• The global medicine market — based on invoice price levels — is expected to grow at 3-6% CAGR through 2026.
• Medicine use and spending trends have been negatively impacted by the COVID-19 pandemic but will be more than offset by incremental spending on related vaccines and therapeutics.
• Global medicine spending will be lifted by stronger pharmerging market growth through 2026 and offset by slower growth in developed markets caused by losses of exclusivity for original brands.
• A total of 300 new drugs are expected to be launched over the next five years to 2026, significantly higher than levels seen on average during the past decade, and are expected to skew toward specialty, niche and orphan drugs.
• New product launches in the next five years will result in $196 billion in new spending, largely offset by reductions in brand spending, with $188 billion due to losses of exclusivity.
• The two leading global therapy areas — oncology and immunology — are forecast to grow 9-12% and 6-9% CAGR, respectively, through 2026, lifted by significant increases in new treatments and medicine use and offset by the impact of biosimilars.
• In neurology, many new medicines are expected across a range of diseases, including novel migraine therapies, potential treatments for rare neurological diseases and potential therapies for Alzheimer’s and Parkinson’s diseases.

Global spending on medicines — based on invoice price levels — is expected to grow at 3-6% CAGR through 2026 to reach about $1.8 trillion by 2026, including spending on COVID-19 vaccines and novel therapeutics, according to a new report, The Global Spending and Usage of Medicines, released by the IQVIA™ Institute for Human Data Science.

The total cumulative spending on COVID-19 vaccines since their introduction through 2026 is projected to be $251 billion, largely from the initial wave of vaccinations to be completed by 2022 in most countries. In subsequent years, booster shots are expected to be required annually or more often as the limited durability of immunity and the continued emergence of viral variants drive recommendations for additional inoculations.

“While the pandemic has been extremely disruptive to patients and health systems, underlying pre-pandemic trends in medicine use and spending remain significant drivers of the outlook, including the impact of record levels of new drug launches and patent expiries of small molecule and biologic drugs,” said Murray Aitken, IQVIA senior vice president and executive director of the IQVIA Institute for Human Data Science. “The ability of countries around the world to roll out a global vaccination program — overcoming hesitancy from patients and persistent logistical challenges — will be key to the transition to an endemic virus and have widespread impacts on the outlook for all medicine use through 2026 and beyond.”

A few key highlights of the report include:

• Substantial global market growth from COVID-19 vaccines and therapeutics: Global spending on vaccines is projected to total $251 billion over the six years from their first introduction to 2026. Novel therapeutics for the virus will total $58 billion over the same period, for a total of $309 billion of COVID-19 vaccine and therapeutic spending. The pandemic will reduce non-COVID spending by a total of $175 billion over the same period, and the net increase in spending globally is expected to total $133 billion.

• Pharmerging markets: In pharmerging markets, absolute growth will be led by China, which is expected to grow at a rate of 2.5-5.5% and add more than $30 billion in annual spending by 2026, driven by greater uptake and use of new original medicines.

• The U.S. market: On a net price basis, the U.S. market is forecast to grow 0-3% CAGR over the next five years, down from 3.5% CAGR for the past five years. Historically high numbers of new products will contribute $114 billion in spending over five years, up from $93 billion the last five years but representing a smaller share of the market. The largest drivers of the slowing growth rate are reduced price growth for brands and the increased impact of brand losses of exclusivity, including biosimilars, which more than doubles to $141 billion over five years compared to $57 billion in the prior five years.

• Japan: The third-largest global market will have flat-to-declining medicine spending, including the likely shift from biennial to annual price revisions, which started with off-cycle price cuts in 2021. Current pricing policies that reward innovative patent-protected brands are expected to continue, coinciding with the ongoing shift to generics for older medicines.

• Europe: Spending in Europe is expected to increase 3-6% CAGR or a total of $51 billion over the five years to 2026, not including spending on COVID vaccines and therapeutics.

• Novel medicines: New brands in developed markets through 2026 are projected to increase in absolute spending to $196 billion, up more than 20% over the past five years, and continuing a historically high period of spending on novel medicines and largely recovering from the impact of the pandemic. New active substances launches are also projected to continue at higher levels than seen in the past decade, with an average of 54-63 per year, totaling 290-315 for five years through 2026.

• Loss of brand exclusivity and rise in biosimilars: The impact of exclusivity losses will increase to $188 billion over the next five years, mostly due to the availability of biosimilars, which will have greater impact in some countries than small molecules. The cumulative incremental savings in the years 2022-2026 from new biosimilars will reach an estimated $215 billion.

• Therapy area growth: The two leading global therapy areas — oncology and immunology — are forecast to grow at 9-12% and 6-9% CAGR, respectively, through 2026, lifted by significant increases in new treatments and medicine use and offset by the impact of biosimilars. Oncology is projected to add 100 new treatments over five years, contributing to an increase in spending of $119 billion to a total of more than $300 billion in 2026. Immunology growth is projected to slow to 6-9% from 16.9% CAGR over the past five years as biosimilars provide lower-cost treatments and offset growth from volume and drug launches. In addition, many new therapies are expected in neurology, including novel migraine therapies, potential treatments for rare neurological diseases and potential therapies for Alzheimer’s and Parkinson’s diseases.

The full version of the report, including a detailed description of the methodology, is available at www.IQVIAInstitute.org. The study was produced independently as a public service, without industry or government funding.

About the IQVIA Institute for Human Data Science

The IQVIA Institute for Human Data Science contributes to the advancement of human health globally through timely research, insightful analysis and scientific expertise applied to granular non-identified patient-level data.

Fulfilling an essential need within healthcare, the Institute delivers objective, relevant insights and research that accelerate understanding and innovation critical to sound decision making and improved human outcomes. With access to IQVIA’s institutional knowledge, advanced analytics, technology and unparalleled data, the Institute works in tandem with a broad set of healthcare stakeholders to drive a research agenda focused on Human Data Science, including government agencies, academic institutions, the life sciences industry and payers. More information about the IQVIA Institute can be found at www.IQVIAInstitute.org.

About IQVIA

IQVIA (NYSE:IQV) is a leading global provider of advanced analytics, technology solutions, and clinical research services to the life sciences industry. IQVIA creates intelligent connections across all aspects of healthcare through its analytics, transformative technology, big data resources and extensive domain expertise. IQVIA Connected Intelligence™ delivers powerful insights with speed and agility — enabling customers to accelerate the clinical development and commercialization of innovative medical treatments that improve healthcare outcomes for patients. With approximately 77,000 employees, IQVIA conducts operations in more than 100 countries.

IQVIA is a global leader in protecting individual patient privacy. The company uses a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. IQVIA’s insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors and scientific advances, in an effort to advance their path toward cures. To learn more, visit www.iqvia.com.

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