Costs for medications are expected to rise 3 to 5% in all health care settings in 2014, according to a report published online ahead of print, by the American Journal of Health-System Pharmacy (AJHP), the professional journal of the American Society of Health-System Pharmacists (ASHP). ASHP publishes this annual projection of drug expenditures to help hospitals and health-systems plan drug budgets, which are a significant operating expense.

The report, National Trends in Prescription Drug Expenditures and Projections for 2014, by Glen T. Schumock, Pharm.D., MBA, PhD, et al, will be published in the March 15, 2014, edition of AJHP and examines recent trends in drug expenditures, projects drug expenditures for 2014, and explores factors likely to influence drug expenditures.

Prescription drugs account for approximately 11% of overall U.S. health care expenditures. As with other health care expenditures, growth in prescription drug spending has lessened in recent years, with a 0.7% decrease in spending during the 12-month period ending Sept. 30, 2013, compared with 2012. The authors said they expect a reversal of this trend in 2014, projecting a 3 to 5% increase in drug expenditures across all settings, a 5 to 7% increase in expenditures for clinic-administered drugs, and a 1 to 3% increase in hospital drug expenditures.

(As full disclosure nears, doctors’ pay for drug talks plummets)

“Our projections for 2014 indicate a clear reversal of the downward growth in prescription drug expenditures we have seen over the last several years,” said Schumock, who is head of the Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois, Chicago. “Drug expenditure trends will remain dynamic, and so health systems will need to carefully monitor local drug use patterns.”

These increases in expenditures are influenced by a variety of factors, according to the report, including new drug approvals and patent expirations. Using data provided by IMS Health, the authors report several trends in prescription drug spending, including:

  • Clinics and nonfederal hospitals experienced increased drug spending (4.5% and 1.8% growth, respectively) in 2013 relative to 2012, while decreased expenditures were seen in federal facilities (-13.7%) and in long-term care (-4.2%), mail order (-1.9%) and retail pharmacy (-0.3%) sectors.
  • Changes in expenditures for specific medications, drug classes, and therapeutic categories. These included:
  1. A significant decrease in expenditures across all settings for oxycodone.
  2. A significant increase in expenditures for influenza vaccines in the clinic setting, which may be due to new vaccine formulations and vaccination recommendations.
  3. A decrease in the expenditure growth rate for anti-cancer drugs (from 2012 to 2013), although anti-cancer drugs remain the top expenditure for hospitals and clinics.
  4. Changes in the availability of generic products, with fewer first-time generic drugs expected to reach the market in 2014.