The COVID-19 pandemic has upended almost every industry, and the pharma industry is no exception. In a Drug Store News webinar held Monday, Doug Long, IQVIA vice president of industry relations for U.S. retail, outlined the ways that the novel coronavirus has impacted the U.S. pharmaceutical market.
The full webinar, sponsored by Unichem Pharmaceuticals, can be watched on demand here.
Long sized up a number of industry trends amid COVID, including a slowdown in mergers and alliances, including the merger of Aurobindo and Sandoz, and the Mylan-Upjohn merger. COVID-19 also has resulted in most pharmaceutical reform having "fallen by the wayside." Long predicted that until we get through COVID and the next election cycle, reform will not occur.
The pandemic hasn't eliminated the perennial issue of reimbursements, though. "DIR fees are not going away," Long said. "There’s a lot of patient groups trying to get changes in DIR fees."
On the subject of total market and retail side growth, Long noted that they are both in the 7% range. "What’s interesting is that the percent change for retail and mail is greater than the percent change for the total market. Generally that’s been the other way around probably due to more oncology business in the total market than the retail and also is one of the impacts of the COVID-19," he said.
Long noted that the market last year was $511 billion at the invoice price basis and about 52% of that was traditional pharmaceuticals and about 48% was specialty. "The growth in specialty just continues to happen," he said, adding that in the next year or two 50% of the market may be specialty. "The growth rate on specialty is growing at 11% retail and traditional is growing at 1%," Long said.
Autoimmune, oncology and diabetes categories account for 50% of growth in the United States, and around the world. "Diabetes is more of a retail space than the other two and there’s been a lot of activity in terms of launches," he said. He also noted that respiratory drugs have seen a surge. "There's been quite a comeback in respiratory which makes sense because the first thing everyone tries to do is make sure they have all their respiratory drugs filled when the COVID-19 crisis hit."
On the subject of innovation, Long said that 2019 was not as good a year as 2018, which was the greatest year in the history of launches. Still, there were 50 launches, almost half of those were orphan drugs.
"Innovation is starting to increase. A lot of new medicines are innovators, not followers," Long siad. "This is a very innovative marketplace. We had oncology, infectious disease, and neurology. The change happened rapidly. The movement to COVID-19 drugs in terms of testing — we’re going to do this in record time going forward."
On the subject of opioids, Long said they have fallen off the map a little bit and there is some good news. Opioid prescriptions in 2019 were 9% lower than the previous year. Strengths are down 15%. The prescriptions are down 41% from their peak in 2011. Morphine equivalents are down 52%.
"The high-dosage stuff is even harder to get. COVID exacerbated the situation. There is a slowdown in legal fentanyl coming to us because hadn’t been able to be in product in China and other places," Long said. "Medication-assisted treatments continue to grow. Combined with 28-day residential care, they could be up to 50% effective."
As far as the future, Long said there are signs that COVID-19 is either at peak or close to peak in many areas. With states like Florida opening and doing elective surgeries again, Long said a good number of states are making plans to do elective surgery.
"We are seeing first increases in prescription over the prior week so maybe we are starting to come out of peaks and valley. We are starting to see more office visits. We're seeing a 1.5% increase in new to brand, which is someone newly diagnosed coming into your store."
Finally, Long said, "As we got through March the numbers really fell in seeing healthcare providers and the number of telehealth visits really increased. We had ten-year growth in telehealth in one month.This is continuing to happen. I think telehealth is here to stay but HCP visits are coming back."