OBJECTIVES: In France, a forecast growth rate in spending related to the list of expensive hospital drugs, funded in addition to DRG-based payment, is determined annually (2% in 2012). If hospitals exceed the rate, they will be controlled, based on the proper use of drugs. The objective is to question the relevance of this national growth rate as a regulation tool. METHODS: This study used 2011/2012 data from "medicalized information system program". Expensive drug expenditures are aggregated by each type of French hospitals (without private sector): cancer centers (CC=19), university hospitals (UH=32), hospitals centers (HC=415) and private non-profit hospitals (PNPH=104). In order to identify their specificities, we analyzed the expenditures of the first therapeutic class in value by hospital type and how much the top 3 drugs, that drive the overall growth, contribute to their respective growth. RESULTS: Overall spending grew by 4.95% in 2012. Antineoplastic drugs (1% of decrease) represent 48% of overall expenditures. Their market share varies from 34% in UH expenditures to 95% in CC, the only hospital type that meet the forecast rate. The top 3 drugs (2 immunosuppressant drugs and 1 replacement enzyme; 17% of overall expenditures) contribute to 3.93 points of the total growth. Their contribution to the growth of each hospital types is uneven: from -0.02 point out of -6% in CC to 5.35 points out of 9.03% in UH. CONCLUSIONS: There is a divergence in the growth of spending for the different hospital types because of their specific characteristics leading to different consumption profiles. Therefore, some hospitals are more impacted by changes in the spending structure, as CC for antineoplastic drugs. A regulation by an annual growth rate is useful because of its flexibility. But relevance of a single national rate does not reflect the care's offer heterogeneity and needs local analyses.