"Two temporary changes that the U.S. won't be able to count on in future years helped hold down the rate of health spending in 2012. First, there's what the pharmaceutical industry calls the patent cliff. Blockbuster drugs such as Lipitor have lost patent protection, opening the market to lower-cost generic competitors and helping hold spending on prescription drugs to a 0.4 percent increase between 2011 and 2012. A one-time cut in what Medicare pays nursing homes also took effect in 2012."