为了加快文章的出版，AJHP会在接受后尽快在网上发布手稿。这些手稿已经经过同行评审和编辑，但在技术格式化和作者校对之前发布。这些手稿不是最终版本，将在稍后用最终文章（根据AJHP风格进行格式化和作者校对）替换。 为了报告药品开支的历史模式、确定可能影响未来支出的因素，并预测2023年美国药品支出的增长，重点关注非联邦医院和诊所部门。通过检查使用IQVIA国家销售透视数据库的制药商的药品购买数据来评估历史模式。审查可能影响2023年医院和诊所药品支出的因素，包括新药批准、专利到期和潜在的新政策或立法。对生物类似药、癌症药物、糖尿病药物、仿制药、COVID-19疫情影响和特殊药物进行了重点分析。对于非联邦医院、诊所和总体（所有部门），2023年药品开支的增长估计是基于定量分析和专家意见的组合。 2022年，美国总体药品支出同比增长9.4％，达到6335亿美元。使用情况（增长5.9％）、价格（增长1.7％）和新药（增长1.8％）推动了这一增长。阿达木单抗是2022年销售最好的药物，其次是塞格露肽和阿比西酮。非联邦医院和诊所的药品开支分别为372亿美元（下降5.9％）和1169亿美元（增长10.4％）。在诊所中，新产品和使用增长推动了增长，价格变化的影响较小。在非联邦医院中，使用量下降导致支出下降，而价格变化和新药则促进了支出的增长。预计2023年将批准或预计批准一些影响支出的新药。专科和癌症药物将继续推动支出，随着COVID-19疫情的发展而逐步演变。 对于2023年，我们预计总体处方药支出将增长6.0％至8.0％，而在诊所和医院，我们预计相对于2022年增长8.0％至10.0％和1.0％至3.0％。由于影响实际支出的众多本地因素，这些未来药品支出增长的全国估计可能不代表任何特定的卫生系统。 ©2023年美国医院药剂师协会。版权所有。如需使用，请发送电子邮件至：journals.permissions@oup.com。

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.To report historical patterns of pharmaceutical expenditures, to identify factors that may influence future spending, and to predict growth in drug spending in 2023 in the United States, with a focus on the nonfederal hospital and clinic sectors.Historical patterns were assessed by examining data on drug purchases from manufacturers using the IQVIA National Sales Perspectives database. Factors that may influence drug spending in hospitals and clinics in 2023 were reviewed, including new drug approvals, patent expirations, and potential new policies or legislation. Focused analyses were conducted for biosimilars, cancer drugs, diabetes medications, generics, COVID-19 pandemic influence, and specialty drugs. For nonfederal hospitals, clinics, and overall (all sectors), estimates of growth of pharmaceutical expenditures in 2023 were based on a combination of quantitative analyses and expert opinion.In 2022, overall pharmaceutical expenditures in the US grew 9.4% compared to 2021, for a total of $633.5 billion. Utilization (a 5.9% increase), price (a 1.7% increase) and new drugs (a 1.8% increase) drove this increase. Adalimumab was the top-selling drug in 2022, followed by semaglutide and apixaban. Drug expenditures were $37.2 billion (a 5.9% decrease) and $116.9 billion (a 10.4% increase) in nonfederal hospitals and clinics, respectively. In clinics, new products and increased utilization growth drove growth, with a small impact from price changes. In nonfederal hospitals, a drop in utilization led to a decrease in expenditures, with price changes and new drugs contributing to growth in spending. Several new drugs that will influence spending have been or are expected to be approved in 2023. Specialty and cancer drugs will continue to drive expenditures along with the evolution of the COVID-19 pandemic.For 2023, we expect overall prescription drug spending to rise by 6.0% to 8.0%, whereas in clinics and hospitals we anticipate increases of 8.0% to 10.0% and 1.0% to 3.0%, respectively, compared to 2022. These national estimates of future pharmaceutical expenditure growth may not be representative of any particular health system because of the myriad of local factors that influence actual spending.© American Society of Health-System Pharmacists 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.