IQVIA sees big opportunities in biosimilars, patent expiries

IQVIA, a leader in forecasting trends that impact the use of and cost of medicines, is once again peering into its crystal ball. The IQVIA Institute for Human Data and Science’s recently released its report on the direction of the global health market in the coming five years. 

“Medicines represent an unparalleled contribution to global health, but their value is keenly negotiated by stakeholders across the developed and developing world,” the report said. “The global outlook for medicine use and spending is a much-watched barometer for the results of these ‘negotiations’ and provides insights into the prospects of life sciences companies, insurers and the health of populations around the world.”

IQVIA projects that the global pharmaceutical market will exceed $1.5 trillion by 2023, and although it is expected to grow at a 3%-to-6% compound annual growth rate over the next five years, — a slowdown from the 6.3% growth that took place over the past five years.

Growth in the United States will be driven by new products, but will be offset by losses of exclusivity of branded products, along with the emergence and growth of biosimilars, IQVIA said.

In the United States, while invoice spending is expected to increase at a 4%-to-7% compound annual growth rate to between $625 billion and $655 billion, over the next five years, net manufacturer revenue growth is expected to be slower, at 3%-to-6%.

Brand prices are expected to increase at a historically low 4%-to-7% on an invoice basis for protected branded products over the next five years, but 0%-to-3% on a net manufacturer revenue basis.

The report also revealed that spending on medicines is expected to tally over $600 billion on an invoice basis in 2023, including spending in all channels, including retail pharmacies, hospitals, doctors’ offices and on all product types, for example, small molecules, biologics, brands, generics, and biosimilars.

The impact of losses of exclusivity in developed markets is expected to be $121 billion between 2019 and 2023, with 80% of this impact, or $95 billion, in the United States. By 2023, 18 of the current top 20 branded drugs will be facing generic or biosimilar competition, IQVIA predicted.

By 2023, biosimilar competition in the biologics market will be nearly three times larger than it is today. This will result in a roughly $160 billion reduction in spending over the next five years, IQVIA said.

“The biggest single event in the biosimilars market in the next five years will be the introduction of adalimumab (Humira) biosimilars in the United States in 2023,” the report said. “By the end of 2023, only two of the current top 20 original brands, nivolumab (Opdivo) and pembrolizumab (Keytruda), will not be facing generic or biosimilar competition. By 2023, U.S. policies are expected to encourage more biosimilar applicants to file and to reshape reimbursement dynamics that have hampered early uptake of some molecules.”

IQVIA predicted that even with biosimilars driving a spending decrease, the share of total medicine spending going to specialty will reach 50% by 2023 in most developed markets as the majority of new medicines have been and will continue to be in specialty classes. In 2018, specialty comprised 41% of developed market spending — compared with 30% in 2013.

Cost and accessibility continue to be challenges that need to be addressed. IQVIA said the emergence of a limited number next generation biotherapeutic drugs is good news for patients, but the costs per patient for these therapies are challenging current payment models.

“Specialty, niche and orphan drugs, in increasing numbers, are reshaping the pricing environment as some have significant costs,” the report said.

Also on IQVIA’s radar is the increased use of mobile apps. Such applications are forecast to come to market alongside prescription devices with indications and disease-specific treatment effectiveness claims in their software labels.

Finally, the growth of artificial intelligence, machine learning and deep learning programs leading to the discovery and development of medicines, as well as policies and new legislation that will impact opioid prescribing and use, also are on IQVIA’s watch list.