Prescription drug spending in the United States rose by 10.2% to nearly $806 billion last year, thanks in part to the popularity of GLP weight-loss drugs. GLP-1s are now the top drug category by total spending and the fastest-growing segment in the market, according to the report from the American Society of Health-System Pharmacists.
Looking ahead to 2025, researchers caution that proposed U.S. tariffs on pharmaceutical ingredients and components, especially those sourced from China, could exacerbate shortages and push patients toward more-expensive brand-name alternatives.
“GLP-1s are transforming how we treat metabolic disease, but their rise coincides with growing concerns about supply chain vulnerability,” said Eric Tichy, PharmD, MBA, lead author of the report and division chair of supply chain management at Mayo Clinic. “Tariff-related cost increases could hit the most cost-effective drugs the hardest and ultimately affect hospitals, clinics and patients who depend on affordable generics.”
Among the highlights of the report:
- Clinic drug spending rose by 14.4% to $158.2 billion, while nonfederal hospitals saw a more modest 4.9% increase to $39 billion. With GLP-1 shortage issue largely resolved, continued growth in this category is expected, although direct-to-consumer channels may complicate efforts to track usage trends.
- Overall U.S. drug spending is projected to increase by between 9% and 11% in 2025, with clinic expenditures rising from 11% to 13% and hospital spending growing between 2% and 4%.
- Oncology spending continues to grow at a double-digit pace, driven by the introduction of new high-cost drugs and broader application of existing therapies.
- Vaccine expenditures have declined post-pandemic, even with new vaccine products on the market. This trend may continue because of growing antivaccine sentiment.
- New generics and biosimilars may help moderate overall spending growth by providing lower-cost alternatives as key patents — including for Entresto, a widely used heart failure drug – expire.
“As medication spending continues to shape the financial and operational realities of health care, this report, along with the American Journal of Health-System Pharmacy’s quarterly medication pipeline updates, offers pharmacy and health-system leaders the insights they need for effective planning,” said Daniel J. Cobaugh, PharmD, senior vice president of professional development and publishing at ASHP. “It brings clarity to complex trends and supports informed, forward-looking decision making.”