The 9 most influential FDA-approved drugs and vaccines of 2023

Hundreds of drugs are approved in the U.S. every year, but GoodRx recently listed one dozen approvals that it said were the most influential for 2023.

The report by GoodRx, a digital pharmaceutical platform, highlighted drugs that it said represented a major advancement compared to other treatment options.

The new list came as the U.S. public has been hearing a lot about weight-loss drugs such as Ozempic and Wegovy; and a new drug in that category, Zepbound, is included on the GoodRx list. However, the list includes a wide range of drugs and vaccines, including a contraceptive, treatments for respiratory diseases, and a treatment for Alzheimer’s disease.

Top of the list: vaccines and treatments for communicable diseases

The No. #1 most influential drug on the list is probably already familiar to most, especially if they know someone who has been infected with COVID-19. Paxlovid, which treats the symptoms of the disease, was approved on an emergency basis in late 2021, and has been used in more than 11 million treatment courses, the report noted. The drug, which received full FDA approval last May, has been a first-choice recommendation for COVID treatment for non hospitalized adults and adolescents ages 12 and older.

“Paxlovid has been a mainstay of COVID therapeutic management since its initial [Emergency Use Authorization] designation in December 2021. Having full FDA approval also helps us with hesitant patients not wanting to take a medication that isn’t ‘FDA approved,’” said Christina Madison, PharmD, the founder and CEO of The Public Health Pharmacist. “It’s great news that this [medication] has gone through the rigorous approval process and has been found to be safe and effective.”

Three other drugs were approved for another respiratory illness that gained attention in 2023, respiratory syncytial virus (RSV) – and these are the included as the #2 most influential drugs. Before this year, the only RSV prevention option was a medication for infants called Synagis. This year the FDA approved two RSV vaccines, Arexvy and Abrysvo. The agency also approved Beyfortus, a preventive medication for infants and some toddlers.

New drugs for contraception, and postpartum depression

A new contraceptive, Opill, is the first over-the-counter (OTC) birth control pill approved in the U.S – and is the #3 most influential drug. It will go on market in early 2024, and will be available at pharmacies, retailers, and online.

The FDA also approved Zurzuvae, which the report called a notable step forward for postpartum depression. The drug, which is the #4 most influential drug, is said to take affect more quickly than traditional anti-depressants, and it’s more convenient than IV medications, which have also been used for postpartum depression.

“Though we’ve had some success in the past treating PPD with therapy, off-label antidepressants, and Zulresso (brexanolone), the truth is none of these treatments are ideal. Therapy and antidepressants can take weeks or months to fully take effect,” said Sarah Gupta, MD, a board-certified psychiatrist. “And though Zulresso can work in as little as 3 days, it has to be given as an IV infusion over 60 hours in a supervised healthcare setting — which is a dealbreaker for many patients. It seems likely that Zurzuvae will be a total game-changer when it comes to postpartum depression and maternal outcomes.”

A new chronic weight management option

Zepbound was another newly-approved drug, and the clinical tests showed it to be effective for certain groups of people with obesity – and it is the #7 most influential drug. The report said in some cases it has resulted in people losing up to 25% of their initial body weight, but that it wasn’t approved for everyone.

“It’s…potentially useful for patients who do not respond well to semaglutide (Wegovy) or liraglutide (Saxenda),” said Minisha Sood, MD, an assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. “In the current climate of medication shortages, it also affords those who have been struggling with lack of access to semaglutide or liraglutide an opportunity to receive incretin-based treatment for obesity.”

Other notable new drugs

The report included several other drugs. A new OTC medication to reverse opioid overdoses, naloxone, is being called “a big step forward” for saving lives during the ongoing epidemic of opioid use –and is the #6 most influential drug.

Another drug, Leqembi is the first clinically supported medication for Alzheimer’s – and is the #5 most influential drug. Alzheimer’s has continued to be a very difficult condition to treat, with an earlier drug being approved but not showing a clinical benefit.

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Roctavian is a new gene therapy for hemophilia A and is drawing attention for its effectiveness and safety data – and is the #8 most influential drug. The report noted that long-term effects are still a question mark for this drug.

Finally, two gene therapies for sickle cell disease (SCD) were approved in 2023. Casgevy and Lyfgenia both were approved for the treatment of SCD – and are the #9 most influential drugs. Lyfgenia helps alleviate pain from the condition, and Casgevy is being hailed as a potential cure for the disease.