National trends in prescription drug expenditures and projections for 2015

Schumock, Glen T.; Li, Edward C.; Suda, Katie J.; Wiest, Michelle D.; Stubbings, JoAnn; Matusiak, Linda M.; Hunkler, Robert J.; Vermeulen, Lee C.

doi:10.2146/ajhp140849

Cited by 42 publications

(31 citation statements)

References 19 publications

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“…The Patient Protection and Affordable Care Act of 2010 incentivized new programs that target adverse drug event prevention within hospitals and during care transitions between inpatient and outpatient settings. However, in outpatient settings, in which 90% of US prescription drug expenditures occur, 1 preventing adverse drug events remains a public health and patient safety challenge, with efforts often focused on medication errors and reducing potentially inappropriate prescribing for older adults (aged ≥65 years) as defined by the Beers criteria. 2,3 Patients in ambulatory care and some postacute care settings can have complex medication regimens, at times prescribed by multiple clinicians, with far less monitoring compared with hospitalized patients.…”

mentioning

confidence: 99%

US Emergency Department Visits for Outpatient Adverse Drug Events, 2013-2014

Shehab

Lovegrove

Geller

et al. 2016

JAMA

534

424

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IMPORTANCE The Patient Protection and Affordable Care Act of 2010 brought attention to adverse drug events in national patient safety efforts. Updated, detailed, nationally representative data describing adverse drug events can help focus these efforts. OBJECTIVE To describe the characteristics of emergency department (ED) visits for adverse drug events in the United States in 2013-2014 and describe changes in ED visits for adverse drug events since 2005-2006. DESIGN, SETTING, AND PARTICIPANTS Active, nationally representative, public health surveillance in 58 EDs located in the United States and participating in the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance project. EXPOSURES Drugs implicated in ED visits. MAIN OUTCOMES AND MEASURES National weighted estimates of ED visits and subsequent hospitalizations for adverse drug events. RESULTS Based on data from 42 585 cases, an estimated 4.0 (95% CI, 3.1-5.0) ED visits for adverse drug events occurred per 1000 individuals annually in 2013 and 2014 and 27.3% (95% CI, 22.2%-32.4%) of ED visits for adverse drug events resulted in hospitalization. An estimated 34.5% (95% CI, 30.3%-38.8%) of ED visits for adverse drug events occurred among adults aged 65 years or older in 2013-2014 compared with an estimated 25.6% (95% CI, 21.1%-30.0%) in 2005-2006; older adults experienced the highest hospitalization rates (43.6%; 95% CI, 36.6%-50.5%). Anticoagulants, antibiotics, and diabetes agents were implicated in an estimated 46.9% (95% CI, 44.2%-49.7%) of ED visits for adverse drug events, which included clinically significant adverse events, such as hemorrhage (anticoagulants), moderate to severe allergic reactions (antibiotics), and hypoglycemia with moderate to severe neurological effects (diabetes agents). Since 2005-2006, the proportions of ED visits for adverse drug events from anticoagulants and diabetes agents have increased, whereas the proportion from antibiotics has decreased. Among children aged 5 years or younger, antibiotics were the most common drug class implicated (56.4%; 95% CI, 51.8-61.0%). Among children and adolescents aged 6 to 19 years, antibiotics also were the most common drug class implicated (31.8%; 95% CI, 28.7%-34.9%) in ED visits for adverse drug events, followed by antipsychotics (4.5%; 95% CI, 3.3-5.6%). Among older adults (aged ≥65 years), 3 drug classes (anticoagulants, diabetes agents, and opioid analgesics) were implicated in an estimated 59.9% (95% CI, 56.8%-62.9%) of ED visits for adverse drug events; 4 anticoagulants (warfarin, rivaroxaban, dabigatran, and enoxaparin) and 5 diabetes agents (insulin and 4 oral agents) were among the 15 most common drugs implicated. Medications to always avoid in older adults according to Beers criteria were implicated in 1.8% (95% CI, 1.5%-2.1%) of ED visits for adverse drug events. CONCLUSIONS AND RELEVANCE The prevalence of emergency department visits for adverse drug events in the United States was estimated to be 4 per 1000 individuals in 2013 an...

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mentioning

confidence: 99%

US Emergency Department Visits for Outpatient Adverse Drug Events, 2013-2014

Shehab

Lovegrove

Geller

et al. 2016

JAMA

534

424

View full text Add to dashboard Cite

show abstract

“…Two US studies projected drug expenditure and one study projected 12% to 14% increases in US total drug expenditures in clinics, and 5% to 7% increases in hospitals [16]. The other study predicted drug expenditure (ambulatory and hospital) would increase by 2% in 2010 and 4% in 2011 [18].…”

Section: Discussionmentioning

confidence: 99%

“…The three studies estimated national health expenditure based on assumptions around economic (varying levels of economic growth) and demographic variables for a 10 year period. Another US study developed projections on drug expenditure and incorporated historical trends in drug expenditure and expected changes in the drugs market that may influence drug expenditure in 2015 [16]. A French study forecasted national drug expenditure based on demographic and epidemiological factors out to 2029, using a Markovian microsimulation model [17].…”

Section: Introductionmentioning

confidence: 99%

Irish GMS Cost Projections and Its Implications between 2016 and 2026

A¹,

Woods²

2015

Pharmacoeconomics

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Type of publicationArticle (peer-reviewed) AbstractIntroduction: Ireland had one of the highest pharmaceutical spends per capita in the EU in 2012. The General Medical Services (GMS) scheme is the largest community drug scheme in Ireland with approximately 40% of the population eligible for free drugs and appliances in 2012. The total cost of GMS prescriptions increased by 414% between 1998 and 2012. This paper projects Irish GMS cost from 2016 to 2026 and examines the implications of the estimated impact on GMS expenditure.

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“…Schumock et al (2015) describe the situation in the United States in the year 2014 similarly: the overall prescription sales amounted 360.7 milliard USD even with an increase of 12.2% compared to year 2013 (pp. 719).…”

Section: Drug Utilization Researchmentioning

confidence: 99%

Economic Evaluation of Health Care Utilization in the Slovak Republic

Haramiova

Malovecka

Koblišková

et al. 2016

CBUP

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Due to the economic changes and fast progress in health technologies countries face the challenge of rapidly growing health expenditures. Drug policies focus on identification of the most problematic areas for implementation of cost-effective measures. For this purpose, they need to be provided with accurate analyses of health expenditures and drug utilization. Primary aim of this study was to analyze health expenditures of Slovak Republic in regards to factors, which are considered to have the largest influence on provision of health care. Secondarily we focused on providing a brief drug utilization analysis. Our study confirmed that since 2000 Slovakia invests a larger share of GDP in health care, while in 2013 overall health expenditure amounted 5.6 million EUR (7.6% of GDP). Despite recent growth (233.6 % since 2000), Slovakia remains under OECD average in regards to health expenditures per capita (PPP, USD). However, it is on the 2 nd place among V4 countries. Patients' share of the overall health expenditures is increasing 12.8 times faster than public reimbursement. Up to 1.5 million EUR was spent on pharmaceuticals in 2013. The most utilized group of drugs in terms of DIDs and sales were cardiovascular drugs. JEL Classification Number: I50, DOI: http://dx.doi.org/10.12955/cbup.v4.763

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National trends in prescription drug expenditures and projections for 2015

Cited by 42 publications

References 19 publications

US Emergency Department Visits for Outpatient Adverse Drug Events, 2013-2014

US Emergency Department Visits for Outpatient Adverse Drug Events, 2013-2014

Irish GMS Cost Projections and Its Implications between 2016 and 2026

Economic Evaluation of Health Care Utilization in the Slovak Republic

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