Hoffman James M, Shah Nilay D, Vermeulen Lee C, Doloresco Fred, Martin Patrick K, Blake Sharon, Matusiak Linda, Hunkler Robert J, Schumock Glen T
Pharmaceutical Department, St. Jude Children's Research Hospital, Memphis, TN, USA.
Am J Health Syst Pharm. 2009 Feb 1;66(3):237-57. doi: 10.2146/ajhp080636.
Drug expenditure trends in 2007 and 2008, projected drug expenditures for 2009, and factors likely to influence drug expenditures are discussed.
Various factors are likely to influence drug expenditures in 2009, 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 that the Medicare Part D benefit has influenced drug expenditures, but the ultimate impact of the benefit on drug expenditures remains unclear. From 2006 to 2007, total U.S. drug expenditures increased by 4.0%, with total spending rising from $276 billion to $287 billion. Drug expenditures in clinics continue to grow more rapidly than in other settings, with a 9.9% increase from 2006 to 2007. Hospital drug expenditures increased at a moderate rate of only 1.6% from 2006 to 2007; through the first nine months of 2008, hospital drug expenditures increased by only 2.8% compared with the same period in 2007.
In 2009, we project a 0-2% increase in drug expenditures in outpatient settings, a 1-3% increase in expenditures for clinic-administered drugs, and a 1-3% increase in hospital drug expenditures.
讨论2007年和2008年的药品支出趋势、2009年的药品支出预测以及可能影响药品支出的因素。
多种因素可能影响2009年的药品支出,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使药品支出增长趋于缓和。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,但该福利对药品支出的最终影响仍不明确。从2006年到2007年,美国药品总支出增长了4.0%,总支出从2760亿美元增至2870亿美元。诊所的药品支出继续比其他环境增长更快,从2006年到2007年增长了9.9%。2006年到2007年,医院药品支出仅以1.6%的适度速率增长;到2008年前九个月,与2007年同期相比,医院药品支出仅增长了2.8%。
2009年,我们预计门诊环境下的药品支出将增长0 - 2%,诊所管理药品的支出将增长1 - 3%,医院药品支出将增长1 - 3%。