Drug costs projected to rise three to five percent in all settings in 2014

The report, National Trends in Prescription Drug Expenditures and Projections for 2014, by Glen T. Schumock, Pharm.D., M.B.A, Ph.D., et al, will be published in the March 15, 2014, edition of AJHP and examines recent trends in drug expenditures, projects drug expenditures for 2014, and explores factors likely to influence drug expenditures.

Prescription drugs account for approximately 11 percent of overall U.S. health care expenditures. As with other health care expenditures, growth in prescription drug spending has lessened in recent years, with a 0.7 percent decrease in spending during the 12-month period ending September 30, 2013 compared with 2012. The authors expect a reversal of this trend in 2014, projecting a three to five percent increase in drug expenditures across all settings, a five to seven percent increase in expenditures for clinic-administered drugs, and a one to three percent increase in hospital drug expenditures.

"Our projections for 2014 indicate a clear reversal of the downward growth in prescription drug expenditures we have seen over the last several years," said Schumock. "Drug expenditure trends will remain dynamic, and so health systems will need to carefully monitor local drug use patterns."

These increases in expenditures are influenced by a variety of factors, according to the report, including new drug approvals and patent expirations. Using data provided by IMS Health, the authors report several trends in prescription drug spending, including:

- Clinics and nonfederal hospitals experienced increased drug spending (4.5 percent and 1.8 percent growth, respectively) in 2013 relative to 2012, while decreased expenditures were seen in federal facilities (-13.7 percent) and in long-term care (-4.2 percent), mail order (-1.9 percent) and retail pharmacy (-0.3 percent) sectors.

- Changes in expenditures for specific medications, drug classes, and therapeutic categories. These included:

o A significant decrease in expenditures across all settings for oxycodone.

o A significant increase in expenditures for influenza vaccines in the clinic setting, which may be due to new vaccine formulations and vaccination recommendations.

o A decrease in the expenditure growth rate for anti-cancer drugs (from 2012 to 2013), although anti-cancer drugs remain the top expenditure for hospitals and clinics.

o Changes in the availability of generic products, with fewer first-time generic drugs expected to reach the market in 2014.