Prescription drug costs are projected to increase between 11% and 13% in 2016, a recent analysis found.
Researchers from the University of Illinois at Chicago College of Pharmacy (UIC COP) used the IMS Health National Sales Perspectives (NSP) database to review recent cost changes and future factors likely to influence spending trends. In doing so, they projected that drug spending will increase by 15% to 17% in clinics, and 10% to 12% in hospital settings.
“These estimates for growth are considerably higher than those we have made in the past but consistent with recent trends and other forecasts,” said Glen Schumock, professor and head of pharmacy systems for UIC COP, in a press release. “We have observed consistent increases in growth over the past 3 years in hospital settings.”
Overall, more than $419 billion was spent on prescription drugs last year, representing an 11.7% increase from the previous year, which was higher than anticipated. The increase was attributed to higher prices for existing drugs (8.4%), spending on new drugs (2.7%) and changes in the volume of drugs used (0.5%).
“Individual drugs with the greatest increases in expenditures in 2015 were specialty agents and older generics,” Schumock said. “These agents are likely to continue to influence total spending this year.”
In 2015, the top therapeutic classes
by volume were antihypertensives, mental health medications, pain medications, antibacterials, and lipid regulators. Diabetes medications was the top class by nondiscounted spending, followed by oncology and autoimmune disorders medications.
Levothyroxine, lisinopril, acetaminophen/ hydrocodone, atorvastatin, and metoprolol were the most commonly prescribed medications, and the top-earning agents were Harvoni, Humira, Enbrel, Crestor, and Lantus SoloStar. More than 80% of prescriptions dispensed were written for unbranded generics, but branded medications accounted for more than 70% of nondiscounted spending.
Additionally, the researchers said the aging patient population, greater patient access to health services under the Affordable Care Act, and the growing US economy will also influence medication costs in the future.
Total prescription volume increased by 1% in 2015. Demand increased for antidepressants, diabetes drugs, respiratory agents, and antiepileptics. Demand for lipid regulators declined overall, with demand for branded statins shifting in favor of generic atorvastatin. Demand for narcotic pain medications fell by more than 16 million prescriptions.
Prescription volume growth has been driven by the expansion of insurance coverage through Medicaid and health exchange plans, although it has been offset by fewer prescriptions being filled by patients with commercial insurance coverage.
The new forecast is “widely anticipated by hospital and health-system pharmacists each year who use it to help project drug spending and develop drug budgets in their own institutions,” Schumock said.
One issue that has generated significant concern among health-system pharmacy administrators in the past year is high-cost generics.
“While generic drugs generally continue to have a moderating influence on prescription drug expenditures overall, this impact has been lessened by a decline in blockbuster drugs subject to patent expiration and changes in the generic marketplace that influence prices,” the researchers wrote. “Substantial price increases for some generic drugs have been observed across dosage forms and widely reported in the lay press.”
Specifically, they pointed to “triple-digit price increases” in injectable medications, such as calcitonin, hydralazine, and vasopressin. Several oral medications, including hydroxychloroquine, fluoxetine, atenolol, propranolol, digoxin, amitriptyline, tetracycline, phytonadione, and captopril, also saw massive price increases in 2015.
The analysis was published in the American Journal of Health-System Pharmacy