Enormous Demand for Weight-Loss Drugs Drives Up Total U.S. Prescription Spending

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BETHESDA, Md., April 24, 2024 ~ According to the latest report from the American Society of Health-System Pharmacists (ASHP), spending on prescription medications in the United States saw a significant increase of 13.5% in 2023. This growth was primarily driven by the blockbuster success of weight-loss drugs, which have been marketed as diabetes treatments.

The report, titled "National Trends in Prescription Drug Expenditures and Projections for 2024," also highlighted a slight decrease in hospital drug spending as the COVID-19 pandemic came to an end and less-costly oral treatments replaced expensive remdesivir injections.

The ASHP report predicts that spending on weight-loss drugs will continue to rise as supplies catch up with the high demand. This trend is expected to escalate further with the introduction of new similar drugs and as the FDA approves these medications for more conditions. Eric Tichy, Pharm.D., M.B.A., division chair of supply chain management at Mayo Clinic and lead author of the report, stated that this growth in weight-loss drugs was the main driver behind the overall increase in prescription medication spending.

One notable finding from the report was that semaglutide, a weight-loss drug, saw a doubling in sales last year, making it the top-selling drug in the U.S. This replaced adalimumab, which is used to treat autoimmune diseases like rheumatoid arthritis and Crohn's disease. Despite the availability of less costly biosimilars, sales of adalimumab continued to grow. Additionally, tizepatide, a diabetes drug approved for weight loss late last year, saw an astounding 373% increase in spending.

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In contrast to prescription medication spending, hospital drug expenditures decreased by 1.1%. The report attributed this decrease to several factors such as a decline in expensive COVID medications usage, increased adoption of lower-cost biosimilars, and growth in the 340B program which allows some hospitals to purchase drugs at a reduced price.

Tichy commended hospitals and health systems for their efforts in managing drug expenditures, which typically make up about 10% of their budgets. He also urged pharmacy and health-system leaders to continue proactively managing drug spending and anticipating any potential disruptions.

The report also highlighted the impact of the Inflation Reduction Act, which has been in effect for two years. While it is expected to bring savings in the future, its full effect will not be felt until 2026 for retail and mail-order pharmacies and 2028 for hospitals and clinics. Tichy noted that while price negotiations required under the law may reduce prices on certain drugs, it could also lead to an increase in spending as more people use these medications.

Other key findings from the report include a 15% increase in drug expenditures in clinics due to higher usage of expensive injectable medications for cancer, immunology, and neurology. The report also noted that inflation in drug prices was lower than consumer price inflation for the fourth consecutive year, with consumer price inflation at 3.4% compared to 2.9% for drug prices.

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Daniel J. Cobaugh, Pharm.D., FAACT, DABAT, senior vice president of professional development and publishing at ASHP and editor-in-chief of AJHP (American Journal of Health-System Pharmacy), which published the report, emphasized the importance of this report for policymakers, pharmacy leaders, and hospital decision-makers. He stated that it provides valuable insights into the complex factors influencing medication costs and can inform strategic decisions about resource allocation to support appropriate use of these complex agents.

In conclusion, the ASHP's report on prescription drug expenditures highlights the significant impact of weight-loss drugs on overall spending in 2023. It also sheds light on other factors such as biosimilar uptake and inflation rates that contribute to changes in medication costs. With this information, healthcare professionals and policymakers can make informed decisions to manage drug expenditures effectively.
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