Growth in prescription spending has slowed again in 2016… — Kaiser Family Foundation, January 2018
Spending on Prescription Medicines Remains Stable Drug spending growth slower than other health care services in 2016.
4.3%
4.7%
Major pharmacy benefits managers all report stable drug prices for commercial plans in 2017.
5.4% 0.2%
0.8%
U.S. spending on prescription drugs as a share of total health care dollars is similar to other developed countries.
12%
13%
13%
Germany
France
14%
1.3% -3.4% U.S.
Overall Health Care
Physician Services
Hospital Services
Retail Prescription Drugs
CVS Health (Caremark)
Prime Therapeutics
Express Scripts
Source: Centers for Medicare & Medicaid Services, December 2017
Canada
Source: OECD estimates of retail prescription drug spending, 2015
Prescription Drugs Are Not the Primary Drivers of Health Care Spending For every $1 spent on health care in the U.S., just 14¢ is spent on prescription drugs.
The drivers of health care spending are payments to hospitals and doctors, which are expected to grow by $1.1 trillion over the next decade — more than four times greater than the growth in prescription drug spending. Projected National Health Care Spending
Prescription Drugs
14%
38%
18%
30%
Physicians and Clinical Services
Billions of Dollars
Other services, such as home health care, nursing care facilities, etc.
Source: BIO Analysis of Altarum Institute data, December 2017; Prescription drugs include both retail & physician-administered drugs
Note: Some physician-administered drugs are included in hospital and physician spending, which today is 3–5% of national health spending. Source: CMS, National Health Expenditure Projections 2017–2026
drugcostfacts.org
The Role of Competition and Low-Cost Generic Drugs in the Health Care System Generic Share of Total Prescriptions Dispensed in the U.S.
89%
Increasing Competition Leads to Consumer Savings Competition in the market and expiring patents produce substantial savings on prescription drugs. In fact, new competition from generic and biosimilar drugs will reduce prescription drug spending by $143.5 billion (between 2017 and 2021). Patent Expirations Driving Savings in Prescription Drugs Over Next Five Years
UK 83%
Germany 81%
Canada 73%
OEDC 52%
France 30%
Japan 34%
Source: OECD Health Statistics 2017
Billions of Dollars Saved
Source: 2017 Association for Accessible Medicines Generic Drug Access & Savings in the U.S. report
$40 $35 $30 $25 $20 $15 $10 $5
$143.5B $37.3 $30.6
$27.4
$26.9 $21.2
2017
2018
2019
2020
2021
Source: IQVIA, “Outlook for Global Medicines through 2021
How Hospitals and Insurers Impact Patients’ Prescription Drug Costs Hospitals mark up the cost of medicines — significantly
Insurers require patients to pay almost 5x more out of pocket for prescription drugs than for hospital care
500%
14%
BEFORE
price negotiations with payers
250%
Out of Pocket Ratio*
Average markup of drugs by hospitals
3%
Average markup of drugs by hospitals
AFTER
price negotiations with payers Source: Analysis by the Moran Company of 20 medicines from a range of therapeutic classes, October 2017
Prescription Drugs
Hospital Care
*Out-of-pocket expenditures divided by total expenditures Source: Centers for Medicare & Medicaid Services, National Health Expenditure Data, 2017
May 10, 2018 - which today is 3â5% of national health spending. Other services, such as home ... Source: IQVIA, âOutlook for Global Medicines through 2021.
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