The COVID-19 pandemic has had a major impact on the US health care market. Some of the affected areas are returning to normal and innovation continues, explained Doug Long, MBA, IQVIA, keynote speaker during Thursday at the Academy of Managed Care Pharmacy Annual Meeting, AMCP 2022.
The COVID-19 pandemic has disrupted the US economy and many areas of life over the past two years, including the delivery of healthcare services and some aspects of the pharmaceutical industry. During today’s keynote session at the Academy of Managed Care Pharmacy annual meeting in Chicago, Doug Long, MBA, vice president, industry relations at IQVIA, described some of the disruptions, sketched trends and made some predictions about the near future. . US Healthcare.
Overall, Long gave the “health ecosystem” an A+ for its response to the pandemic, bringing three vaccines to market in record time, ramping up vaccine production, and adjusting supply chain processes to handle increases and decreases in volume. indicates success. Pharmacists and healthcare providers have long been praised for taking on new and innovative tasks.
“So, a rating and congratulations,” said Long, a veteran presenter at healthcare meetings. He compared the healthcare sector to the automobile industry: “Think how this ecosystem has fared better than trying to get a car today,” he said.
A well-documented impact from the pandemic was the decline in new diagnoses, particularly in cancer. At the start of the pandemic in April 2020, there were 87% fewer mammograms, 83% fewer Pap smears and 90% fewer colonoscopies than baseline expectations.
“So, it’s no surprise that people who eventually see a doctor are probably more advanced [disease stages]said Long.
He said that although these screenings have gone well, they have not yet returned to where we would expect them to. By the end of the first quarter in 2021, mammograms were still down 14%, Pap smears were down 20%, and colonoscopies were down 25%.
In 2020, there were approximately 1 billion underdiagnosed visits. These are visits that did not occur, including visits to the doctor’s office, telehealth visits, and elective procedures. Oncology, endocrinology and rheumatology had the largest gaps, Long noted.
In late 2021, the general medical claims trend began to pick up. Office visits recovered at the beginning of the year and intensified at the end of the year, but institutional or hospital visits were not as stable. Telehealth visits hit 13% of all medical claims and are now down
Moving on from the impact of the pandemic, Long turned his attention to where the pharmaceutical market currently stands. Growth in the specialty market is overtaking the growth of traditional medicines; However, conventional wisdom had expected at this point to be a larger feature than conventional. Although it hasn’t happened yet, Long hopes to do so in 2022. Right now, traditional medicine specialties account for 50.3% of total non-exempt spending, compared to 49.3%.
While drugs for diabetes were the top medical class in 2021 with $69.3 billion in sales and an increase of 16.4% year-over-year, the top product was the anticoagulant Eliquis (apixban), with $12.0 billion in sales and 23.0% in sales. Development. The diabetes drugs Trulicity (dulaglutide), Ozempic (semaglutide), and Jardiance (empagliflozin) ranked second, third, and fourth.
Branded pharmaceutical list prices rose 4.4% in 2020, but net prices declined 2.9%, marking the fourth year at or below the Consumer Price Index, according to IQVIA data. Long also pointed to the annual percentage change in prices for national health spending, published in the Ultram Report in November 2021. The report showed a negative change in drug prices as of October 2021 compared to the previous year, but hospital and physician prices are up.
“There’s this perception that health care is very expensive here, and it is, but it’s not because of drug costs,” Long said. “What is driving it is hospital services,” which he has shown is up 200% since 2000.
Data from IQVIA that analyzed total drug spending as a percentage of health care in the United States and 10 other countries found that the United States spends 14% of health care spending on drugs, which is 11 for all 15. % is slightly less than the average. Country. Germany, France, Japan, Italy, Spain and South Korea all spent a larger percentage of health care spending on drugs than the United States.
Long said generic sales continued to decline and fell 5.2 per cent in January 2022 due to the drop in prices. As a result, 83.5% of prescriptions were non-branded generics in 2021, but they accounted for only $9.5%. Overall, non-branded and branded generics accounted for 18.4% of spending in 2021.
In addition, biosimilars are yielding more savings. “We are now at the sweet spot of biosimilars,” he said.
Between 2020 and 2024, biosimilar use is expected to result in savings of $104 billion and most of those estimates are due to Humira’s patent closing. There are already seven FDA-approved Humira biosimilars with anticipated launch dates between January and November 2023.
Biosimilars account for more than 60% of bevacizumab and trastuzumab market share and biosimilars account for more than 50% of rituximab market share. In addition, sales of filgrastim and pegfilgrastim continue to grow.
Long told the audience to keep an eye on Humira biosimilars next year and biosimilars for Stelara after that.
In 2021, 74 products were launched, of which 35% were in oncology and 15% in infectious disease. The biggest launch by sales was WeGoVie (semaglutide) for weight loss, with sales of $601.8 million in 2021.
He highlighted some possible launches in 2022 to keep an eye on:
- Two for Alzheimer’s disease – Donanaumab from Eli Lilly and Gentanumab from Genentech
- Tirazeptide from Eli Lilly for Diabetes
- Ducravasitinib from Bristol Myers Squibb for Moderate to Severe Plaque Psoriasis
- Vutrisiran from Alnylam for amyloid transthyretin amyloidosis
- Mavacamten from Bristol Myers Squibb for hypertrophic cardiomyopathy
- Adgrasib from Mirati Therapeutics for non-small cell lung cancer
“What’s interesting is that it’s a mix of big companies and small companies,” Long said. “It used to be that big pharma was the commercial engine of launch. And now some of these launches can be done by smaller companies, because they require fewer people, smaller patient populations, and all that.”