion Generic name: Infliximab Launch date: 1998 Side Effects Remicade may cause serious side effects such as: Increased risk of infections including tuberculosis, bacterial sepsis, and fungal infectionIncreased risk of certain cancers such as lymphoma, cervical cancer, and certain skin cancersReactivation of hepatitis BNew or worsening psoriasisNew or worsening heart failureAbnormal heart rhythm, heart attack, and other heart problemsLiver injuryBlood problemsInfusion reactions such as stroke or anaphylaxisAn immune condition that causes symptoms similar to lupus Less serious side effects may include: Upper respiratory infectionCoughStomach painHeadache 7 Lantus Tom Merton / Caiaimage / Getty Images Lantus (insulin glargine injection) was developed at Sanofi-Aventis's biotechnology research center in Frankfurt-Höchst, Germany. Lantus is approved for: Diabetes Manufacturer: Sanofi Global Sales in 2017: $5.7 billion Generic name: Insulin glargine [rDNA origin] injection Launch date: 2000 Side Effects The most common side effect of Lantus is hypoglycemia (low blood sugar). This can be serious and life-threatening. Other serious side effects include: Severe allergic reaction (anaphylaxis)Heart failure in people taking Lantus along with thiazolidinediones Less serious side effects may include: Weight gainInjection site reactionsLow potassium levelsSwelling 8 Neulasta Mark Harmel / The Image Bank / Getty Images Neulasta (pegfilgrastim) is manufactured by Amgen Pharmaceuticals. Neulasta is approved for: Neutropenia related to cancer chemotherapy Hematopoietic subsyndrome of acute radiation syndrome Manufacturer: Amgen Global Sales in 2017: $4.7 billion Generic name: Pegfilgrastim Launch date: 2002 Side Effects Neulasta may cause serious side effects, some of which can be life-threatening. These can include: Enlarged or ruptured spleenRespiratory distressSevere allergic reaction (anaphylaxis)Sickle cell crisis in people with sickle cell diseaseKidney injuryBlood problems, including increased white blood cell count, decreased platelets, and capillary leak syndromeInflammation of the aortic arteryIncreased risk of blood cancer The most common side effect of Neulasta is aching bones or muscles in the arms and/or legs. 9 Avonex Peter Dazeley / Photographer's Choice / Getty Images In the U.S., Avonex (interferon beta-1α) is marketed in by Biogen Idec and by Merck under the brand name Rebif. Gemany's Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB and CinnaGen Company cloned Interferon-beta-1α and since 2006 the drug has been sold as CinnoVex, a biosimilar, in Iran. Avonex/Rebif is approved for: Multiple sclerosis (MS) Manufacturer: Biogen Idec Global Sales in 2017: $2.1 billion Generic name: Interferon-beta-1α Launch date: 1996 Side Effects Avonex may cause serious side effects in some people. Some of these side effects may be life-threatening. Mental health problems, including depression, hallucinations, and thoughts of suicideNew or worsening liver problems, including liver failureSevere allergic reaction (anaphylaxis)Heart problems, including heart failureBlood problems, including low red and white blood cell count and low platelet countsDamage to the small blood vesselsHigh blood pressure in the lungsSeizuresAutoimmune conditions such as autoimmune hepatitis and hypo- or hyperthyroidismSerious injection site reactions leading to infection or necrosis (cell death) Common side effects include flu-like symptoms such as fever, aches, chills, and fever. Injection site reactions such as pain, itching, or redness may also occur. 10 Lucentis Portra Images / DigitalVision / Getty Images Developed by Genentech, the injectable drug Lucentis (ranibizumab) is marketed in the U.S. by Genentech and outside the U.S. by Novartis. Lucentis is approved for: Age-related macular degeneration Macular edema following retinal vein occlusion Diabetic macular edema Diabetic retinopathy Myopic choroidal neovascularization Manufacturer: Roche, Novartis Global Sales in 2017: $1.5 billion Generic name: Ranibizumab Launch date: 2006 Side Effects Lucentis may cause serious side effects, which may include: Infections of the eyeCataractsDetached retinaBlood clots, which can lead to heart attack or stroke Some of the most common side effects of Lucentis include: Red eyes or eye painFloaters in the eyeInfections of the nose or throatAnemia Summary Biologic medications are drugs manufactured from living cells. They work by targeting specific proteins or cells in the body. Biologics are used to treat conditions such as immune diseases, cancer, and diabetes. They may not work for everyone, and they can have serious side effects. Be sure to discuss these medications with your healthcare provider before using them. 23 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Arthritis Foundation. Biologics. American Cancer Society Cancer Action Network. Understanding biologic and biosimilar drugs. Food and Drug Administration. Humira (adalimumab injection) label. Humira. Before making a decision, get the facts. Food and Drug Administration. Rituxan (rituximab injection) label. Rituxan. Understanding important side effect information. Fouda GE, Bavbek S. Rituximab hypersensitivity: From clinical presentation to management. Front Pharmacol. 2020;11:572863. doi:10.3389/fphar.2020.572863 Food and Drug Administration. Enbrel (etanercept) label. Enbrel. New to Enbrel? Here are some helpful things to know as you get started. Food and Drug Administration. Herceptin (trastuzumab) label. Herceptin. Potential side effects of Herceptin. Food and Drug Administration. Avastin (bevacizumab injection) label. Avastin. What are the possible side effects of Avastin? Food and Drug Administration. Remicade (infliximab) label. Remicade. Important safety information. Food and Drug Administration. Lantus (insulin glargine [rDNA origin] injection) label. Lantus. Once-daily lantus® is the most prescribed Long-acting insulin. Food and Drug Administration. Neulasta (pegfilgrastim) label. Neulasta. Neulasta patient brochure. Food and Drug Administration. Avonex (interferon beta-1a injection) label. Avonex. Avonex safety and side effects. Food and Drug Administration. Lucentis (ranibizumab injection) label. Lucentis. Lucentis side effects. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit