-
Spending on all U.S. medicines increased 4.5 percent to $344 billion
on a net price basis, despite lower price growth, due to higher
patient use of new and protected brands. -
In 2018, 29 billion fewer morphine milligram equivalents (MMEs) were
dispensed to patients on a volume basis compared to 2017. -
The steepest decline occurred in the “high-strength” formulations
(>=90 MMEs/day), which declined by 61 percent since 2011. -
Decline drivers include shifts in clinical usage, new regulatory and
reimbursement policies and legislation tightening restrictions on
prescription opioid use since 2012. -
Overall medicine spending is expected to increase 3-6 percent on net
basis to $420 billion by 2023.
DANBURY, Conn. & RESEARCH TRIANGLE PARK, N.C.–(BUSINESS WIRE)–The latest report from the IQVIA™ Institute for Human Data Science found
prescription opioid dosage volume — as defined by morphine milligram
equivalents, or MMEs — declined 17 percent in 2018, marking the
single-largest annual drop ever recorded within the U.S. market.
The study, Medicine Use and Spending in the U.S.: A Review of 2018
and Outlook to 2023, shows that prescription opioid volume had
increased annually since 1992, reaching its highest level in 2011. A
series of regulatory and legislative restrictions subsequently occurred.
Those combined with tighter clinical prescribing guidelines and greater
reimbursement controls resulted in 4 percent-per-year declines on
average from 2012 through 2016, followed by a 12 percent drop in 2017
and the historic 17 percent decline last year.
Despite those national trends, state-level variability was wide
regarding per capita volume of opioid and medication-assisted treatment
(MAT) prescriptions. Specifically, Arkansas, Oklahoma and Kansas had the
highest number of opioid prescriptions relative to MAT prescriptions,
while all New England states showed fewer than average opioid
prescriptions and higher MAT use.
Prescription drug monitoring programs now in place in 49 states
significantly limit prescribing of high-dose opioids, which are
associated with a higher risk of dependency and overdose and saw the
steepest decline in 2018.
“As the national discussion regarding the opioid epidemic in this
country continues, we hope to inform and advance that dialogue with some
of the important findings in this report,” said Murray Aitken, IQVIA
senior vice president and executive director of the IQVIA Institute for
Human Data Science. “For instance, while prescription opioid usage
continues to decline, we saw many more people receiving
medication-assisted treatment for opioid addiction. Our research shows
new therapy starts for MATs increased to 1.2 million people in 2018,
nearly a 300 percent increase compared with those seeking addiction help
in 2014. This is an important indicator of the effects of increased
funding and support for treatment programs to address addiction.”
Additional highlights of the 2019 U.S. Medicines Report include:
-
Medicine Usage Trends: There were 5.8 billion prescriptions
dispensed in 2018, up 2.7 percent from 2017 when adjusted for
prescription duration. More than two thirds of total prescriptions
last year were for chronic conditions, which are increasingly filled
with 90-day prescriptions. The largest increase in medicine use in
2018 was seen in anti-hypertensives, with an increase of 48 million
prescriptions filled last year, and mostly driven by an aging
population and expanded guidelines to lower blood pressure. Increased
focus on patient adherence, including incentives in Medicare Part D,
is resulting in greater use of 90-day prescriptions and higher
adherence rates among patients with common chronic conditions. -
Medicine Spending and Growth Dynamics: In 2018, spending grew
4.5 percent among off-invoice discounts and rebates, while growth at
the invoice level was 5.7 percent. Discounts, rebates and other price
concessions on brands reduced absolute invoice spending by an
estimated 28 percent to $344 billion. Spending grew in 2018 due in
part to the launch of new branded products as well as an increase in
the volume of current branded products. Net price growth was 0.3
percent in 2018, or 1.6 percent below the Consumer Price Index, while
price increases for protected brands moderated to 5.5 percent on an
invoice-price basis. -
Patient Out-of-Pocket (OOP) Costs: Total patient out-of-pocket
costs for retail prescription drugs were estimated to be $61 billion
in 2018, marking a $2 billion increase compared with 2017 and up $5
billion from 2014. Medicare patients faced higher annual OOP cost
levels than patients in commercial plans or on Medicaid. Almost 20
percent of Medicare Part D patients had OOP costs higher than $500
annually while only 8.8 percent of the broader population had similar
OOP expenses. Commercially insured patients increasingly used
manufacturer coupons to offset initial cost exposure and average final
OOP costs remained at $42 per brand prescription, similar to 2017
levels. -
Outlook to 2023: While the full impact of potential policy
changes on manufacturer net sales is unclear, total net spending
growth on pharmaceuticals is forecast to increase at a compound annual
growth rate of 3-6 percent on net price basis, and 4-7 percent on
invoice price basis through 2023. The baseline scenario for the next
five years forecasts net medicine spending in the U.S. will increase
from $344 billion in 2018 to $420 billion in 2023, an aggregate growth
of $76 billion compared to aggregate net growth of $84 billion over
the past five years. The largest driver of this growth will be the
launch of new brands, which are forecast to contribute $73 billion of
new spending as clinical development efforts across the pharmaceutical
industry result in new drug approvals and uptake.
The full version of the report, including a detailed description of the
methodology, is available at www.IQVIAInstitute.org.The
study was produced independently as a public service, without industry
or government funding.
About the IQVIA Institute for Human Data Science
The IQVIA Institute for Human Data Science contributes to the
advancement of human health globally through timely research, insightful
analysis and scientific expertise applied to granular non-identified
patient-level data.
Fulfilling an essential need within healthcare, the Institute delivers
objective, relevant insights and research that accelerate understanding
and innovation critical to sound decision-making and improved human
outcomes. With access to IQVIA’s institutional knowledge, advanced
analytics, technology and unparalleled data, the Institute works in
tandem with a broad set of healthcare stakeholders to drive a research
agenda focused on Human Data Science, including government agencies,
academic institutions, the life sciences industry and payers. More
information about the IQVIA Institute can be found at www.IQVIAInstitute.org.
About IQVIA
IQVIA (NYSE:IQV) is a leading global provider of advanced analytics,
technology solutions and contract research services to the life sciences
industry. Formed through the merger of IMS Health and Quintiles, IQVIA
applies human data science — leveraging the analytic rigor and clarity
of data science to the ever-expanding scope of human science — to enable
companies to reimagine and develop new approaches to clinical
development and commercialization, speed innovation and accelerate
improvements in healthcare outcomes. Powered by the IQVIA CORE™, IQVIA
delivers unique and actionable insights at the intersection of
large-scale analytics, transformative technology and extensive domain
expertise, as well as execution capabilities. With more than 58,000
employees, IQVIA conducts operations in more than 100 countries.
IQVIA is a global leader in protecting individual patient privacy. The
company uses a wide variety of privacy-enhancing technologies and
safeguards to protect individual privacy while generating and analyzing
information on a scale that helps healthcare stakeholders identify
disease patterns and correlate with the precise treatment path and
therapy needed for better outcomes. IQVIA’s insights and execution
capabilities help biotech, medical device and pharmaceutical companies,
medical researchers, government agencies, payers and other healthcare
stakeholders tap into a deeper understanding of diseases, human
behaviors and scientific advances, in an effort to advance their path
toward cures. To learn more, visit www.iqvia.com.
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Contacts
Tor Constantino
IQVIA Media Relations
tor.constantino@iqvia.com
+1.484.567.6732
Andrew Markwick
IQVIA Investor Relations
andrew.markwick@iqvia.com
+1.973.257.7144