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Generics are now 75% of dispensed prescriptions, with generics up 5.9% in 2009 and branded products down 7.6%
IMS Health’s annual summary of the US drug market shows a higher-than-normal increase in 2009, at least compared to the two previous years, when the annual sales grew 1.8% (2008) and 3.8% (2007). But the 5.1% increase is only just three percentage points over the increase in dispensed prescriptions, indicating that overall price inflation remains low. (IMS Health notes that it periodically revises its estimates, and has changed the 2008 and earlier figures from what was reported last year; it also revised sub-category figures from April 1, the day of the initial announcement, to those reported on April 6.)
“In 2009, demand for pharmaceuticals proved stronger than in the prior two years, yet remained at historically low levels,” says IMS’ Murray Aitken, SVP. “While the 32 innovative products launched last year brought important new treatment options to patients . . . they drove only a limited increase in drug spending.”
Biggest get bigger
IMS Health tracks retail sales per channel, and the picture here is that while change is only gradual, it is continuing in the same direction as the past several years: chain pharmacies and mail service up; independent pharmacies down, while foodstores, clinics and hospitals held fairly steady. Chains’ sales volume grew 5.8%, to $105.5 billion, and represented 35.1% of the overall market. Mail service grew even faster—10.8%, to $51.5 billion—representing 17.1% of the overall market. Independents’ sales grew 1.1%, to $37.3 billion, but they continue to fall behind as a fraction of the overall market, with their sales dropping from 12.9% of the overall market in 2008 to 12.4% in 2009.
Chains also stretched their dominance as location of where prescriptions are filled, accounting for 54.3% of 2009’s 3.922 billion prescriptions. Independents filled 19.2% of 2009’s prescriptions, down from 20.0% the year before. Surprisingly, though, mail service’s volume also declined, from 6.3% of prescriptions filled in 2008 to 6.1% in 2009. Mail service is known for aggressively promoting use of generics; if that remains the case, the conclusion could be that they have been equally aggressive in high-priced specialty pharmaceuticals (which, as a category of drugs, IMS Health says grew by 7.5% last year and now comprise 21% of US market value).
Other markers of note:
Purely on the basis of drug sales, the top five pharma companies (in order) are Pfizer, Merck, AstraZeneca, GSK and Roche. Johnson & Johnson dropped from fifth in 2008 to eighth in 2009, and GSK and Roche have traded places.
IMS Health’s global forecast shows 5-8% growth over the next five years, according to its annual Market Prognosis. That’s a slight uptick from the company’s 4—6% growth rate prediction for 2010.
IMS also sees the industry hitting the trillion-dollar mark, growing $300 billion in the next five years to reach $1.1 trillion in 2014. That’s despite the fact that total drug spending is expected to drop $80—$100 billion worldwide after several blockbusters like Lipitor (cholesterol), Plavix (anticoagulation) or Seroquel (CNS) face competition from generics, particularly in the US.
Biosimilars—generic versions of biotech products—will only begin to show up at the end of the five-year period, says Murray Aitken, SVP at IMS. “While the recently passed healthcare reform legislation provides a pathway for biosimilars, it will be some time before FDA gets regulations written, begins accepting submissions, and starts making its approval decisions,” he says. The regulatory framework is different in Europe, where some biosimilars are starting to emerge.
More good news comes for what IMS Health calls the “pharmerging” markets, including Brazil, China, India, Mexico, Russia, Venezuela and 12 other countries, which are expected to grow 14—17% through 2014, compared with 3–6% for established markets. IMS notes that aggregate growth for both types of markets will be similar—$120- $140 billion.
But IMS Health does see some setbacks in pharma’s future, including spending cuts in publicly funded health systems. IMS points to countries like France, Germany, Spain and Turkey that have already announced plans to limit access to drug therapies or reduce reimbursements, and says more governments may follow suit. PC