PREDICTIONS
Explore all 9 predictions below by scrolling through to view each forecast. For additional charts and more information download the full report.
Global spending on medicines reached
$1.2 trillion in 2018 and is set to and is set to exceed $1.5 trillion by 2023
1/9
1,600
1,400
1,200
1,000
800
600
400
200
0
10%
9%
8%
7%
6%
5%
4%
4%
2%
1%
0%
Spending US$Bn
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
Forecast
Source +
WHAT TO
WATCH
2019 TO 2023
Learn more about our 10 areas to watch through the interactive graphic below. Download the full report to read the implications for each of the 10 areas.
Spending
Growth
Click to explore the trends.
Patient Engagement
Digital Therapeutics
AI AND MACHINE LEARNING
Real-World Evidence
EMERGING BIOPHARMA
COMPANIES
PRICING
REFORMS
Prescription Opioids
Margin
Pressures
Neglected Tropical
Diseases
Advanced
Therapies
Patient Engagement
Pharmaceutical companies will continue hiring specialists in patient care and patient advocacy, building health advocacy roles internally with most of the top 20 pharma companies having a senior level patient advocacy role by 2019.
Digital Therapeutics
Mobile apps are increasingly submitted to the FDA for clearance or approval. These prescription digital therapeutics (DTx) are a new emerging treatment modality with indications and disease-specific treatment effectiveness claims in their software labels.
Artificial Intelligence and Machine Learning
Over the next five years, life sciences companies will continue to develop and invest in artificial intelligence, machine learning and deep learning programs leading to breakthroughs impacting the discovery and development of medicines.
Real-World Evidence
Manufacturers of new medicines where safety has been well demonstrated, but additional or alternative uses for those drugs have not yet been approved, will incorporate Real-World Evidence in clinical trials to support approval for novel indications.
Emerging Biopharma Companies
More emerging biopharma companies (EBP) will launch new medicines in the next five years, due to shifts in strategy as well as the rising absolute number of active R&D compounds. More than one-third of drugs launched in the next five years will be brought to market by EBP companies.
Pricing Reforms
In response to stakeholder perceptions in the United States that they are paying inappropriately high costs for medicines, the federal government has proposed
a sweeping set of pricing reforms for government programs with varying levels
of impact and probability of being enacted.
Prescription Opioids
Existing policies and new legislation will likely impact opioid prescribing and use through 2023, and the dynamics around prescription opioids, and issues around illicit drug use and overdoses, will remain complex and challenging to address. A range of likely scenarios around opioid prescribing trends include a continuation of the ongoing rapid declines in use, or a pattern of convergence at the levels of current lower-use states.
Margin Pressures
The next five years likely pose a number of challenges to biopharmaceutical companies, with payer actions on prices looming, and it remains to be seen whether these companies can repeat their past successes in terms of revenues and cost management. Technology investments, such as cloud-computing, artificial intelligence and machine-learning, are among the tools being explored to improve productivity.
Neglected Tropical Diseases
In the past decade, philanthropic organizations focused on neglected tropical diseases have made significant progress and many of the clinical development programs they have started or supported are beginning to result in drug approvals.
Advanced Therapies
A range of novel technologies, such as induced pluripotent stem cells (iPSC) and CRISPR/Cas9, and others involving modified cells or gene-modification tools are under development. These will treat limited patient populations and raise important questions for healthcare stakeholders around cost and accessibility.
Source IQVIA Market Prognosis, Sep 2018; IQVIA Institute, Dec 2018
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Growth Rate Constant US$
Source IQVIA Market Prognosis, Sep 2018; IQVIA Institute, Dec 2018
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Source IQVIA National Sales Perspectives, Dec 2017; IQVIA Institute, Dec 2018
Note Annual costs based on invoice prices, with overall invoice-level spending divided by estimated numbers of patients. Patient estimates are based on audited volumes assuming all patients use the drug according to the approved label. Products are included in medians based on segment assignments. Oncology includes both orphan and non-orphan products. All other products that have orphan indications are grouped together and some products have both orphan and non-orphan indications in this group. Specialty and traditional products exclude orphan or oncology products but are otherwise defined according to IQVIA definitions. Projected median costs are based on simple extrapolation of the medians in the prior ten years.
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Source IQVIA Market Prognosis, Sep 2018; IQVIA Institute, Dec 2018
Notes OTC = Over-the-counter
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Source IQVIA Market Prognosis, Sep 2018; IQVIA Institute, Dec 2018
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Source IQVIA Market Prognosis, Sep 2018; IQVIA Institute, Dec 2018
Notes Developed markets include: U.S., Japan, Germany, France, Italy, U.K., Spain, Canada, S. Korea, Australia; New Brands defined as those launched less than two years previously, measured separately in each country as launches of the same products are at different times.
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Source IQVIA Market Prognosis, Oct 2018; Institute, Dec 2018
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Source IQVIA MIDAS, MAT Jun 2018; ARK Patent Intelligence, IQVIA Institute, Dec 2018
Notes Developed markets include: U.S., Japan, Germany, France, Italy, U.K, Spain, Canada, S. Korea, Australia.
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
Invoice spending in the US is expected to grow at 4-7% across all channels, but net manufacturer revenue wil grow 3-6%
700
600
500
400
300
200
100
0
Spending US$Bn
Growth Rate
Net Manufacturer Revenue
2014
16%
14%
12%
10%
8%
6%
4%
2%
0%
2/9
Invoice Growth
Forecast
2015
2016
2017
2018
2019
2020
2021
2022
2023
Invoice to Net Difference
Net Growth
Source IQVIA Market Prognosis, Sep 2018; IQVIA Institute, Dec 2018
Report The Global Use of Medicine in 2019 and Outlook to 2023. IQVIA Institute for Human Data Science, Jan 2019
In the United States, the median list price for oncology and orphan drugs could potentially reach above $200,000 per year by 2023
800,000
700,000
600,000
500,000
400,000
300,000
200,000
100,000
0
Annual Cost of Treatment, US$
Annual Cost per Brand
2001
3/9
Forecast
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
Launch Year
China spending on medicines will slow to 3-6% Compound Annual Growth over the next 5 years.
Original Brands
Non-Original Branded Products
2008
4/9
Unbranded Products
OTC and Other
Forecast
7
Japan Spending Growth Dynamics 2018–2023
Constant US$Bn
2018
5/9
86
Forecast
40
9
5
19
2023
140–170
3–6%
0%
9%
3%
9%
CAGR
2018–2023
34
32
63
44
2013
95
2018
137
8%
4%
11%
7%
11%
CAGR
2013–2018
27
12
39
17
34
21
54
29
CAGR
2008–2013
19%
24%
21%
16%
20%
Specialty Growth
Traditional Growth
Population Dynamics
Exchange Rate Effects
2023
12
7
6
11
80
New products launching between 2019 and 2023 are expected to have a higher level of spending, but will represent only 6.7% of brand spending.
New Brand Spending
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
6/9
New Brands Share of Brand Spending
Forecast
Average 2009–13 = $15.3Bn and
3.7% of Brands
Average 2014–18 = $43.4Bn and
8.2% of Brands
Average 2019–23 = $45.8Bn and
6.7% of Brands
3.4%
3.1%
3.8%
4.2%
3.9%
7.4%
10.6%
10.5%
6.6%
5.8%
5.4%
7.0%
8.1%
7.1%
6.1%
14.0
12.8
16.1
17.1
16.4
34.6
54.7
56.8
37.0
34.0
33.0
44.5
54.8
51.0
45.9
Impact of losses of exclusivity for small molecules in developed markets will increase 15% in the next five years; for biologics, impact wil increase 2.5x.
Biologics
Small Molecules
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
7/9
Forecast
Total Brand Losses Due to LOE
-0.2
-0.8
-1.2
-1.6
-3.1
-5.2
-5.1
-3.0
-1.7
-1.9
-20.1
-20.5
-21.5
-22.0
-13.3
-26.1
-21.7
-14.9
-21.8
-19.6
-20.3
-21.2
-22.7
-23.6
-17.2
-31.5
-26.7
-17.8
-23.3
-21.5
$105Bn
$121Bn
Developed Markets Spending on Top Ten Biotech Medicines and Expected First Biosimilar Availability
Adalimumab
(Humira)
2012
–2014
8/9
Insulin glargine
(Lantus)
Etanercept
(Enbrel)
Infliximab
(Remicade)
Insulin aspart
(Novolog)
Rituximab
(Rituxan/MabThera)
Insulin lispro
(Humalog)
Bevacizumab
(Avastin)
Nivolumab
(Opdivo)
Trastuzumab
(Herceptin)
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
–2028
2017 Spending US$Bn
First Biosimilar Availability by Country
20.7
10.5
9.9
8.3
6.2
6.0
5.7
5.2
5
4.8
Specialty Medicines Share of Spending
by Country, 2008–2023
2008
9/9
Forecast
2019–2023
60%
50%
40%
30%
20%
10%
0%
Forecast
2019–2023
Forecast
2019–2023
US
EU5
Other Major Developed
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
US
Germany
UK
Italy
Spain
France
Australia
Japan
Canada
South Korea
Median of Specialty
Median of Traditional
Median of Non-Oncology Orphan
Median of Oncology
