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 industry trends that stakeholders should 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 data points 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 prepandemic 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 more numerous 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 (bit.ly/3w8ckYi-SPC). 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, dextroamphetamine-amphetamine, albuterol, and amoxicillin. Reasons are multifold and include product disruptions resulting from adverse weather hitting production facilities to a gap in FDA inspections of manufacturing facilities dating back to the COVID–19 pandemic.
Mr. Long shared these other notable marketplace trends:
- 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 antiretrovirals, medications for attention-deficit/hyperactivity disorder, respiratory agents and drugs for mental health.
- Oncology will remain the largest therapeutic area by 2028, although the marketplace is getting crowded, with 10 PD-1 (programmed death-1) immune checkpoint inhibitors and multiple entrants that could slow down growth.
- In immunology, there are more indications than ever before, with drugs specific to Crohn’s disease, psoriasis, etc.
- 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) and Arexvy (GSK) and long-acting monoclonal antibody 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.