title: National trends in prescription drug expenditures and projections for 2016.
abstract: OBJECTIVE
  Historical trends and factors likely to influence future pharmaceutical expenditures are discussed, and projections are made for drug spending in 2016 in nonfederal hospitals, clinics, and overall (all sectors).
  
  
  METHODS
  Drug expenditure data through calendar year 2015 were obtained from the IMS Health National Sales Perspectives database and analyzed. Other factors that may influence drug spending in hospitals and clinics in 2016, including new drug approvals and patent expirations, were also reviewed. Expenditure projections for 2016 were based on a combination of quantitative analyses and expert opinion.
  
  
  RESULTS
  Total U.S. prescription sales in the 2015 calendar year were $419.4 billion, which was 11.7% higher than sales in 2014. Prescription expenditures in clinics and nonfederal hospitals totaled $56.7 billion (a 15.9% increase) and $33.6 billion (a 10.7% increase), respectively, in 2015. In nonfederal hospitals, growth in spending was driven primarily by increased prices for existing drugs. The hepatitis C combination drug ledipasvir-sofosbuvir was the top drug overall in terms of 2015 expenditures ($14.3 billion); in both clinics and nonfederal hospitals, infliximab was the top drug. Individual drugs with the greatest increases in expenditures in 2015 were specialty agents and older generics; these agents are likely to continue to influence total spending in 2016.
  
  
  CONCLUSIONS
  We project an 11-13% increase in total drug expenditures overall in 2016, with a 15-17% increase in clinic spending and a 10-12% increase in hospital spending. Health-system pharmacy leaders should carefully examine local drug utilization patterns in projecting their own organization's drug spending in 2016.
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL. schumock@uic.edu.
authors.forename: Glen T
authors.initials: GT
authors.lastname: Schumock
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, University of New England, Portland, ME.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Li
authors.affiliation: Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edwards Hines Jr. VA Hospital, Hines, ILDepartment of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL.
authors.forename: Katie J
authors.initials: KJ
authors.lastname: Suda
authors.affiliation: UC Health, Cincinnati, OHJames L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Wiest
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL.
authors.forename: JoAnn
authors.initials: J
authors.lastname: Stubbings
authors.affiliation: IMS Health, Plymouth Meeting, PA.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Matusiak
authors.affiliation: IMS Health, Plymouth Meeting, PA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hunkler
authors.affiliation: Center for Clinical Knowledge Management, UW Health, Madison, WISchool of Pharmacy, University of Wisconsin, Madison, WI.
authors.forename: Lee C
authors.initials: LC
authors.lastname: Vermeulen
mesh_terms: D000554:Ambulatory Care Facilities / Q000191:economics / Q000639:trends; D017277:Drug Approval / Q000191:economics; D016527:Drug Costs / Q000639:trends*; D004469:Economics, Hospital / Q000639:trends; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D010593:Pharmaceutical Services / Q000191:economics / Q000639:trends; D010594:Pharmacies / Q000191:economics / Q000639:trends; D055553:Prescription Drugs / Q000191:economics*; D014481:United States
chemical_list: D055553:Prescription Drugs