title: National trends in prescription drug expenditures and projections for 2014.
abstract: OBJECTIVE
  An analysis of trends in U.S. pharmaceutical spending is presented, including projections for drug expenditures in nonfederal hospital and clinic settings in 2014.
  
  
  METHODS
  Trends in pharmaceutical expenditures and developments likely to influence future spending, including new drug approvals and patent expirations, were analyzed using data from the IMS Health National Sales Perspectives database. Projections were based on a combination of quantitative and qualitative analyses and expert opinion.
  
  
  RESULTS
  Total prescription sales for the 12 months ending September 2013 were approximately $326 billion, 0.7% lower than sales during the previous 12 months; pharmaceutical spending by clinics and nonfederal hospitals grew by 4.5% and 1.8%, respectively. Vaccines were among the products driving large sales increases in clinic settings, with alteplase and pegfilgrastim topping the list of fast-growing drugs by hospital expenditures. Few new drug approvals anticipated in 2014 are expected to result in major expenditures by hospitals and clinics. Expansion of access to health care and other changes related to the Patient Protection and Affordable Care Act, as well as continued improvement in the U.S. economy, may drive growth in pharmaceutical spending over the next 12-24 months.
  
  
  CONCLUSIONS
  Growth in U.S. prescription drug expenditures is expected to rebound in 2014, with a projected 3-5% increase in total drug expenditures across all settings this year, including a 5-7% increase in clinic spending and a 1-3% increase in hospital spending. Health-system pharmacy leaders should carefully examine local drug-utilization patterns to determine their respective organization's anticipated spending in 2014.
authors.affiliation: Glen T. Schumock, Pharm.D., M.B.A., Ph.D., is Professor and Head, Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois-Chicago, Chicago. Edward C. Li, Pharm.D., BCOP, is Associate Professor, Department of Pharmacy Practice, College of Pharmacy, University of New England, Portland, ME. Katie J. Suda, Pharm.D., M.S., is Research Health Scientist, Department of Veterans Affairs, Center of Innovation for Complex Healthcare, Edward Hines Jr. VA Hospital, Hines, IL. Linda M. Matusiak, B.A., is Senior Manager, Research Support; and Robert J. Hunkler, M.B.A., is Director, Professional Relations, IMS Health, Plymouth Meeting, PA. Lee C. Vermeulen, B.S.Pharm., M.S., FCCP, is Director, Center for Clinical Knowledge Management, UW Health, Madison, WI, and Clinical Professor, School of Pharmacy, University of Wisconsin-Madison. James M. Hoffman, Pharm.D., M.S., BCPS, is Associate Member, Pharmaceutical Sciences, and Medication Outcomes and Safety Officer, St. Jude Children's Research Hospital, Memphis, TN, and Associate Professor of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis.
authors.forename: Glen T
authors.initials: GT
authors.lastname: Schumock
authors.forename: Edward C
authors.initials: EC
authors.lastname: Li
authors.forename: Katie J
authors.initials: KJ
authors.lastname: Suda
authors.forename: Linda M
authors.initials: LM
authors.lastname: Matusiak
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hunkler
authors.forename: Lee C
authors.initials: LC
authors.lastname: Vermeulen
authors.forename: James M
authors.initials: JM
authors.lastname: Hoffman
mesh_terms: D017277:Drug Approval / Q000191:economics*; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D010604:Pharmacy / Q000639:trends*; D055553:Prescription Drugs / Q000191:economics*; D014481:United States
chemical_list: D055553:Prescription Drugs