A relative success story in the battle to limit health spending growth is the prescription drug category, which a few years ago was a major source of concern. A report from IMS on drug use and costs in 2012 suggests that use of drugs and cost remain stable. (IMS Report) Overall prescription drug spending was about $326 billion in 2012, which was down about 1%. There were about 1.2% more prescriptions filled, but on a per capita basis this was down .1%, while the cost of an average prescription was constrained by continuing use of generics and lower branded drug price increases, combining for a 3.5% decline in per capita drug spending. Branding spending fell to $230 billion, but new specialty drug brands continue to grow and contribute heavily to overall branded spending, and the pipeline largely consists of these drugs. The top five drug classes were oncology at $26 billion, mental health at $23.5 billion, respiratory at $22 billion, diabetes at $22 billion and pain at $18 billion. Patient cost sharing, primarily in the form of higher deductibles, continues to increase, and may have an effect on patient use of a variety of health services. Although cost sharing has gone up, 72% of prescriptions cost patients 10% or less. Other categories of utilization showed little growth; office visits rose less than 1% on a per capita basis, non emergency hospitalizations declined by .5%, while ER visits rose by 5.8%. The drops in utilization may raise concerns about whether patients are deferring needed care or just avoiding inappropriate visits.
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