Schumock Glen T, Li Edward C, Wiest Michelle D, Suda Katie J, Stubbings JoAnn, Matusiak Linda M, Hunkler Robert J, Vermeulen Lee C
Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL
Department of Pharmacy Practice, College of Pharmacy, University of New England, Portland, ME.
Am J Health Syst Pharm. 2017 Aug 1;74(15):1158-1173. doi: 10.2146/ajhp170164. Epub 2017 May 22.
Historical trends and factors likely to influence future pharmaceutical expenditures are discussed, and projections are made for drug spending in 2017 in nonfederal hospitals, clinics, and overall (all sectors).
Drug expenditure data through calendar year 2016 were obtained from the QuintilesIMS National Sales Perspectives database and analyzed. Other factors that may influence drug spending in hospitals and clinics in 2017, including new drug approvals and patent expirations, were also reviewed. Expenditure projections for 2017 for nonfederal hospitals, clinics, and overall (all sectors) were made based on a combination of quantitative analyses and expert opinion.
Total U.S. prescription sales in the 2016 calendar year were $448.2 billion, a 5.8% increase compared with 2015. More than half of the increase resulted from price hikes of existing drugs. Adalimumab was the top drug overall in 2016 expenditures ($13.6 billion); in clinics and nonfederal hospitals, infliximab was the top drug. Prescription expenditures in clinics and nonfederal hospitals totaled $63.7 billion (an 11.9% increase from 2015) and $34.5 billion (a 3.3% increase from 2015), respectively. In nonfederal hospitals and clinics, growth in spending was driven primarily by price increases of existing drugs and increased volume, respectively.
We project a 6.0-8.0% increase in total drug expenditures across all settings, an 11.0-13.0% increase in clinics, and a 3.0-5.0% increase in hospital drug spending in 2017. Health-system pharmacy leaders should carefully examine their own local drug utilization patterns to determine their own organization's anticipated spending in 2017.
探讨历史趋势以及可能影响未来药品支出的因素，并对2017年非联邦医院、诊所及总体（所有部门）的药品支出进行预测。
获取并分析了截至2016年日历年的药品支出数据，这些数据来自昆泰IMS全国销售视角数据库。还审查了其他可能影响2017年医院和诊所药品支出的因素，包括新药批准和专利到期情况。基于定量分析和专家意见相结合的方法，对2017年非联邦医院、诊所及总体（所有部门）的支出进行了预测。
2016日历年美国处方药销售总额为4482亿美元，与2015年相比增长了5.8%。增长的一半以上来自现有药品的价格上涨。阿达木单抗是2016年支出最高的药品（136亿美元）；在诊所和非联邦医院中，英夫利昔单抗是支出最高的药品。诊所和非联邦医院的处方药支出分别总计637亿美元（较2015年增长11.9%）和345亿美元（较2015年增长3.3%）。在非联邦医院和诊所中，支出增长分别主要由现有药品价格上涨和销量增加推动。
我们预测2017年所有机构的药品总支出将增长6.0 - 8.0%，诊所将增长11.0 - 13.0%，医院药品支出将增长3.0 - 5.0%。卫生系统药房负责人应仔细审查自身当地的药品使用模式，以确定其所在机构2017年的预期支出。
