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Health spending up after years of self-rationing IMS Health

Health spending up after years of 'self-rationing,' report finds

By Andis Robeznieks
Posted: April 15, 2014 - 3:45 pm ET

Patients are returning to the healthcare system after “several years of self-rationing,” as reflected in a 3.2% increase in 2013 prescription-drug expenditures to $329.2 billion, according to a new report.

Physician office visits, hospital encounters and filled prescriptions all increased in 2013, the IMS Institute for Healthcare Informatics, a Parsippany, N.J.-based division of data analytics consultant IMS Health, said in a new report.

The primary reason for last year's healthcare-spending increase was the low number of drug-patent terminations, which contributed to a more than $4 billion increase in spending on brand-name drugs, the report stated. Overall, the lower number of patent terminations had a $10 billion impact on spending, it said.

Nevertheless, overall health spending is still down. “Growth in medicine spending remains at historically low levels, despite a significant uptick last year, and continues to contribute to the bending of the healthcare cost curve,” Murray Aitken, executive director of the IMS Institute for Healthcare Informatics, said in a news release.

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Price increases on protected brands accounted for $20 billion in spending growth, compared to $15.6 billion in 2012, according to the report. Though prices rose, the increases appeared to be offset by off-invoice discounts and rebates, which resulted in an overall price increase of 1%. Spending on generic drugs increased $5.8 billion and accounted for 86% of dispensed prescriptions.

These spending fluctuations were not a result of any government initiative, IMS researchers concluded. Rather, they were just “a reflection of cyclical patterns of patent expiries.”

The report cited specialty treatments for oncology, hepatitis C, HIV and other autoimmune diseases as accounting for $73 billion in spending—an increase of 11%. On the primary-care side, the report found that spending on diabetes medicines also grew by 11% to $37 billion.

For the first time, the majority of office visits were attributed to specialty physicians rather than primary-care doctors, the report noted.

The number of physician-office visits increased 2.7%, the first increase in four years, but still 8% below the level seen in 2008. This total reflected a 4.9% increase in the number of visits to specialists and a 0.7% decrease in visits to primary-care doctors.

Among senior citizens age 65 and older, physician-office visits increased 6.7% overall, with a 9.5% increase in visits to specialists and a 2.6% increase in visits to primary-care providers, according to December 2013 data taken from the IMS Institute for Healthcare Informatics' National Disease and Therapeutic Index.

For adults ages 26-64, physician office visits increased 2.2% with a 5.9% increase in specialist visits, but a 2.1% decrease in primary-care visits. For younger adults, ages 19-25, overall physician visits increased 1%, with a 3.4% increase in visits to specialists and a 2.7% decrease in primary-care visits.

Hospital-based encounters—including inpatient admissions, outpatient visits and emergency department utilization—increased 2.6%, according to the report. Hospital outpatient visits increased by almost 3.3% to 412 million in 2013, up from 399 million in 2012. Those 2013 outpatient visits came from 281 million patients with commercial insurance, 69 million Medicaid enrollees and 62 million Medicare beneficiaries.

The report, using information culled from several IMS databases, excluded over-the-counter drugs and flu shots, but examined prescription-drug spending, as well as insulin products which don't require a prescription.

Follow Andis Robeznieks on Twitter: @MHARobeznieks

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