In a Drug Store News webinar on June 22, Doug Long, vice president of industry relations for U.S. retail at IQVIA, shared trends impacting the pharmaceutical marketplace.
You can watch the full webinar here.
The areas Long highlighted include the impact of vaccination rates, and eligibility and physician visits on prescription volume, price, reimbursements, generics, branded and biosimilars.
He also provided data on the first half of the year, how retail pharmacy and the U.S. pharmaceutical market have performed, and an update on COVID-19 vaccinations.
“Forty-four percent of the entire population is vaccinated and 76% of those age 65 and over are fully vaccinated,” Long said. “People who have been vaccinated already are the ones who will be vaccinated, with the exception of the younger ones. Vaccination time has passed us by.”
When it comes to telehealth, he said that there was a huge demand for visits at the end of March into April 2020, and these visits didn’t generate as many new prescriptions as visits to offices or institutions because of a reluctance to prescribe new therapies, without the aid of labs, vitals and diagnoses.
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This is good news considering there were 11 million patients who vanished from the retail pharmacy in the 12-month period from March 2020 through March 2021. Noting that mass merchandisers were impacted the most from loss of traffic because there was a reluctance to go to big stores, Long said, “They may have gone to food stores, chain drug or independents.”
“People spend less time on a telehealth call with physicians than a regular office visit,” he said. Although he believes that telehealth is here to say, these visits are handicapped by the absence of vitals and labs at this point. "In the last four weeks, telehealth claims are lower than they were last year."
Elective procedures also are showing a setback over the last month, although they recovered recently as providers are now trying to clear the backlog.
When it comes to diagnosis visits, Long said if COVID didn’t occur, we would have a billion more diagnosis visits in 2020 than we did. “There were big gaps, in March, April and May when we had all of the lockdowns,” he said. "The expected number of diagnosis visits were down 19%. In 2021, so far, the expected number of diagnosis visits is down 9% and we're looking for a shortfall of about 230 million prescriptions.”
Long also weighed in on the absence of the cough-cold and flu season last year, saying that it was 94% below normal as the transmission was prevented by people not being in the workplace, wearing masks and sanitizing.
More recently in the last six or seven weeks, Long reported that there has been an increase in adult vaccinations and in pediatrics vaccines.
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One area where Long said he sees improvement is in long-term care, however, it is still down substantially. “The patient count went from 90% to 80% capacity. People were reluctant to put people in long-term care, he said. "You see home health care strengthened. Clinics are running in the high single digits and hospitals recovered somewhat, but they are not out of the woods yet.”
In the specialty pharmacy arena, Long said specialty will be a bigger percent of the market on a dollar basis than traditional pharmaceuticals by the end of this year.
On the topic of unadjusted prescriptions, he pointed to the fact that all of the growth is coming from branded prescriptions, with Pfizer, Moderna and J&J’s vaccines coming in as Nos 1, 2 and 3, respectively.
“There’s no influence on cough-cold or flu in March, April or May last season. The true test of marketplace when we get to July, the COVID vaccinations will be behind us; we’ll see what true demand is and figure out whether there’ will be flu vaccines,” Long said.
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What does the future hold? Long said that the chain drug community is trying to figure out if people will get the flu vaccine in the same high numbers this year as they did last year. “One reason is that a lot of vaccine used to happen at company headquarters that went to retail last year. That’s the wild card," he said. "The other wild card is, will there be a flu season or not?”
The United States will be watching what happens in Australia, Chile and Argentina, where the flu season goes from May and peaks in August and September. “So far through May 2021, the number is a little more than May and June 2020, but it is way below the five-year average,“ Long said. "This is important. What do vaccinations look like there in August might be a proxy for us.“
Touching on generics, Long identified a generic price deflation, and although the Food and Drug Administration is prolifically approving about 90% of generics, generics companies are not launching these products because of the increased competition on these molecules. “Generic companies are deciding, if I can’t make a commercial return, they are not launching," he said. "The numbers are abysmal in 2020 and 2021. There’s a race to the bottom in generics, I fear."
Long also weighed in on the improved state of clinical trials, saying that although there was a dip in February, March and April, levels are higher than ever. "COVID put a pause on innovation, but it’s roaring back," he said.
The mRNA vaccine development is yet another area that Long views as having a positive future. He said that mRNA vaccines came out in record time and are being looked at for use in other vaccines and treatments.
He also touched upon the opioid epidemic, stating that amid the COVID pandemic, there were over 90,000 overdose deaths in 2020 that were mainly attributed to synthetic fentanyl.
As far as Long’s outlook for 2021, some of the things on his watch list are pharmacy reimbursement, access to specialty drugs, track and trace technology, digital pharmacy, and, of course, what Amazon is going to do.
Finally, Long concluded that the supply chain did not falter amid the pandemic, despite problems with shutdowns in China and India, and problems with air transportation.
This is the third DSNwebinar in which Long discussed the pharmaceutical market amid COVID-19.
The webinar was sponsored by Granules.