National trends in prescription drug expenditures and projections for 2022

Abstract

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. 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.

Drugs Prescribing Trends in Three Polyclinics in Benghazi-Libya 2020

“…The data of this study indicated that, the total number of prescriptions were much higher than previous local study conducted in 2009 [17] and finding of this study was comparable to the study conducted between years 1997-2002 by which referring to dramatic changes in prescribing medicines trend in the public sector noting that average number of drugs per prescription was less than the current work [13].…”

“…In compared to previous local studies an average consultation time is as twice as before but it could be still too short to get patient history, to examine the patient, to decide about drugs needed to be written on the prescription or to give advice to the patient [17].…”

Progress in fed-batch culture for recombinant protein production in CHO cells

“…Biosimilars will enter the markets in the context of COVID-19 (Schulze et al 2022a , b ; Tichy et al 2022 ), it depends on a robust and scalable manufacturing with excellent productivity. PI is a key trend involving process strategies.…”

A standardized postoperative bowel regimen protocol after spine surgery

“…US medication pricing is complex and varies by care setting. Recent US and Canadian reports have shown increasing rates of prescription medication spending in both inpatient and outpatient settings (26)(27)(28). A US health insurance organization reported that for 10 specialty medications within the top 25 medications by 2019 Medicare Part B spending (9 intravenous immunotherapy agents, 1 intramuscular neuromuscular blocker), hospital and physician office charges were 108% and 22% higher, respectively, compared to specialty pharmacies (29).…”