处方药支出的全国趋势及2025年预测。

Tichy Eric M, Rim Matthew H, Cuellar Sandra, Tadrous Mina, Schumock Glen T, Johnson Thomas J, Newell Mary Kate, Hoffman James M

Mayo Clinic, Rochester, MN, USA.

Northwestern Medicine, Chicago, IL, USA.

Am J Health Syst Pharm. 2025 Jul 12;82(14):806-821. doi: 10.1093/ajhp/zxaf092.

PURPOSE

To report historical patterns of pharmaceutical expenditures, to identify factors that may influence future spending, and to predict growth in drug spending in 2025 in the United States, with a focus on the nonfederal hospital and clinic sectors.

METHODS

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 2025 were reviewed-including new drug approvals, patent expirations, and potential new policies or legislation. Focused analyses were conducted for biosimilars, cancer drugs, endocrine drugs, generics, specialty drugs and vaccines. For nonfederal hospitals, clinics, and overall (all sectors), estimates of growth of pharmaceutical expenditures in 2024 were made based on a combination of quantitative analyses and expert opinion.

RESULTS

In 2024, overall pharmaceutical expenditures in the US grew 10.2% compared to 2023, for a total of $805.9 billion. Utilization (a 7.9% increase) and new drugs (a 2.5% increase) drove this increase, while prices remained flat (a 0.2% decrease). Semaglutide was the top drug in 2024, followed by tirzepatide and adalimumab. Drug expenditures were $39.0 billion (a 4.9% increase) and $158.2 billion (a 14.4% increase) in nonfederal hospitals and clinics, respectively. In clinics, increased utilization drove growth, with a small contribution from new products, while prices remained flat. In nonfederal hospitals, new products, price, and new volume each contributed modestly to growth in spend. Several new drugs that will influence spending are expected to be approved in 2025. Specialty, endocrine, and cancer drugs will continue to drive expenditures.

CONCLUSION

For 2025, we expect overall prescription drug spending to rise by 9.0 to 11.0%, whereas in clinics and hospitals we anticipate an 11.0% to 13.0% increase and a 2.0% to 4.0% increase, respectively, compared to 2024. These national estimates of future pharmaceutical expenditure growth may not be representative of any health system because of the myriad of local factors that influence actual spending.

目的

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2025年美国药品支出的增长情况，重点关注非联邦医院和诊所部门。

方法

通过使用艾昆纬（IQVIA）全国销售视角数据库检查从制造商处购买药品的数据来评估历史模式。审查了可能影响2025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。对生物类似药、抗癌药、内分泌药物、仿制药、专科药物和疫苗进行了重点分析。对于非联邦医院、诊所和总体（所有部门），基于定量分析和专家意见相结合的方法对2024年药品支出的增长进行了估计。

结果

2024年，美国总体药品支出与2023年相比增长了10.2%，总计8059亿美元。使用量（增长7.9%）和新药（增长2.5%）推动了这一增长，而价格持平（下降0.2%）。司美格鲁肽是2024年的头号药品，其次是替尔泊肽和阿达木单抗。非联邦医院和诊所的药品支出分别为390亿美元（增长4.9%）和1582亿美元（增长14.4%）。在诊所，使用量增加推动了增长，新产品贡献较小，而价格持平。在非联邦医院，新产品、价格和新的使用量对支出增长的贡献都不大。预计2025年将有几种影响支出的新药获批。专科、内分泌和抗癌药物将继续推动支出增长。