Hoffman James M, Shah Nilay D, Vermeulen Lee C, Doloresco Fred, Grim Penny, Hunkler Robert J, Hontz Karrie M, Schumock Glen T
Pharmaceutical Department, St. Jude Children's Research Hospital, Memphis, TN, USA.
Am J Health Syst Pharm. 2008 Feb 1;65(3):234-53. doi: 10.2146/ajhp070629.
Drug expenditure trends in 2006 and 2007, projected drug expenditures by setting for 2008, and factors likely to influence drug expenditures are discussed.
Various factors are likely to influence drug expenditures in 2008, including drugs in development, the diffusion of new drugs, drug safety concerns, generic drugs, Medicare Part D, and changes in the drug supply chain. The increasing availability of important generic drugs and drug safety concerns continue to moderate growth in drug expenditures. The drug supply chain remains dynamic and may influence drug expenditures, particularly in specialized therapeutic areas. Initial data suggest the Medicare Part D benefit has influenced drug expenditures, but the ultimate impact of the benefit on drug expenditures remains unclear. From 2005 to 2006, total drug expenditures increased by 8.7% to $275 billion. Drug expenditures in clinics continue to grow more rapidly than in other settings, with a 20.9% increase from 2005 to 2006, and drug expenditures in clinics are now greater than the amount spent in hospitals. Hospital drug expenditures increased at a moderate rate of only 3.8% from 2005 to 2006; through the first nine months of 2007, hospital drug expenditures increased by only 2.2% compared with the same period in 2006.
In 2008, we project a 5-7% increase in drug expenditures in outpatient settings, a 12-14% increase in clinics, and a 4-6% increase in hospitals.
讨论2006年和2007年的药品支出趋势、2008年各机构预计的药品支出以及可能影响药品支出的因素。
2008年，多种因素可能影响药品支出，包括处于研发阶段的药物、新药的推广、药品安全问题、仿制药、医疗保险D部分以及药品供应链的变化。重要仿制药供应的增加和药品安全问题继续缓和药品支出的增长。药品供应链仍然处于动态变化中，可能影响药品支出，尤其是在专业治疗领域。初步数据表明医疗保险D部分福利已经影响了药品支出，但是该福利对药品支出的最终影响仍不明确。从2005年到2006年，药品总支出增长了8.7%，达到2750亿美元。诊所的药品支出继续比其他机构增长得更快，从2005年到2006年增长了20.9%，现在诊所的药品支出已经超过了医院的支出。从2005年到2006年，医院药品支出仅以3.8%的适度速度增长；到2007年前九个月，与2006年同期相比，医院药品支出仅增长了2.2%。
2008年，我们预计门诊机构的药品支出将增长5 - 7%，诊所将增长12 - 14%，医院将增长4 - 6%。
