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. 2022 Jul 8;79(14):1158-1172.
doi: 10.1093/ajhp/zxac102.

National trends in prescription drug expenditures and projections for 2022

Eric M Tichy  1 , James M Hoffman  2 , Katie J Suda  3 , Matthew H Rim  4 , Mina Tadrous  5 , Sandra Cuellar  4 , John S Clark  6 , Jennifer Ward  7 , Glen T Schumock  4
Affiliations

National trends in prescription drug expenditures and projections for 2022

Eric M Tichy et al. Am J Health Syst Pharm. .

Abstract

Purpose: 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.

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 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.

Results: 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.

Conclusion: 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.

Keywords: COVID-19; biosimilars; cancer drugs; drug expenditures; pandemic; public policy.

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Figures

Figure 1.
Figure 1.
Annual growth in drug expenditures compared to previous year, 2000-2021.
Figure 2.
Figure 2.
Trends in expenditures for COVID-19 treatments and COVID-19 cases.
See this image and copyright information in PMC

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References

    1. A timeline of COVID-19 developments in 2020. AJMC. Published January 1, 2021. Accessed February 10, 2022. https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020
    1. Martin AB, Hartman M, Benson J, Catlin A; National Health Expenditure Accounts Team. National health spending in 2020: growth driven by federal spending in response to the COVID-19 pandemic. Health Aff (Millwood). 2022;41:13-25. - PubMed
    1. US Food and Drug Administration. Biosimilar interchangeable and interchangeable products. Published October 2018. Accessed February 9, 2022. https://www.fda.gov/drugs/biosimilars/biosimilar-product-information
    1. Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19). Our World in Data. Accessed February 13, 2022. https://ourworldindata.org/coronavirus
    1. IQVIA Specialty Drug Definition [proprietary data]. IQVIA; 2021. Accessed February 28, 2022.