Doug Long, vice president of industry relations at IQVIA, provided an analysis of the most up-to-date industry data and highlighted pharmacy trends, issues, and forecasts in demographic sales and markets for 2022 and beyond.
Mr. Long began by recapping the COVID-19 impact on pharmacy. “This has been a fascinating story to watch,” he observed. “We are basically stable in all kinds of metrics. There was a big lift from Omicron in January, but we have gotten that past this.” He recounted that 75% of deaths from COVID-19 occurred in people over age 65 years, and very few deaths occurred in persons under age 35 years.
Mr. Long commended the pharmacy profession for its performance during the pandemic. “NACDS members and retail pharmacist stepped up tremendously, and the place to go to get covid vaccination was the retail pharmacy.”
Regarding the impact of COVID-19 vaccination on total prescriptions, he observed that year to date, as of June 2022, COVID-19 vaccines make up almost three of every 100 retail prescriptions, down from six of every 100 scripts in 2021. “That number will probably pick up a bit with the availability of the booster,” he said. Antivirals, he added, have seen a large increase in volume in the lasts few months, particularly with Paxlovid.
Looking at another manifestation of the pandemic, Mr. Long said that telemedicine “did not really exist in any measure prior to covid.” However, he said, “It rose the occasion in April 2020 and represented about 15% of all claims. It has settled in now at about 8% of claims.”
The disadvantage with telemedicine, he pointed out, is the lack of access to laboratory results, which makes doctors uncomfortable. As a result, he stated, “telehealth will not generate as many prescriptions as office visits.” The caveat, he added, is with attention-deficit/hyperactivity (ADHD) drugs, which accelerated with telehealth. However, there has been pull-back among some chains (CVS, Walmart), he observed, that were uncomfortable with prescribing ADHD drugs for young children. The cumulative institutional healthcare claim trend is flat in 2022 compared with 2021, while office claims have increased over 2021, he added.
So far, Mr. Long said, elective procedures have not recovered. Elective procedures in 2022 continue to decline compared with 2021, potentially due to rising economic constraints. “With inflation up, people may be postponing elective procedures. New prescriptions have recovered, on the other hand, now that doctors’ offices are reopening,” he observed.
Retail drug channels are also growing, he said. The fastest expansion is in grocery stores, up 10.8% year to date. “There are always winners and losers,” he observed. Specialty spend is more than 50% of invoice dollars for the first time, growing at 11.1%, and driven by autoimmune and oncology medications, he said. “Some top products, however, will soon face competition, i.e., Humira.” HIV is the number-one class in specialty, Mr. Long added. “HIV is extremely important to the retail section.”
Among other drug classes, immunology and antithrombotics show the greatest 5- and 1-year growth. The pain and mental health categories are steady, he said. The medications for multiple sclerosis are lagging due to a lack of innovation and generic competition. In retail drugs, the number-one product is Eliquis, while Ozempic exhibited the most growth—73% over a year. Overall, he observed, the total pharmacy investment is strong. “Spending increased by $82 billion over the pat 5 years, driven by new products and brand volume, offset by expires.”
Examining drug categories, diabetes, respiratory, antithrombotics, and HIV all show strong growth, he said. Protected brand list prices increased 4.6% in 2021, while net prices increased by 1%, the fifth year at or below the consumer price index, Mr. Long commented. Acute prescriptions are finally recovering, he said, and antidiabetics show the greatest 5-year growth.
“This year appears to be settling into our new normal in retail,” he observed. “Retail is in a good position.”
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