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JAMES M. HOFFMAN, PHARM..D., M.S., BCPS, is Medication Outcomes. and Safety Officer, Pharmaceutical Department, St. Jude Children’s Research Hospital, Memphis, TN, and Assistant Professor, Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center, Memphis. NILAY D. SHAH, PH.D., B.S.PHARM., is Assistant Professor of Health Services Research, Division of Health Care Policy and Research, Mayo Clinic College of Medicine, Rochester, MN, and Associate Consultant, Mayo Clinic, Rochester. LEE C. VERMEULEN, M.S., FCCP, is Director, Center for Drug Policy, University of Wisconsin Hospital and Clinics (UWHC), Madison, and Clinical Associate Professor, School of Pharmacy, University of Wisconsin—Madison, Madison. FRED DOLORESCO, PHARM.D., M.S., is Clinical Assistant Professor, Department of Pharmacy Practice, School of Pharmacy, and Research Assistant Professor HS, Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY. PATRICK K. MARTIN, PHARM.D., is Administrative Pharmacy Resident, UWHC. SHARON BLAKE, B.A., is Senior Product Manager, Commercial Measurement; LINDA MATUSIAK, B.A., is Senior Data Analyst; and ROBERT J. HUNKLER, M.B.A., is Director, Professional Relations, IMS Health, Plymouth Meeting, PA. GLEN T. SCHUMOCK, PHARM.D., M.B.A., FCCP, is Associate Professor, and Director, Center for Pharmacoeconomic Research, College of Pharmacy, University of Illinois—Chicago, Chicago.

Address correspondence to Mr. Vermeulen at the University of Wisconsin Hospital and Clinics, 600 Highland Avenue, M/C 9475, Madison, WI 53792 (lc.vermeulen{at}hosp.wisc.edu).

Purpose. Drug expenditure trends in 2007 and 2008, projected drug expenditures for 2009, and factors likely to influence drug expenditures are discussed. Summary. Various factors are likely to influence drug expenditures in 2009, including drugs in development, the diffusion of new drugs, drug safety concerns, generic drugs, Medicare Part D, and changes in the drug supply chain. The increasing availability of important generic drugs and drug safety concerns continue to moderate growth in drug expenditures. The drug supply chain remains dynamic and may influence drug expenditures, particularly in specialized therapeutic areas. Initial data suggest that the Medicare Part D benefit has influenced drug expenditures, but the ultimate impact of the benefit on drug expenditures remains unclear. From 2006 to 2007, total U.S. drug expenditures increased by 4.0%, with total spending rising from $276 billion to $287 billion. Drug expenditures in clinics continue to grow more rapidly than in other settings, with a 9.9% increase from 2006 to 2007. Hospital drug expenditures increased at a moderate rate of only 1.6% from 2006 to 2007; through the first nine months of 2008, hospital drug expenditures increased by only 2.8% compared with the same period in 2007. Conclusion. In 2009, we project a 0–2% increase in drug expenditures in outpatient settings, a 1–3% increase in expenditures for clinic-administered drugs, and a 1–3% increase in hospital drug expenditures. Index terms: Costs; Drugs; Economics; Health-benefit programs; Pharmacy, institutional, hospital; Product development; Toxicity

 

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