College of Pharmacy, University of Tennessee Health Science Center, MS, Memphis, TN 38105, USA.
Am J Health Syst Pharm. 2012 Mar 1;69(5):405-21. doi: 10.2146/ajhp110697.
Factors likely to influence drug expenditures, drug expenditure trends in 2010 and 2011, and projected drug expenditures for 2012 are discussed.
Data were analyzed to provide drug expenditure trends for total drug expenditures and the hospital and clinic sectors. Data were obtained from the IMS Health National Sales Perspectives database. From 2009 to 2010, total U.S. drug expenditures increased by 2.7%, with total spending rising from $299.2 billion to $307.5 billion. Drug expenditures in clinics grew by 6.0% from 2009 to 2010. Hospital drug expenditures increased at the moderate rate of 1.5% from 2009 to 2010; through the first nine months of 2011, hospital drug expenditures increased by only 0.3% compared with the same period in 2010. The dominant trend over the past several years is substantial moderation in expenditure growth for widely used drugs, primarily due to the ongoing introduction and wide use of generic versions of high-cost, frequently used medications. At the end of 2010, generic drugs accounted for 78% of all retail prescriptions dispensed. Another pattern is substantial increases in expenditures for specialized medications, particularly in the outpatient setting as growth in prescription drug expenditures for clinic-administered drugs consistently outpaces growth in total expenditures. Various factors are likely to influence drug expenditures in 2012, including drugs in development, the diffusion of new drugs, generic drugs, drug shortages, and biosimilars.
For 2012, we project a 3-5% increase in total drug expenditures across all settings, a 5-7% increase in expenditures for clinic-administered drugs, and a 0-2% increase in hospital drug expenditures.
讨论可能影响药品支出的因素、2010 年和 2011 年药品支出趋势,以及 2012 年药品支出预测。
对提供总药品支出以及医院和诊所部门药品支出趋势的数据进行了分析。数据来自 IMS Health National Sales Perspectives 数据库。2009 年至 2010 年,美国药品总支出增长 2.7%,总支出从 2992 亿美元增加到 3075 亿美元。2009 年至 2010 年,诊所药品支出增长 6.0%。2009 年至 2010 年,医院药品支出以温和的 1.5%速度增长;截至 2011 年 9 月,与 2010 年同期相比,医院药品支出仅增长 0.3%。过去几年的主导趋势是广泛使用的药品支出增长大幅放缓,主要原因是高成本、常用药物的通用版本不断推出和广泛使用。2010 年底,仿制药占所有零售处方的 78%。另一个趋势是专门药物支出大幅增加,尤其是在门诊环境中,因为诊所管理药物的处方药支出增长持续超过总支出增长。各种因素可能会影响 2012 年的药品支出,包括正在研发的药物、新药的推广、仿制药、药品短缺和生物类似药。
我们预计 2012 年所有领域的总药品支出将增长 3-5%,诊所管理药物的支出将增长 5-7%,医院药品支出将增长 0-2%。