Mayo Clinic, Rochester, MN, USA.
St. Jude Children's Research Hospital, Memphis, TN, USA.
Am J Health Syst Pharm. 2022 Jul 8;79(14):1158-1172. doi: 10.1093/ajhp/zxac102.
To report historical patterns of pharmaceutical expenditures, to identify factors that may influence future spending, and to predict growth in drug spending in 2022 in the United States, with a focus on the nonfederal hospital and clinic sectors.
Historical patterns were assessed by examining data on drug purchases from manufacturers using the IQVIA National Sales Perspectives database. Factors that may influence drug spending in hospitals and clinics in 2022 were reviewed-including new drug approvals, patent expirations, and potential new policies or legislation. Focused analyses were conducted for biosimilars, cancer drugs, generics, COVID-19 pandemic influence, and specialty drugs. For nonfederal hospitals, clinics, and overall (all sectors), estimates of growth of pharmaceutical expenditures in 2022 were based on a combination of quantitative analyses and expert opinion.
In 2021, overall pharmaceutical expenditures in the US grew 7.7% compared to 2020, for a total of $576.9 billion. Utilization (a 4.8% increase), price (a 1.9% increase) and new drugs (a 1.1% increase) drove this increase. Adalimumab was the top drug in terms of overall expenditures in 2021, followed by apixaban and dulaglutide. Drug expenditures were $39.6 billion (a 8.4% increase) and $105.0 billion (a 7.7% increase) in nonfederal hospitals and in clinics, respectively. In clinics and hospitals, new products and increased utilization growth drove growth, with decreasing prices for both sectors acting as an expense restraint. Several new drugs that are likely to influence spending are expected to be approved in 2022. Specialty and cancer drugs will continue to drive expenditures along with the evolution of the COVID-19 pandemic.
For 2022, we expect overall prescription drug spending to rise by 4.0% to 6.0%, whereas in clinics and hospitals we anticipate increases of 7.0% to 9.0% and 3.0% to 5.0%, respectively, compared to 2021. These national estimates of future pharmaceutical expenditure growth may not be representative of any particular health system because of the myriad of local factors that influence actual spending.
报告药品支出的历史模式，确定可能影响未来支出的因素，并预测美国 2022 年药品支出的增长，重点关注非联邦医院和诊所部门。
使用 IQVIA National Sales Perspectives 数据库检查制造商药品采购数据，评估历史模式。审查了可能影响 2022 年医院和诊所药品支出的因素，包括新药批准、专利到期以及潜在的新政策或立法。针对生物仿制药、癌症药物、仿制药、COVID-19 大流行影响和专科药物进行了重点分析。对于非联邦医院、诊所和整体（所有部门），2022 年药品支出增长的估计是基于定量分析和专家意见的结合。
2021 年，美国整体药品支出与 2020 年相比增长 7.7%，达到 5769 亿美元。利用（增长 4.8%）、价格（增长 1.9%）和新药（增长 1.1%）推动了这一增长。阿达木单抗是 2021 年总支出最高的药物，其次是阿哌沙班和度拉糖肽。非联邦医院和诊所的药品支出分别为 396 亿美元（增长 8.4%）和 1050 亿美元（增长 7.7%）。在诊所和医院，新产品和利用增长推动了增长，两个部门的价格下降都起到了抑制支出的作用。预计 2022 年将有几种可能影响支出的新药获得批准。随着 COVID-19 大流行的演变，专科药物和癌症药物将继续推动支出。
对于 2022 年，我们预计整体处方药物支出将增长 4.0%至 6.0%，而诊所和医院的支出预计将分别增长 7.0%至 9.0%和 3.0%至 5.0%，与 2021 年相比。由于影响实际支出的地方因素众多，这些未来药品支出增长的全国估计可能无法代表任何特定的卫生系统。
