IMS Institute Reports U.S. Spending on Medicines Grew 2.3 Percent in 2010, to $307.4 Billion
Modest Rise in Real Per Capita Spending; Fewer Physician Office Visits and New Therapy Starts Lead to Subdued Use of Medicines by Patients
“Last year, we saw the convergence of key dynamics leading to diminished growth in drug spending, which included the greater use of generics, loss of patent protection for major branded products, slower demand and less spending on new therapies,” said
In its latest analysis, the
- Volume of medicines consumed: The total volume of medicines consumed in oral or nasal form increased 0.5 percent in 2010, representing a decline of 0.3 percent on a per capita basis due to lower or declining demand in nearly every major therapy area. Medicines administered by injection or infusion increased 0.2 percent last year, or a per capita decline of 0.6 percent, primarily the result of reduced utilization in hospital settings.
- Patient doctor visits and new therapy starts: The number of visits to doctor offices was down 4.2 percent in 2010, extending a declining trend that began in mid-2009. Also, the number of patients starting new treatments for chronic conditions declined by 3.4 million last year. Contributing factors may include the enduring effect of high unemployment levels and rising healthcare costs, more careful healthcare spending by some, and the impact of additional patients losing their healthcare coverage.
- Patient payment for medicines: The average patient copayment was
$10.73 in 2010, down20 cents from 2009, mainly due to the increased use of generics. Commercial third-party insurance was used by patients to pay for 63 percent of dispensed prescriptions, down from 66 percent five years ago. Prescriptions filled under aMedicare Part D plan or throughMedicaid coverage represented 30 percent of all prescriptions in 2010, compared with 22 percent in 2006, the first year of theMedicare Part D program.
- Pricing of medicines: The average cost of oral or inhaled medicines, which made up 60 percent of overall spending last year, declined 0.1 percent in 2010 due to changes in price as well as in the mix of generics and branded products. Costs of medicines administered by injection or infusion, representing 28 percent of spending, rose 5.7 percent last year. Spending on protected brands increased by
$16.6 billion in 2010 due to invoice price changes, compared with$15.8 billion the prior year. Increasing levels of off-invoice discounts and rebates negotiated by payers and intermediaries accompanied these increases, resulting in net growth from pricing of$12.1 billion , or 4.2 percent of total spending. - Retail channels used by patients: Of the 3.99 billion prescriptions filled through retail channels, chain drugstores increasingly were chosen by patients – reflecting both the convenience of these pharmacies and the availability of discounted generics. In addition, chain drugstores continued to acquire independent stores, and overall increased their market share by 0.5 percent last year.
- New products: Forty-four new branded products became available to patients in 2010. Ten of those products featured innovative mechanisms of action, including a new oral therapy for multiple sclerosis, a monoclonal antibody for osteoporosis and bone metastases, and a therapeutic vaccine for prostate cancer. Additionally, five orphan drugs and six new chemical entities using existing mechanisms were launched, bringing new options to patients with rheumatoid arthritis, prostate cancer and meningitis. Average spending per new branded product – those available 24 months or less – was
$62 million last year, down from$114 million in 2006. This reflects a shift in the mix of new products toward orphan drugs and medicines with the same mechanism of action as existing treatments. - Brands and generics: Spending on brands declined 0.7 percent in 2010, while spending on branded and unbranded generics rose 4.5 percent and 21.7 percent, respectively. Generics now account for 78 percent of all retail prescriptions dispensed – a result of the greater availability of molecules in generic form as patents expire, along with patients choosing lower-cost options. On average, more than 80 percent of a brand’s prescription volume is replaced by generics within six months of patent loss.
Said Kleinrock, “It became apparent in 2010 that the healthcare landscape is shifting in significant ways. Physicians and patients have more therapy options than ever, and yet spending on medicines is rising at historic lows with the impact of patent expiries and reduced patient activity. The long-term effect on patient health of fewer doctor office visits and new therapy starts is unclear and requires closer attention.”
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