Eric M. Tichy · American Journal of Health-System Pharmacy 2025 · retrospective database analysis and forecasting study · n=?

National trends in prescription drug expenditures and projections for 2025

Cited 16 times in the scientific literature.

Level 4 - case-series / case-control

Level is by design analogy, not clinical CEBM (retrospective aggregated sales database analysis and expert forecasting).

OpenAlex W4409665036 · doi:10.1093/ajhp/zxaf092 · record verified 2026-08-27

What was done

Historical drug purchase patterns in the United States were evaluated using the IQVIA National Sales Perspectives database, with focused assessments on biosimilars, oncology, endocrine, generic, specialty drugs, and vaccines. Pharmaceutical expenditure growth for 2024 and forward-looking projections for 2025 across nonfederal hospitals, clinics, and all sectors combined were estimated using quantitative analyses and expert opinion.

What was found

In 2024, total US pharmaceutical expenditures increased by 10.2% compared to 2023, totaling $805.9 billion. This increase was driven by increased utilization (+7.9%) and new drugs (+2.5%), while prices fell slightly (-0.2%). Semaglutide was the top drug by spending, followed by tirzepatide and adalimumab. Drug spending was $39.0 billion (+4.9%) in nonfederal hospitals and $158.2 billion (+14.4%) in clinics. For 2025, overall US prescription drug spending is projected to grow by 9.0% to 11.0%, clinic spending by 11.0% to 13.0%, and nonfederal hospital spending by 2.0% to 4.0%.

Why it matters

This paper provides national spending benchmarks and short-term forecasts that assist hospital and health-system leaders in budgeting, highlighting substantial growth in clinic-administered therapies and metabolic medications.

Limits

The abstract reports aggregate purchasing data from a proprietary database without patient-level details or exact sample sizes. Projections for 2025 rely partially on expert opinion and policy assumptions, and national expenditure figures may not reflect individual health system dynamics.

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