Nominal, or unadjusted, spending on pharmaceuticals reached $325.8 billion in 2012, a 0.1% decrease from $329.2 billion in 2011 – the first time the growth rate has fallen, said IMS Institute Director of Research Development Michael Kleinrock. Real per capita spend fell 3.5%, or $33 per patient, from $931 in 2011 to $898 in 2012. .Sales to 19 to 25 year olds fell in 2012 – but that was after a spike in 2011 due to a provision in the ACA that allowed them to stay longer on their parents’ insurance. That said, the group only accounted for 3% of total U.S. prescription sales according to the Pink Sheet.
The downward trend could indicate insured U.S. citizens are rationing their use of the health care system due to higher out-of-pocket costs, which could have a negative effect on both patients and the system in the future.
Pharmaceutical spending declined largely due to a slew of patent expirations, and also to a weaker than usual cold and flu season.
- Lost revenues from patent expirations led to a decline of $28.9 billion in spending.
- Generic use continues to rise – now accounting for 84% of dispensed prescriptions, up from 80% in 2011, and driving $8 billion in spending growth in 2012. IMS expects generics to account for 87% of spending by 2017. Patients choose generics 95% of the time when they are available.
- FDA approved 39 new molecular entities (both small molecules and biologics) in 2012 – the highest number in over a decade.
- The past year also saw a slew of orphan disease medications entering the market, as well as nine new oncology treatments – the most in over a decade. There were 11 new drugs launched that offered a new mechanism of action – the highest number of new mechanisms of action since 2005.
- Despite the influx of specialty medicines, small molecule drugs still make up 75% of total drug spending and are sold largely through retail pharmacy channels.
- About 55% of drugs dispensed are oral formulations, but injectables made up 31% of drugs.
- The top five therapeutic classes in 2012, based on spending, were oncologics ($25.9 billion), mental health ($23.5 billion), respiratory agents ($22.1 billion), diabetes treatments ($22 billion) and pain medications ($18.2 billion)