Drug costs are set to rise 3%-5% in all US healthcare settings this year, driven by factors including fewer new generics coming to market, say new forecasts.

Prescription drugs account for around 11% of total US healthcare costs, and spending on these products has lessened in recent years, dropping 0.7% to around $326 billion in the year ending September 30 2013 compared with 2012, according to a new study, which has been published online ahead of print by the American Journal of Health-System Pharmacy (AJHP).

However, the authors expect a reversal of this trend in 2014, forecasting a 3%-5% increase in drug spending across all settings, with a 5%-7% rise in expenditures for clinic-administered drugs and a 1%-3% increase in hospital drug spending.

These increases are influenced by a variety of factors, say the authors. Using data from IMS Health, they report higher drug spending for clinics and non-federal hospitals (up 4.5% and 1.8%, respectively) in 2013 relative to 2012, but 13.7% lower spending for federal facilities, and also for long-term care (-4.2%), mail-order (-1.9%) and retail pharmacy (-0.3%) sectors.

They also report changes in expenditures for specific medications, drug classes and therapeutic categories, including:

- a significant decrease in spending across all settings for oxycodone;

- a notable increase in spending for influenza vaccines in the clinic setting, which they suggest may be due to new vaccine formulations and vaccination recommendations; 

- Alteplase and pegfilgrastim topping the list of fast-growing drugs in terms of hospital expenditures;

- a decrease in the growth rate for spending on anti-cancer drugs from 2012 to 2013, although these medicines still represent the top expenditure for hospitals and clinics: and

- changes in the availability of generic drugs, with fewer first-time generics expected to reach the market in 2014.

The authors also expect few of the new drug approvals anticipated this year to result in major expenditures by hospitals and clinics, but say that expansion of access to healthcare and other changes related to the Affordable Care Act (ACA), as well as continued improvement in the US economy, may drive growth in pharmaceutical spending over the next 12-24 months.

Author Professor Glen Shumock of the College of Pharmacy at the University of Chicago, Illinois, said the study findings indicate “a clear reversal of the downward growth in prescription drug expenditures we have seen over the last several years.”

“Drug expenditure trends will remain dynamic, and so health systems will need to carefully monitor local drug use patterns,” he advises.