Douglas Long Highlights Key Trends in Healthcare and Pharmaceutical Markets

In his AMCP 2023 keynote, “Healthcare and Pharmaceutical Market Trends 2022-2023,” IQVIA Vice President of Industry Relations and MBA Douglas Long discussed healthcare and telemedicine utilization, incidence of respiratory infections, drug cost, even more in the United States.

Long reported that health care utilization has rebounded, telemedicine has taken hold, and traditional drug costs have fallen. He also noted an increase in his ADHD prescriptions and a decrease in generics from a business perspective. But he was optimistic about biosimilars, citing data showing increased spending on specialty medicines.

respiratory disease

He first presented mapped data from IQVIA’s Flu, Cold, and Respiratory Disease Activity Notification (FAN) reports, highlighting trends in respiratory infection rates and alert status between last and current season.

These respiratory diseases are worse in 2023 compared to 2022. In fact, all symptoms recorded by FAN surpassed historical trends in 2022-2023 compared to 2021-22 and 2020-2021. early winter. Forecasts are for a reduction in these symptoms. These trends were particularly pronounced among children, with a further increase in respiratory infections beginning in September and a clear decline during the student winter holidays.

“Why this year has been so bad … people wore masks, didn’t go to work, didn’t go to school, so they lost their natural immunity and it came back furiously,” Long said. said. “This is where pharmacies in particular really go. Think about all the vaccines dispensed or injected at retail pharmacies. Because.”

As of January this year, the COVID-19 vaccine accounted for only 0.8% of all retail pharmacy prescriptions. That’s down from 2% last year and down from his 5.8% in 2021.

“At the moment, COVID is kind of in the background and no one knows what is going to happen, because no one really knows,” said Long, also referring to the drop in deaths from COVID-19. Did.

Access to healthcare

While figures for the end of 2022 are still being finalized, IQVIA’s Healthcare Utilization Index report showed that US healthcare is operating at near pre-COVID levels. According to the report, higher rates of screening and diagnostic tests and office, facility and telemedicine visits are occurring in the fourth quarter of 2021 than in the first two months of 2020, and elective procedures and new prescriptions are 95% back to normal. price.

Claims data also showed that the use of office and institutional services increased by 6.2% and 1.1% respectively, while telemedicine decreased by 0.5% over the two periods. Retail prescriptions also fell by 1.3% for him, which could be due to a decline in his COVID-19 vaccinations, while mail-order prescriptions for him increased by 4.3%.

There was a notable change in oncology care visits, with a 41% increase in in-person visits in 2022 compared to 2021. Long wasn’t too surprised by these numbers, as many clinics were still closed for in-person visits at the beginning of 2021. It has become accustomed to use and accounted for 7-9% of claims in 2022.

spending trends

Pharmaceutical sales in the retail sector are experiencing a surge in revenue. Long’s data show that between January 2022 and his January 2023 grocery store sales increased by 20.4% year-to-date. This growth is understandable, he said, as individuals are starting to get into the habit of buying everything they need from one place. During the pandemic, he started getting prescriptions from the same store where he did his grocery shopping.

Mr. Long presented data from IQVIA’s specialty and traditional medicine sales. This showed that in 2022, specialty drugs will account for 51% of his total drug spending, excluding discounts, while traditional drugs will account for less than 50% of spending.

Charted data reveal that traditional drugs accounted for 72% of net spending in 2011, while specialty drugs accounted for only 28%. However, while net spending on specialty drugs increased, net spending on traditional drugs declined over time. Trend lines crossed in 2018, with 55% of net spending on specialty drugs and 45% on traditional drugs by 2021.

A breakdown of net specialty drug spending trends for various diseases from 2011 to 2021 showed that spending on drugs to treat autoimmune diseases increased by a whopping 459% over that decade. Also, spending on cancer drugs increased 326%, specialty drugs increased 305%, HIV drugs increased 219%, and multiple sclerosis drugs increased 211%.

For traditional drug spending, diabetes was the only disease condition to see comparable growth, with an increase of 217%. His net spending on mental health care increased only 38% over this decade, the smallest increase in his group. Interestingly, however, attention deficit hyperactivity disorder (ADHD) drug dispensation increased by 11.1% in the third quarter of 2022 compared to the start of the pandemic.

Additionally, between 2016 and 2021, pharmaceutical spending increased by $82 billion. This was primarily driven by new product and brand sales volumes, offset by expiration dates.

Top products for 2022

According to IQVIA data, the top 10 products are growing at 26.2% and account for 22.7% of the market share. Downscaled, the top 20 is growing at 24.6%, accounting for 30.7% market share.

Unsurprisingly, Adalimumab (Humira) jumps to the top of this list with a moving annual total (MAT) of $30.3 billion in September 2022, with apixaban (Eliquis) next with a MAT of $18.1 billion. is in As of January 2023, semaglutide (Ozempic) sales increased by $6.7 billion in absolute growth, an increase of 74.7%. Sales of Empaglifozin (Jardiance) increased his $3.9 billion, up 46.6%.

generics and biosimilars

“For a long time there has been a race to the bottom of the generic drug market,” Long said of its pricing and sales.

Over the past eight years, total North American generics sales have declined by $17 billion. In addition, IQVIA data showed that nearly 90% of prescriptions were for unbranded generic drugs, which, on a dollar basis, accounted for his 8.4% of sales.

“It’s a slippery slope,” said Long, referring to Acorn Pharmaceuticals’ bankruptcy filing and its closure in February. “We see shortages today, but we will see more shortages in the future unless we give them a breather because they cannot reinvest in the business.”

Biosimilars, on the other hand, appear to have a brighter future in the market. That number is 12.5% ​​for biologics and 1.3% for small molecules, compared to overall US pharmaceuticals, which has a compound annual growth rate (CAGR) of 5.6% from 2017 to 2021.

Molecules with biosimilars constitute a total of $38 billion in claims spending, with biosimilar development targeting an additional $96 billion. Long also said he already has 30 biosimilars introduced to the U.S. market, and 10 more biosimilars he expects to launch by the end of 2023. This year, he hit $11.4 billion in revenue, then by 2027 he’s expected to grow rapidly to $38.5 billion, more than triple. in size.

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