More than half a million Americans have annual prescription drug costs of more than $50,000, according to a study released Wednesday by pharmacy benefits manager Express Scripts.

That’s roughly the population of a city approaching the size of Boston, spending more than the median household income in the U.S. on medicine each year.

More than 100,000 Americans spent more than $100,000 on prescription medicine in 2014, Express Scripts found; that’s almost triple the number the year before. Driving the costs for those with the highest expenses: primarily medicines for hepatitis C and cancer, the report showed.

And the number of super-high spenders prescribed $100,000 or more worth of medications nearly tripled from 47,000 to 139,000, pharmacy benefits manager Express Scripts says.

According to Statista estimates, which were calculated based on numbers presented by IBIS World, pharmacies and drugstores in the United States will generate a revenue of $257 Billion U.S. dollars in 2015.

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“As a Chiropractor, what are you doing to combat this growing trend? Do you have a voice in your practice and community?”

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