By Karen Blum
The pharmaceutical marketplace may be a hard thing to predict, but there is at least one event that attendees at the major specialty pharmacy conferences can bank on each year: Doug Long’s piercing analysis of key industry trends that stakeholders need to heed when crafting their competitive strategies.
Mr. Long, the vice president of industry relations for IQVIA, rolls out his presentation at several conferences annually. During Asembia’s AXS24 Summit, in Las Vegas, he focused on key drug utilization trends from the previous year. He first highlighted immunology, novel obesity and antibiotic drugs as particularly hot therapeutic topics.
Immunology drug use reached 1.2 billion days of therapy in 2023, up 60% from 2019, Mr. Long said. Treatment of Crohn’s disease and psoriasis accounted for 26% and 15% of growth, respectively, he added, citing IQVIA in-house data. There were 2.6 billion antibiotic days of therapy last year, returning to pre-pandemic levels.
There also were nearly 700,000 new prescriptions for glucagon-like peptide-1 (GLP-1) receptor agonists for diabetes and obesity in February 2024, up 181% compared with two years prior, Mr. Long said, adding that 34% of growth in the total market came from GLP-1s. “That’s from volume and line extensions, not really price, even though they’re expensive.”
It’s a trend likely to continue, he said, as the pipeline can be considered an “obesity gold rush,” with 120-plus weight-loss agents being developed by more than 60 companies: “There’s a whole bunch of them on the horizon—so this is not going to go away.”
Drug Shortages Hit Record High
Mr. Long also cited the perennial issue of drug shortages, which are higher than ever before. During the first three months of 2024, there were 323 active medication shortages, according to ASHP and the University of Utah Drug Information Service. Previously, the record high was 320 shortages in 2014.
Looking back on 2023, 58% of drug shortages were in short supply for more than two years, he said. Key drugs on shortage include GLP-1s, cisplatin and carboplatin, Adderall (dextroamphetamine-amphetamine, Teva), albuterol, and amoxicillin. Reasons are multifold and include product disruptions resulting from weather events such as a tornado hitting Pfizer’s production facility in North Carolina to a gap in FDA inspections of manufacturing facilities dating back to the COVID-19 pandemic.
Mr. Long shared these other notable marketplace trends:
• For the total market, specialty growth was weaker than traditional growth. As of February 2024, specialty spending for the previous year grew by 13% while traditional growth grew by 14%. That’s partly because GLP-1s are traditional, not specialty drugs, he said.
• The top therapy classes by sales were immunology, antidiabetics and antithrombotics, and oncologics, followed by HIV antivirals, medications for attention-deficit/hyperactivity disorder, respiratory agents and drugs for mental health.
• Three therapy areas are “running hot”: oncology, immunology and diabetes. Oncology will remain the largest therapy area by 2028. However, the oncology marketplace is getting crowded, with 10 PD-1 (programmed death-1) immune checkpoint inhibitors and multiple entrants to the space that could slow down growth. In the immunology space, there are more indications than ever before, with drugs specific to Crohn’s disease, psoriasis, etc. The diabetes class “has really exploded” with GLP-1s.
• There were 80 drug launches in 2023, compared with 58 in 2022 and 76 in 2021. The top launches by sales were the respiratory syncytial virus vaccines Abrysvo (Pfizer), Arexvy (GSK) and nirsevimab-alip (Beyfortus, Sanofi).
• The top eight specialty products exhibited vigorous growth from 2022 to 2023, including a 258% increase in sales for semaglutide (Wegovy, Novo Nordisk), a 248% increase in sales for upadacitinib (Rinvoq, AbbVie), and a 115% increase in sales for daratumumab and hyaluronidase-fihj (Darzalex Faspro, Janssen).
Mr. Long reported no relevant financial disclosures beyond his stated employment.
