America has a serious drug problem. Apart from the raging opioid crisis that's forecast to claim the lives of nearly half a million people over the next decade, the country is also reeling from the exorbitant costs associated with specialty medicines. By 2024, the top five best-selling medicines are projected to generate a staggering $62.3 billion in worldwide revenue, with the lion's share of these sales coming from American consumers, according to a report by EvaluatePharma. 

To put this jaw-dropping figure into context, the National Football League -- which is America's most popular sport by a country mile -- has designs on growing its annual revenue to over $20 billion by 2024. Furthermore, the burgeoning U.S. cannabis market is on track to grow into a $30 billion industry by 2024. These two highly lucrative businesses combined won't come anywhere close to the stately revenue figure of big pharma's top five best-selling medicines during this period. 

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Which prescription drugs make this esteemed list? Here's a quick rundown of the five medicines expected to become the industry's biggest earners in the next decade. 

The top five

  1. Merck's (MRK 0.24%) cancer-fighting immunotherapy Keytruda tops this list, with a projected revenue haul of $17 billion by the end of 2024. Merck's Keytruda is also the drug with fastest pace of sales growth on this list, thanks to its ability to grab several key new indications over the prior two years. 
  2. AbbVie's (ABBV 1.26%) flagship anti-inflammatory medicine Humira is predicted to slip to second place on this list, with an estimated 2024 revenue forecast of $12.4 billion. In 2018, this drug blew away the rest of the field with a gobsmacking $19.9 billion in global sales. 
  3. Bristol-Myers Squibb (BMY -0.18%) and Pfizer's (PFE -0.97%) next-generation blood-thinner, Eliquis, is a close third, with 2024 sales expected to hit a monstrous $12 billion. Bristol and Pfizer raked in a whopping $6.4 billion from Eliquis in 2018.
  4. Bristol's PD-1 inhibitor, Opdivo, a rival to Merck's Keytruda, is slated to generate a healthy $11.3 billion by 2024. Once upon a time, Bristol's Opdivo was widely predicted to top this list, but a major miss in advanced lung cancer opened the door for Merck's Keytruda to become the undisputed champion of the PD-1 inhibitor space. 
  5. AbbVie and Johnson & Johnson's (JNJ 0.23%) game-changing blood cancer drug Imbruvica is set to occupy fifth place, with an estimated revenue haul of $9.5 billion. Now, AbbVie and J&J's Imbruvica might ultimately slip out of the top five. There are several new drugs gunning for Imbruvica's most lucrative indications, and Pfizer's breast cancer drug Ibrance should also bring home no less than $9 billion in annual sales by 2024.  

The investing picture

Even though a whopping 70% of Americans reportedly support a single-payer system like Medicare for all that would undermine the commercial prospects of these five drugs, it's highly unlikely that the U.S. healthcare system will radically alter course in the wake of the next election cycle. The pharmaceutical industry has an extremely powerful lobbying presence in Washington D.C., which directly influences the pace and scope of legislation regulating the industry as a whole. That's the stark reality of the political landscape -- despite the growing popularity among the electorate for cost-saving measures such as hard caps on prescription drug prices or the elimination of pharmacy benefit managers. 

Investors, in kind, shouldn't be overly concerned about owning any of these elite drugmakers heading into the next decade. After all, AbbVie, Bristol, J&J, Merck, and Pfizer all sport top-notch shareholder rewards programs, and their growth prospects should remain fairly healthy as well. AbbVie, for instance, currently offers a juicy 6.5% dividend yield, which is basically unheard of for a Dividend Aristocrat. So if you're on the prowl for a top-notch income and growth play, these blue-chip drugmakers are definitely worth a look.