Medical pharmacy in 2027
A 2027 research agenda for biologics, treatment mix and the place where care happens.
An infused therapy and a prescription filled at a pharmacy can appear in different parts of the spending accounts. A forecast needs to follow both.
The federal baseline projects $587.6 billion in retail prescription spending in 2027. That figure is useful, but it does not represent the entire drug market. Medicines supplied by hospitals and physicians are counted within those service categories.
For this series, medical pharmacy means drugs administered by clinicians and paid through the medical benefit. The next analysis would examine where spending changes as more people receive treatment, the therapies they receive change, or treatment moves between settings.
Three questions for 2027.
Which therapies are reaching more patients?
Track use and spending by drug and therapeutic area. Separate new patients, treatment duration and dosage changes before interpreting a rise in total spending.
When do alternatives change actual cost?
Biologic and biosimilar competition is a research question about adoption, coverage and payment. A new entrant alone does not establish the timing or size of savings.
How much does the setting matter?
Compare hospital outpatient departments, physician offices and other infusion settings. Drug payment and administration payment need to be considered together, with comparable treatment and patient populations.
Keep policy changes in the right benefit.
Negotiated Medicare prices for an additional 15 selected Part D drugs take effect on January 1, 2027. Those prices are relevant to the broader pharmacy outlook. They are not a medical-benefit trend estimate, and should not be applied across Part B drugs or commercial plans. CMS selected drugs and prices ↗
What the finished analysis needs.
Begin with CMS Part B drug spending and utilization, quarterly Average Sales Price files, and provider-level service data where the setting is identifiable. Retain the original units and distinguish Medicare fee-for-service evidence from the commercial market.
Public Part D spending data do not disclose drug-specific manufacturer rebates. That limits direct estimates of net cost. A defensible forecast will also need explicit uptake, substitution and site-of-care assumptions, followed by a check against later observations.
A therapy-level view of observed spending, volume and payment changes, followed by low, central and high 2027 scenarios. No numerical scenarios have been estimated for this draft.
Public sources for the next analysis
These sources define the planned research. No combined medical-pharmacy dataset or market forecast has been produced for this concept.