This annual report provides a comprehensive analysis of medicine use, spending, and access trends in the United States. It shows that overall spending growth remains moderate despite continued innovation, driven by brand competition, generics, and biosimilars. Specialty medicines account for a growing share of spending but serve relatively small patient populations. The report highlights shifts in care delivery, including increased outpatient and home-based care, pandemic-related disruptions, and persistent affordability challenges for certain patient groups. It emphasizes that list prices do not reflect net costs and that most patients experience stable or declining out-of-pocket expenses.

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