0
200
Spending US$Bn
2011
2013
2017
Invoice to Net Difference
Reflects the revenues for manufacturers after all discounts and rebates paid to intermediaries, the government or patient coupons have been deducted.
Invoice to Net Difference
15%
5%
2021
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Reflects the revenues for manufacturers after all discounts and rebates paid to intermediaries, the government or patient coupons have been deducted.
Source: IQVIA Market Prognosis, IQVIA Institute, Mar 2018
Chart notes: Invoice spending is based on IQVIA reported values from wholesaler transactions measured at trade/invoice prices and exclude off-invoice discounts and rebates that reduce net revenue received by manufacturers. Net spending reflects company recognized revenue after off-invoice discounts, rebates and price concessions are applied.
(Specifically for Total Chart) Includes all medicines in both pharmacy and institutional settings.
(Specifically for Retail Chart) Includes medicines in retail and mail settings. CMS Prescription drug expenditures in the National Health Expenditure Accounts include all payers at retail pharmacies and then deduct rebates, whereas some of the concessions made by manufacturers and deducted in IQVIAs estimates are not considered by CMS.
Net total spending growth will average 2–5% over the next five years and invoice growth will average 4–7%.
2019
2009
600
Total
Toggle between Total and Retail to take a closer look at the difference and rollover the legend for more details about net and invoice spending
Total
Reflects the revenues for manufacturers after all discounts and rebates paid to intermediaries, the government or patient coupons have been deducted.
Source +
Forecast
400
2015
-5%
-10%
10%
Net Spending
0%
2020
Net Spending Growth
Reflects the difference between invoice spending (sales by manufacturers measured between wholesalers and their customers) and net spending.
Net Spending
100
2022
700
2010
2016
2012
Invoice Spending Growth
Source -
Net total spending growth will be slower than retail invoice growth over the next five years
Reflects the difference between invoice spending (sales by manufacturers measured between wholesalers and their customers) and net spending.
Growth
300
2014
Retail and mail-order spending will grow at 3–6% on an invoice basis over the next five years and 1–4% on a net basis.
Retail
2018
Retail
2008
500