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By Bill Berkrot
April 15 (Reuters) - Americans used more health services andspent more on prescription drugs in 2013, reversing a recenttrend, though greater use of cheaper generic drugs helpedcontrol spending, according to a report issued on Tuesday by aleading healthcare information company.
Spending on medicines rose 3.2 percent in the United Stateslast year to $329.2 billion. While that was far less than thedouble-digit increases seen in previous decades, it was arebound from a 1 percent decline in 2012, the report by IMSHealth Holdings Inc. found.
Among factors driving the increased spending were the costof new medicines, price increases on some branded drugs, a $10billion reduced impact of patent expirations compared with 2012,and the first rise in the use of healthcare services in threeyears, IMS found.
IMS compiles and provides data on prescription drug use andtrends for the pharmaceutical and healthcare industry.
The relatively small spending increase was helped in part bygreater use of cheap generic drugs, which edged up to 86 percentof all prescriptions filled in the United States from 84 percentin 2012, despite fewer major new generic drug introductionscompared with the impact seen in 2012.
Healthcare utilization was up across the board, with risesin doctor office visits, hospitalizations and volume ofprescriptions filled, IMS said.
The increased use of healthcare services does not reflectthose newly insured under the Affordable Care Act and Medicaidexpansion, which did not fully kick in until this year. But itcould be reflective of declines in unemployment, with morepeople gaining employer-based health insurance, and recent gainsin consumer confidence.
"The recession was officially over a long time ago, but whathas taken a much longer time is for the (healthcare services)demand to recover," Michael Kleinrock, director of researchdevelopment for IMS Institute for Healthcare Informatics, saidin a telephone interview.
"In late fall of 2012, we started to see a beginning of therecovery in terms of new therapy starts," Kleinrock said.
New medicines for cancer, hepatitis C, multiple sclerosis,diabetes and rare diseases has led to a shift in some patientspending tendencies, the report found.
Patients gained access to 36 novel new medicines in 2013,including a record 17 so-called orphan drugs that treat smallpatient populations at typically very high cost.
"We saw patients see more specialists than primary care forthe first time," Kleinrock said. "Incurring a primary care visitco-pay in order to be referred to see a specialist certainlydoesn't feel like value for money, so many patients may be selfreferring," he suggested.
Those trends could well continue over the next two years asseveral promising new cancer drugs come to market, as well asnew oral hepatitis C treatments with extremely high cure ratesand few side effects.
The first of those hepatitis drugs, Sovaldi, from GileadSciences Inc, has led to intense criticism for itsprice tag of about $84,000 for a 12-week course of treatment.
"It's interesting to see the debate about cost when you'recuring a disease which has much more overall cost," saidKleinrock, referring to the cost of treating liver cancer ortransplants if the hepatitis progresses without treatment.
While the overall number of hospitalizations increased, emergency room visits that turn into in-patient admissionsdeclined dramatically, by 14.6 percent, IMS found.
That could point to continued use of high-cost emergencyservices for non-emergency primary care for many people.
On that front, Kleinrock said, "We noted, that perhapsthere's still some work to do." (Reporting by Bill Berkrot; Editing by Leslie Adler)
