A new report shows how medication use is expanding and changing.
Prescription medications are vital to improving and/or maintaining the health of millions of Americans and their use continues to grow, along with patient spending on them. The IQVIA Institute for Human Data Science recently issued a report tracking medicine use and spending over the last few years. Data in this slideshow are taken from that report.
Dispensing statistics in 2018
5.8 billion prescriptions were dispensed in 2018, a 2.7 percent increase over 2017.
7.5 million patients began new medication therapies in 2018, a 40 percent increase over 2017.
Total patient out-of-pocket costs for medications (excluding coupons) were about $61 billion in 2018.
The volume of opioids prescribed in 2018, measured in morphine milligram equivalents (MMEs), dropped by 17%, due largely to changes in regulations and clinical guidelines and increased public awareness of opioid addiction.
Trends in prescription medication usage
The top 10 traditional therapy areas (e.g., antihypertensives, mental health, pain) made up 97.8 percent of prescriptions in 2018.
Prescription adherence rates rose across all geographic regions and types of payers (Medicare, Medicaid, commercial) between 2016 and 2018.
Prescriptions for specialty medications-used to treat chronic, complex or rare diseases-increased by 5 percent to 127 million between 2017 and 2018.
The overall rate of generic dispensing, where it’s possible to do so, has been at 97 percent since 2013.
Medicine spending and growth dynamics
In 2018, spending on medicine grew by 4.5 percent after accounting for off-invoice discounts and rebates, while spending at the invoice level increased by 5.7 percent.
Per-capita spending on medicine has grown by $44 since 2009, after adjusting for population growth and inflation.
Spending on new drug brands was $11 billion in 2018, compared with $12 billion in 2017. Spending in 2018 reflected the launch and uptake of about 60 new active substances.
Net spending on biologics was $125.5 billion in 2018, a 9.5% increase over 2017.
Opioid prescribing and use
The volume of opioids prescribed dropped by 29.2 billion MMEs in 2018, or 17.1 percent, the largest single-year decline ever.
The number of annual opioid prescriptions declined from 244.5 million to 169 million between 2014 and 2018, while medication-assisted treatments increased from 11 million to 16.2 million.
Adult per-capita MME use peaked at 768 in 2011, and has since declined to 432 MMEs.
Prescription drug monitoring programs are now in place in 49 states, which has significantly limited prescribing of high doses of opioids.
Patient out-of-pocket costs
Overall out-of-pocket costs rose by 3.3 percent in 2018, from $59 billion to $61 billion.
8.8 percent of all insured patients pay more than $500 in out-of-pocket costs for prescription medications annually, but among those covered by Medicare 19.8 percent pay that amount.
Coupon spending among patients with commercial insurance was $13 billion in 2018, an all-time high and an 18 percent increase over the previous year.
The final average out-of-pocket costs, including brand-name drugs and generics, was $9.05 in 2018, compared with $9.28 in 2017.
Outlook to 2023
Net total spending on medicines is expected to be in the range of $405 billion-$435 billion.
Net total spending growth will average between 3% and 6%.
The number of expiring patents on medications will steadily increase, peaking in 2023 when protected brands will lose $33 billion due to patent expirations and associated competition.