Total spending on U.S. medicines increased 1% on a real per capita basis in 2013, while the use of healthcare services rose for the first time in three years, according to a report by the IMS Institute for Healthcare Informatics.
The study, “Medicine Use and Shifting Costs of Healthcare: A Review of the Use of Medicines in the United States in 2013,” found that total dollars spent on medications in the United States reached $329.2 billion last year, up 3.2% on a nominal basis and a rebound from the 1% decline in 2012. Primary drivers include the reduced impact of patent expiries, price increases, higher spending on innovative new medicines and greater use by patients of the healthcare system.
Patent expiries in 2013 contributed $19 billion to lower medicine spending, compared with $29 billion the previous year. Overall utilization of healthcare services grew slightly as consumers returned to the healthcare system — primarily through more office visits to specialist physicians, as well as outpatient treatments — following several years of self-rationing.
“Following several years of decline, 2013 was striking for the increased use by patients of all parts of the U.S. healthcare system — even in advance of full implementation of the Affordable Care Act,” said Murray Aitken, executive director of the IMS Institute for Healthcare Informatics. “Growth in medicine spending remains at historically low levels despite a significant uptick last year, and continues to contribute to the bending of the healthcare cost curve.”
The report’s key findings include:
- An increase in the utilization of healthcare services and medicines. The number of physician office visits, hospitalizations and prescriptions filled all increased in 2013. The number of patient office visits to primary care physicians fell by 0.7% in 2013, while visits to specialists increased by 4.9% overall and by 9.5% for seniors. The number of hospitals visits increased last year, most notably by patients who were commercially insured and received outpatient treatments. Patients filled an average of more than 12 retail prescriptions last year, up nearly 2% year over year. Those ages 65 years and older filled an average of 28 prescriptions annually, down slightly from 2012;
- Spending on medicines. While drug-spending levels have contributed to slower growth in healthcare costs since 2007, nominal spending rose sharply last year. The largest single driver of the 4.2 percentage point shift in spending growth in 2013 was the $10 billion lower impact of patent expiries. Price increases for branded products added $4 billion more in spending growth last year compared with 2012; however, net price growth was essentially flat year over year, reflecting off-invoice discounts and rebates. Overall spending on medicines remained concentrated in traditional small-molecule pills dispensed through retail pharmacies, even as higher growth was seen in biologics and specialty drugs;
- Transformations in disease treatment. Patients gained access to 36 new molecular entities in 2013, including 10 new notable cancer treatments — the most in more than a decade. A total of 27 new oncology drugs have launched in the past three years. Additionally, clusters of innovation are transforming patient care in hepatitis C, multiple sclerosis and diabetes, as well as stroke and acute coronary syndrome. Seventeen orphan drugs — developed for patient populations of fewer than 200,000 individuals — launched in 2013, the most in any year since the passage of the Orphan Drug Act in 1983; and
- Patient payment for health care and medicines. Patients with insurance are incurring higher out-of-pocket costs for healthcare services despite lower co-pays for many prescriptions and additional discounts for preventive medicines. Prescription drug costs paid by most patients are declining, with average out-of-pocket costs of less than $5 for 57% of all retail prescriptions filled. At the same time, 30% of total patient out-of-pocket costs relate to just 2.3% of prescriptions, often high-cost specialty medicines.
To see the full report, including charts, click here.