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According to new data from the National Health Expenditures (NHE), retail medicine prices declined by 1% and retail medicine spending grew just 2.5% in 2018. To put that in context, hospital spending, which continued to account for one-third of all health care spending, grew by 4.5%, and physicians and clinical services grew by 4.1%. This data, published in Health Affairs, underscores how policies that single out prescription medicine won’t fix soaring health care costs or lower out-of-pocket costs for Americans. 

Other key data points include:

  • Total patient out-of-pocket spending grew 2.8% in 2018 — faster than 2.2% in 2017.

  • Overall health care spending growth (4.6%) was driven by a 13.2% increase in the net cost of health insurance.

  • Total spending for physician and clinical services grew 4.1%, to $725.6 billion.

  • Total spending for hospitals grew 4.5%, to $1.19 trillion in 2018.

  • Hospital spending was over three and a half times more than retail medicine spending in 2018, but patients paid over $12 billion more in out-of-pocket costs for their retail medicines.

patients pay more outofpocket at pharmacey counter

Learn more at www.LetsTalkAboutCost.org.

Holly Campbell

Holly Campbell is former deputy vice president of public affairs at PhRMA focusing on the cost and value of medicines.

Holly Campbell

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ICYMI: Hospital consolidation is driving up health care costs

August 27, 2026

340B’s reality: A booming business for hospitals, pharmacies and corporate giants

June 25, 2026

A program off track: How 340B drives both hospital consolidation and system gaming

April 27, 2026

Washington Post Editorial Board says 340B has become “corporate welfare”

April 27, 2026

Hospitals drive nearly 80% of the U.S. health spending gap

March 25, 2026

Congress should look under the hood of 340B, hospitals don't want them to

March 19, 2026

340B hospitals buy low and sell high, a new analysis shows

March 12, 2026

New report from Minnesota: 340B is generating billions for big hospitals

March 9, 2026

Latest analysis from Ohio exposes growing abuses of the 340B markup program

July 7, 2025

Reimagining patient access through meaningful policy reform

November 5, 2024

New PES survey: Out-of-pocket costs lead key health care priorities ahead of the November election

October 30, 2024

Don’t put the government between patients and their medicines

August 7, 2024

The IRA could lead to higher out-of-pocket costs for 3.5 million Medicare patients in 2026

June 25, 2024

Ongoing federal probes shed light on PBM and insurer practices

May 20, 2024

WTAS: The consequences of consolidation and vertical integration

May 6, 2024

Insurance data: PBM reform has no material impact on premiums

April 24, 2024

Four years later, Maryland board still hasn’t delivered for patients

February 12, 2024

Setting the Record Straight: Comparing U.S. drug prices to those in foreign countries hurts patients

February 7, 2024

ICYMI: When middlemen get in the way, it’s the patients who lose

December 5, 2023

ICYMI: WSJ — Same Drug, Two Prices: Why the Higher Price Prevails

November 15, 2023

One year to Election Day: Four voter priorities to watch

November 6, 2023

ICYMI: Scott LaGanga and Matt Salo deliver a State of the Industry Report

October 25, 2023

ICYMI: Government watchdog report finds patients in Medicare Part D paid billions more for medicines than insurers and PBMs

September 28, 2023

Medicare Prescription Payment Plan will benefit patients if implemented correctly

September 21, 2023

By the Numbers: 340B continues to climb in profits, dwindle with patient support

September 13, 2023

New PhRMA ad exposes yet another way PBMs get between patients and their medicines

September 5, 2023

New report: Hospitals mark up medicine prices 500%

August 2, 2023

read more

August 2, 2023

Three things to know from the latest Patient Experience Survey

July 20, 2023

ICYMI: PBM exec admits choosing profits over patients

June 2, 2023

4 key facts on medicine prices and spending

May 9, 2023

4 Things to know about PhRMA’s new 50-state poll

May 4, 2023

Americans want state policymakers to lower out-of-pocket costs

May 1, 2023

Three facts about health care spending

April 25, 2023

Nonprofit hospitals fall short on community benefit, studies show

April 24, 2023

States can support access to medicine as COVID-19 Public Health Emergency ends

April 5, 2023

Arkansas puts patients first with new share the savings law

April 4, 2023

Key Trends: Patient experience data reveal how insurers and middlemen impose barriers in health care

March 29, 2023

Why Congress should prioritize fixing the 340B program

March 2, 2023

Holding pharmacy benefit managers accountable

February 23, 2023

Stopping pharmacy benefit managers from “gaming the system”

February 22, 2023

What they are saying: Nonprofit hospitals are gaming the system at the expense of patients

February 21, 2023

Senate hearing to examine bipartisan reforms to rein in middlemen

February 16, 2023

Minnesota lawmakers are letting PBMs off the hook, and threatening patients’ access to medicines

January 31, 2023

ICYMI: PhRMA kicks off the year at the 2023 J.P. Morgan Health Care Conference

January 19, 2023

340B program continues to drive shift in care to more expensive hospital settings

December 15, 2022

In their own words: Financial barriers exacerbate access challenges for insured Americans

December 8, 2022

Putting Delaware patients first: Protecting Patient Assistance Programs

November 22, 2022

New data show how insurers and middlemen shift Rx costs onto patients

November 16, 2022

In their own words: Insured Americans struggle to navigate complex coverage

October 26, 2022

Many seniors are paying more for Part D medicines than their insurer

October 18, 2022

New comments outline ways to protect patients from health plans and PBMs who profit from patient assistance

October 7, 2022

Busting 3 Myths About Copay Coupons

October 5, 2022

Mental Illness Awareness Week – A time for reflection

October 3, 2022

A key fact the White House is reluctant to admit

September 27, 2022

A key fact the White House is reluctant to admit

September 27, 2022

Navigating the patient experience: Burdens and barriers standing between patients and their care

September 12, 2022

Making coupons count for patients at the pharmacy counter

August 25, 2022

Making coupons count for patients with HIV

August 8, 2022

The Senate’s latest price setting proposal will undermine: Our health care system

July 28, 2022

The Senate’s latest price setting proposal will undermine: Patient access to medicines

July 26, 2022

Survey Says: Prescription drug prices are not fueling inflation concerns for Americans

July 22, 2022

Putting patients first at the state level — A conversation with Mark Reisenauer, President of Astellas Pharma US

July 14, 2022

Patients win as West Virginia implements first-in-nation share the savings policy

July 8, 2022

3 things voters are concerned about when it comes to their health care coverage

July 7, 2022

Copay assistance is a lifeline for patients. So why are insurers blocking it?

June 29, 2022

Patients support state action requiring PBMs and insurers to share savings and cap costs for medicines

June 16, 2022

New poll shows voters sounding the alarm on health insurance companies and PBMs

June 6, 2022

PhRMA warns of the growing influence of middlemen over patient access and out-of-pocket costs for patients

May 31, 2022

ICYMI: PhRMA COO Lori Reilly spotlights efforts to improve health care in 2022 and beyond

May 9, 2022

Study finds insurance barriers disproportionately burden patients with chronic illness

May 4, 2022

What’s really happening when it comes to prescription drug costs

April 27, 2022

5 public opinion polling trends to watch

April 22, 2022

Analysis: States can help patients save nearly $1,000 annually on their medicines

April 21, 2022

New analysis confirms hospitals markup prices for oncology therapies

April 21, 2022

How standardized plans can improve patients’ access to medicines

April 18, 2022

The patient experience: Uncovering the barriers to care for insured Americans

March 28, 2022

Correcting the record: Putting medicine costs and spending in context

March 24, 2022

Sharing rebates can save Americans with diabetes 500 each year and improve adherence

March 16, 2022

If drug prices are growing below the rate of inflation, why are patients still feeling the sting at the pharmacy?

March 8, 2022

The patient experience: Insurance barriers continue to impede access to health care, especially among the country’s underserved

February 28, 2022

340B 101: Three charts show the program maximizes hospitals’ bottom line with little consideration for patients

February 8, 2022

Medicaid 101: Three charts on access and spending

February 3, 2022

Government price setting won’t stop insurers from shifting costs to patients

February 2, 2022

New comments outline ways to counteract cost-shifting insurance trends

January 28, 2022

Patients need to pay less for their medicines. States can help.

January 26, 2022

It’s a new year, but sadly Congress is still pursuing flawed price setting policies

January 25, 2022

New poll of all 50 states and 435 Congressional Districts shows perils of so-called Medicare “negotiation”

January 25, 2022

New study finds more than half of brand medicine spending goes to the supply chain and others

January 7, 2022

Making medicines more affordable: Making insurance work like insurance

December 8, 2021

Insurance design barriers can impact patient adherence and can lead to poor health outcomes

November 23, 2021

What is missing in the current drug pricing plan

November 23, 2021

ICYMI: PhRMA CEO speaks at STAT Summit about government price setting

November 19, 2021

Making medicines more affordable: Sharing savings at the pharmacy counter

November 19, 2021

Three things to know about so-called Medicare negotiation polling

November 18, 2021

Making Medicines More Affordable: Making coupons count

November 5, 2021

What they are saying: Government price setting for medicines is not the answer

November 4, 2021

Four things to know from IQVIAs latest report

October 29, 2021

The patient experience: Insurance design hurdles lead to access issues for too many Americans

October 28, 2021

The patient experience: Out-of-pocket costs are driving patients affordability and access challenges

October 19, 2021

To drive up profits, hospitals continue unnecessary medicine mark-ups, burdening patients, employers and health care system

October 14, 2021

New report shows 3 in 10 Americans that have insurance still face a financial barrier to care

October 7, 2021

Industry leaders discuss the impact of the drug pricing debate

September 23, 2021

Five reasons tying VA prices to Medicare Part D misses the mark

September 22, 2021

America’s biopharmaceutical companies to Congress: Government “negotiation” is the wrong approach

September 15, 2021

ICYMI: Event spotlights how we can make Medicare work better for patients

August 4, 2021

The future of the rebate rule: Will policymakers stand with patients?

August 2, 2021

Celebrating Medicare’s 56th anniversary

July 30, 2021

340B hospitals among those that provide lowest levels of community benefit across the country

July 27, 2021

3 factors impacting medication adherence for patients with diabetes

July 20, 2021

New reports shed light on key facts about medicines and affordability

June 8, 2021

Out-of-pocket trends in Medicare Part D show rising costs for seniors

May 24, 2021

Study finds nearly half of payers believe innovative contracts can lead to lower patient out-of-pocket costs

May 17, 2021

New data from insurers show detriments of copay accumulator adjustment programs

April 28, 2021

West Virginia becomes the first state to lower patient costs by sharing the savings

April 20, 2021

Getting the 340B program back on track in 2021

March 10, 2021

Nearly 40% of commercially insured patients face half their annual out-of-pocket expenses from just one health care encounter

March 2, 2021

Top five issues voters want addressed in the administration’s first 100 days

February 18, 2021

Insurers shift medicine costs to patients with severe chronic illnesses

February 1, 2021

The latest misleading “poll” on drug pricing

January 28, 2021

The new Administration should reconsider a recent HHS rule that could negatively impact patient access and affordability

January 27, 2021

Election insights: Common ground areas to address Americans’ health care concerns

January 26, 2021

New insulin report highlights how incentives benefit middlemen, harm patients

January 22, 2021

Key facts: The final rebate rule will be a positive change for patients

January 19, 2021

New data show retail medicine prices fell in 2019

January 13, 2021

Correcting the record: Biopharmaceutical companies remain committed to the 340B program and helping patients

December 17, 2020

Election insights: Voter priorities in the states

December 17, 2020

Insights from the election: Meeting voters where they are on health care

December 15, 2020

Fact Check: How hospitals continue to drive health care spending

December 3, 2020

Final rebate rule represents right way to change Medicare

December 1, 2020

Accumulator adjustment programs lead to surprise out-of-pocket costs and nonadherence, analysis finds

November 19, 2020

Deep dive: The issues that drove the 2020 vote

November 13, 2020

Voters want to address the real drivers of health care costs for patients and the system

November 2, 2020

340B hospitals and for-profit pharmacies generating significant revenue from program meant to help needy patients

October 23, 2020

Study finds biopharmaceutical innovation is responsible for 35% of the increase in life expectancy from 1990 to 2015

October 21, 2020

Survey found insurance premiums grew faster than inflation in 2020

October 20, 2020

Study finds middlemen excluded nearly 850 medicines from formularies this year

September 17, 2020

Recent administration actions undermine patient assistance programs

September 16, 2020

Manufacturer cost-sharing assistance programs can save chronically ill patients hundreds to thousands of dollars annually

August 19, 2020

Commercial health plans have increased patients’ out-of-pocket costs by over 50% in some therapeutic areas

August 12, 2020

Commercial health plans transition from copays to coinsurance and deductibles has increased patient out-of-pocket costs

August 6, 2020

Four things to know about the IQVIA “Medicine Spending and Affordability in the U.S.” report

August 5, 2020

New data show commercially insured patients face increasingly high cost sharing for brand medicines

July 30, 2020

Payers subject 80% of new RA and MS patients to utilization management restrictions

July 22, 2020

Study finds the pharmaceutical industry retains a smaller share of revenue than research-intensive industries

July 14, 2020

ICYMI: Pharmacy benefit managers increasingly exclude medicines from formularies, restricting patient access

June 1, 2020

New rule makes it harder for patients to lower their out-of-pocket costs

May 20, 2020

ICYMI: Patients saved nearly $800,000 out of pocket through innovative contracting arrangements

April 20, 2020

Retail medicine spending to remain stable share of overall health care spending through next decade

April 16, 2020

PhRMA comments on HHS proposed rule on manufacturer cost-sharing assistance and accumulator adjustment programs

March 3, 2020

Addressing barriers that inhibit value-based contracts

February 21, 2020

Fact Check: HCCI analysis overstates medicine spending and prices

February 19, 2020

Cancer medicines cost twice as much at hospitals, study finds

January 21, 2020

New GAO report: Some hospitals participating in 340B may not be eligible for the program

January 14, 2020

Nearly 50% of brand medicine spending goes to the supply chain and others

January 9, 2020

Guest post: Sharing discounts and rebates is the right thing to do

October 21, 2019

More evidence that medicine prices are growing at slowest rate in decades

October 4, 2019

The truth about the marketing and promotion of medicines

October 3, 2019

Survey shows out-of-pocket costs top health care concern for voters

October 2, 2019

Four reasons why the radical Pelosi Plan is the wrong approach

September 24, 2019

Hospitals make 9 times more than physicians’ offices on provider-administered medicines

September 10, 2019

340B Spotlight: How for-profit middlemen are taking advantage of a program meant to support nonprofit entities and patients

August 20, 2019

Three things to know about the Part D GAO report

August 16, 2019

Four states adopt first-in-the-nation laws to protect patients from surprise insurer practices

July 15, 2019

New Let’s Talk About Cost TV ad asks: Why aren’t patients sharing in savings at the pharmacy counter?

July 9, 2019

Study finds hospitals continue to mark up medicines up to 500% of their cost

July 9, 2019

Three reasons why the latest Rx Savings Solutions analysis is misleading

July 2, 2019

How the rebate rule would help reduce patients’ out-of-pocket costs

June 3, 2019

Fresh data show, yet again, 340B is growing while charity care dwindles at many 340B hospitals

May 16, 2019

Ask About Adherence: OIG proposed rule to reform the rebate system could improve adherence

May 15, 2019

New study finds hospitals continue to push patients to costlier outpatient settings

May 13, 2019

4 Things to know about the IQVIA “Medicine Use and Spending” report

May 9, 2019

Six policy solutions to help patients afford their insulin

April 9, 2019

PhRMA comments on OIG proposed rule to reform the rebate system

April 8, 2019

340B continues to drive shift in site of care for physician-administered medicines to more expensive hospital settings

April 5, 2019

Five key facts about the market for insulins

April 1, 2019

OIG proposed rule could help strengthen the Part D market

March 28, 2019

Rebate rule would help ensure seniors with diabetes don’t pay more for their medicine than their insurer

March 25, 2019

The PBM story you haven’t heard: Hidden fees quadrupled in two years

March 20, 2019

OptumRX: Sharing rebates with patients is “worth it”

March 18, 2019

New data show how sharing negotiated discounts could save certain patients hundreds of dollars at the pharmacy counter

February 25, 2019

What you need to know about the new NHE health spending projections

February 22, 2019

New study shows why insurers should share rebates with Medicare Part D beneficiaries on a mandatory basis

February 14, 2019

New IQVIA data show medicine prices grew just 1.5 percent in 2018

January 29, 2019

Health Affairs study misses the mark on medicine costs

January 28, 2019

New whitepaper identifies limitations in using ICER’s “potential budget impact” work to guide private payer budget decisions

January 18, 2019

New government data show medicine price growth continues to decline

January 18, 2019

10 things you should know about medicine spending and costs

January 2, 2019

New study finds hospitals prescribe more medicines, and more expensive medicines, after joining 340B program

December 18, 2018

Six key facts about the market for insulins

December 17, 2018

Americans want to know more than just the list price of a medicine—and we’re answering their call

October 15, 2018

What they are saying: PhRMA member executives on industry’s new approach to DTC television advertising

October 15, 2018

Coupons allow patients to remain on medicines in spite of high cost sharing and deductibles

October 4, 2018

Experts agree: the Bipartisan Budget Act changes to Medicare Part D jeopardize the program

September 24, 2018

What if a couple of small fixes could protect seniors in the donut hole and save them money on out-of-pocket costs?

September 13, 2018

New study finds some hospitals mark up medicine prices at least 700 percent

September 5, 2018

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