Forecast Predicts 3.29% Drug Spend Increase in Health Systems


Vizient report shows that the COVID-19 pandemic resulted in a $200 million increase in the top 10 COVID-related drugs, as well as a decrease in vaccinations between March and April.

A drug pricing forecast predicts a 3.29% increase for pharmaceutical purchases by health systems in 2021, driven by ongoing disruptions due to the coronavirus disease 2019 (COVID-19) pandemic and enduring market trends, according to a press release.

The report said that the COVID-19 pandemic has created many uncertainties, including variations in medication use trends and the impact of total expenditures, which could have a significant effect in the coming year.

“One of the things that makes this year’s forecast particularly more variable is that utilization—the medications that are utilized and the volumes that are prescribed, could be very different depending on how COVID continues this year and into the beginning of next year,” said Steven Lucio, PharmD, BCPS, senior principal of pharmacy solutions at Vizient, in an interview with Pharmacy Times.

Significantly, the report found that the top 10 COVID-19-related medications saw $200 million in increased spending during March and April 2020. Hydroxychloroquine specifically saw a 1132% increase during that period.

On the other hand, the report found that spending on the top 10 vaccines decreased substantially during March and April compared with previous years. Although experts hope that this decrease will bounce back in the coming months, especially with the influenza vaccine to be released soon, Lucio said the long-term health impacts and their resulting costs cannot be predicted yet.

“Obviously, if you don’t have the vaccinations administered then you set up additional challenges,” Lucio said.

In 2021, the forecast predicts a 3.29% increase for pharmaceutical purchases in health systems. The report said this increase continues to be moderate as in the past few years, despite ongoing uncertainty caused by COVID-19. Lucio said generic competition and biosimilars have been major factors limiting the routine price increases of frequently used medications.

Pediatric pharmaceutical spending is expected to have a similar increase of 3.16%, driven largely by the targeting of rare diseases. This population has been less affected by the COVID-19 pandemic than older populations, and the report said that the most significant pediatric impacts have been in missed routine health service appointments and early diagnostic opportunities.

Specialty drugs are expected to have a 4.47% spending increase and experienced a growth in sales between early March and May 2020. The report said factors contributing to this growth could include CDC guidance for patients to have extra medications during the pandemic, fears over pandemic-related drug shortages, a shift from clinic-administered intravenous drugs to at-home agents, and relaxed approval policies for drug refills.

Although the current pandemic has undoubtedly affected drug spend in 2020 and into 2021, Lucio said ongoing problems need to be solved in order to reinforce the pharmaceutical supply chain before another pandemic, natural disaster, or other event impacts patients. He pointed out that a key concern both before and during the COVID-19 pandemic was that many products or active pharmaceutical ingredients are manufactured overseas, creating challenges when other parts of the world are affected or supply chains are cut off.

Strategies to mitigate these concerns have included identifying essential medications and their supply chains in an effort to not only have drug products manufactured before a disaster, but also to have an inventory already in the United States.

“Even after COVID is gone, if we don’t take these additional actions, the next disaster…might put other pressures on the supply chain,” Lucio said.


Drug Price Forecast 2020. Vizient; July 29, 2020. Accessed August 3, 2020.

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