The pharmaceutical market is a bit of a mixed bag right now, and that should give pharmacy operators a chance to figure out how to move forward with the category.
According to Doug Long, IQVIA’s vice president of industry relations, during a presentation, “U.S. Pharmaceutical Trends, Issues and Outlook” at NACDS Total Store Expo, U.S. market dollar sales are up 6%, but prescriptions are down 1%, though adjusted 90-day prescriptions grew by 3%.
Speaking in Boston during the three-day show in late August, Long also said that while the flu season was not as severe as the previous season, flu vaccine sales were good. And, the industry is experiencing generic price deflation and less brand price inflation.
On average, Long said, a retail store fills more than 22,000 adjusted prescriptions per quarter, with chains averaging 30,756 scripts and independent pharmacies averaging 12,233 scripts. Reimbursement, particularly DIR fees, which have dramatically increased over the last 10 years, is an issue that will become even more significant, he said. Even as pharmacies face difficulties with reimbursements, Long said there also has been much more public and media scrutiny on drug prices, as well as a potential for administrative actions.
Overall, generic sales have decreased, and while there were a record number of generic approvals and faster approvals in the past year, fewer products have made it to market. As this has happened, consolidation within the generics sector has picked up steam. Long cited several notable mergers and alliances, including Bristol-Myers and Celgene, AbbVie and Allergan, and Upjohn and Pfizer’s Mylan — the last of which could shake up the specialty generics world at a critical juncture.
Indeed, generics of Advair Diskus and Lyrica were among the recent launches Long singled out as significant in the past year, and a move in an important direction for prescription spending. “We will see more specialty generics if we are going to contain healthcare costs in the future,” he said.
Long is skeptical of the recurring idea of drug importation as a method of curbing drug costs. “We spent millions on Track and Trace to secure the supply chain,” he said. “The generic prescriptions here are cheaper than Canada. I don’t see the advantage of going to Canada to get generics.”
As he surveyed the future, Long said the various services for which patients now are turning to are at pharmacies, including dental services, eye care, orthodontics and dialysis. Additionally, telehealth visits are expected to grow between 4.2% and 7.5% by 2022.
He said that in the past year, opioid regulations and e-prescribing mandates around controlled substances have coincided with continued decreases in opioid deaths. “2018 was the third year that opioid deaths have dropped year to year since 1980,” Long said. “You see a significant decrease in the number of prescriptions.”