Total US spending on medicines rose 1% on a real per-capita basis in 2013, and the use of healthcare services overall rose for the first time in three years, the IMS Institute for Healthcare Informatics has reported.

Total US spending on medications reached $329.2 billion last year, up 3.2% and a rebound from the 1% decline seen 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 drug spending compared to $29 billion in 2012, but at the same time, 36 New Molecular Entities (NMEs) were launched last year, the largest number in a decade and focused on specific disease areas including oncology, hepatitis C and HIV.

US patients filled an average of over 12 retail prescriptions last year, up nearly 2% on 2012, while those aged 65 and over filled an average 28 prescriptions, a slight drop on the previous year.

While drug spending levels have contributed to slower growth in US healthcare costs since 2007, nominal spending rose sharply last year, and the largest single driver of the 4.2 percentage-points shift in spending growth for the year was the $10 billion lower impact of patent expiries, IMS reports. 

Price increases for branded drugs added $4 billion more in spending growth compared to 2012, but net price growth was essentially flat year-on-year, reflecting off-invoice discounts and rebates. 

Overall spending on medicines remained concentrated in traditional small-molecule pills dispensed through retail pharmacies, but higher growth was seen for biologics and specialty drugs, particularly in retail and mail-order settings, the study shows.

Last year also saw transformations in disease treatment, with US patients gaining access to 36 NMEs including 10 new notable cancer treatments – the most in more than a decade, says IMS.  A total of 27 new oncology drugs have been launched in the US in the past three years, while clusters of innovation are transforming patient care in hepatitis C, multiple sclerosis, diabetes, stroke and acute coronary syndrome.

In addition to improved patient outcomes, these and other transformational treatments bring with them a shift in where costs are being incurred in the US healthcare system, yielding the promise of fewer doctor’s office visits, less hospitalisations and reduced use of long-term care facilities, it adds.

Moreover, 17 orphan drugs were launched in 2013, the most in any year since the Orphan Drug Act passed in 1983, and the next decade promises a much faster approval process for drugs gaining the Food and Drug Administration (FDA)’s new Breakthrough Therapy Designation, IMS forecasts.