The Trillion Dollar Market for Medicines:
Characteristics, Dynamics and Outlook
Johns Hopkins Bloomberg School of Public Health
Center for Drug Safety and Effectiveness
Safety, Value and Innovation Seminar
Murray Aitken
Executive Director
www.theimsinstitute.org
[email protected]
February 24, 2014
Contents
• About the IMS Institute
• Methodology and measures
• Global spending on medicines
• Mix of branded and generic medicines
• Transformations in disease treatment
• Implications and discussion
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About the IMS Institute
Unbiased
Information
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Academic
Research
Public Policy
Support
During 2013 we published six major reports
Teva Public Health Discussion 013014
4
Methodology
• Forecasts of spending on medicines globally are based on proprietary
analysis performed by IMS Health and published as IMS Market
Prognosis reports for 42 countries, 11 regions, and globally
• Methodology for each country forecast combines:
− Collection of historical data by sector as captured by IMS audits, estimates of
unaudited market sectors, and 5 most significant macroeconomic indicators based on
historical correlation
− Quantitative projection of baseline based on historical trends and macroeconomic
indicator forecasts provided by the Economist Intelligence Unit
− Identification, evaluation and quantification of specific events that are used to refine
the baseline based on IMS expertise and insight within each country
• Evented 5-year forecasts are produced for retail and hospital, price and
volume, as well as total market
• Additional proprietary analysis of the IMS Market Prognosis reports is
performed by the IMS Institute to generate additional analytics and
insights, some of which are incorporated in the IMS Institute report
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Notes on measures
• Market sizes are measured in U.S. $, converted at Q2 2013
average exchange rates
• All growth rates are measured in constant dollars (local
currency growth)
• “Spending” refers to the amounts paid to pharmaceutical
companies for medicines, not the cost incurred by the enduser or payer
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Total global spending on medicines will reach about $1.2Tn in
2017, an increase of $205-235Bn from 2012
Global spending and growth, 2008-2017
$205-235Bn
$234Bn
$1,1701,200 Bn
$965Bn
$731Bn
2007
2008-2012
Source: IMS Health Market Prognosis, September 2012
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2012
2013-2017
2017
Annual spending growth will reach a low point in 2013, followed
by increased growth particularly in developed markets
ABSOLUTE GROWTH CONST $USBN
Global Growth, 2008-2017
2013-17 Growth
$230 -260Bn
2008-12 Growth
$217Bn
70
60
50
40
30
20
10
0
-10
2008
2009
2010
Developed
2011
2012
Pharmerging
Source: IMS Health Market Prognosis, September 2013
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2013
2014
2015
2016
Rest of World
2017
Medicine spending per capita and growth rates are starkly different
between high income countries and those with income under $25,000
per capita
Per capita Gross National Income 2012 (GNI) vs. Forecast Pharma Spend
PHARMA FORECAST GROWTH (CAGR 2013-17)
20%
Pharma Spend per
Capita
China
$1,000
$500
15%
Brazil
India
$100
Russia
10%
Mexico
5%
S. Korea
Turkey
UK
Italy
0%
0
10
20
30
Canada
Japan
France
Germany
40
Spain
-5%
GNI (US$ THOUSANDS PER CAPITA)
Source: World Bank, 2012; IMS Health Market Prognosis, September 2013
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USA
50
60
Spending levels in 2017 on medicine for specific disease areas will
differ significantly between developed and pharmerging markets
Spending by Therapy area in 2017
Top 20 Classes, 71%
Developed Markets
Others, 29%
Sales in
2017 (LC$)
Top 20 Classes, 45%
Pharmerging Markets*
Others, 55%
Sales in
2017 (LC$)
$74-84Bn
Pain
$22-25Bn
Diabetes
$34-39Bn
Other CNS Drugs
$20-23Bn
Anti-TNFs
$32-37Bn
Antibiotics
$18-21Bn
Pain
$31-36Bn
Oncology
$17-20Bn
Asthma/COPD
$31-36Bn
Hypertension
$14-17Bn
Other CNS Drugs
$26-31Bn
Diabetes
$10-12Bn
Hypertension
$23-26Bn
Dermatology
$10-12Bn
Immunostimulants
$22-25Bn
Antiulcerants
$9-11Bn
HIV Antivirals
$22-25Bn
Cholesterol
$6-8Bn
Dermatology
$22-25Bn
Asthma/COPD
$3-5Bn
Antibiotics
Oncology
$18-21Bn
Anti-Epileptics
$3-5Bn
Cholesterol
$16-19Bn
Antivirals excluding HIV
$3-5Bn
Anti-Epileptics
$3-5Bn
$15-18Bn
Immunosuppressents
Immunosuppressents
$15-18Bn
Allergy
$3-5Bn
Antipsychotics
$13-16Bn
Antidepressants
$3-5Bn
Antiulcerants
$12-14Bn
Antiplatelet
$3-5Bn
$10-12Bn
Antipsychotics
$2-3Bn
Heparins
$1-2Bn
Antidepressants
Antivirals excluding HIV
ADHD
Interferons
$8-10Bn
$7-9Bn
Erectile Dysfunction
$1-2Bn
$6-8Bn
Immunostimulants
$1-2Bn
Source: IMS Health Thought Leadership, September 2013
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A growing share of all medicines are biologic, with biosimilars and nonoriginal biologic (NOB) products now taking a small share of the total
market
The biologics market
Biologics share
of total
pharmaceutical
market:
2002
2007
2012
11%
15%
18%
2017
19-20%
Global biologics size
$46Bn
$106Bn
Share of
biologics:
NOBs
Biosimilars
$169Bn
$205-235Bn
1.0%
1.0%
0.3%
0.3%
0.5% 0.5%
Source: IMS Health Thought Leadership, September 2013
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0.4%
0.4%
2-5%
The U.S., EU5, Japan and China account for just
under 70% of total global medicine spending
Geographic distribution of medicine spending
Spending
Growth
2012
2017
2013-17
$965BN
$1,170 – 1,200BN
$230-260BN
34%
31%
16%
31%
33%
6%
41%
8%
13%
15%
15%
12%
9%
US
EU5
Japan
China
Source: IMS Health Market Prognosis, September 2013
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ROW
3%
34%
Base case forecast for the U.S. is for 1-4% CAGR
U.S. Spending and Growth, 2008-2017
Forecast
400
10%
350
8%
300
6%
250
4%
200
2%
150
0%
100
-2%
50
0
2008
2009
2010
2011
2012
Sales
Source: IMS Health Market Prognosis, September 2013
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2013
2014
Growth
2015
2016
2017
-4%
GROWTH CONST US$
SPENDING US$BN
2013-17 CAGR, 1-4%
Alternative scenarios for the U.S. focus on the
implementation of healthcare reform
Healthcare Reform
Implementation
Implications for Medicine
Spending
Scenario 1: Reforms lead to
expanded access and
performance-based
healthcare system
• Almost full enrollment of the currently
uninsured according to original
government estimate
• Rapid movement toward performancecased system and organization of
healthcare delivery
• Increased demand for medicines resulting
from increased enrollment, screening,
removal of caps, and management of existing
conditions
• Cost-effective medicines with clinical value
being used more extensively
• Continued premium places on innovative
medicines with strong clinical profile
• Total spending on medicines in 2017: $420460Bn
Scenario 2: Slow pace of
change but some expansion
in access and incremental
changes to payment system
• Initial enrollment of currently uninsured
1/3 of target level, though
improvement over time
• Payment system remains largely feefor-service
• Uncertainty of political support slows or
stalls reform implementation
• Modest incremental demand for medicines
and primarily for generics
• Incremental pressure by payers and
employers limit price increases to current
levels at most
• Positioning of competitive medicines primarily
based on price
• Newly launched medicines see slow uptake
and limited commercial returns
• Total spending on medicines in 2017: $350380Bn
Scenario 3: Implementation
leads to major unintended
consequences and change
• Exchanges fail to enroll “young
invincibles” and insurance model fails
• Employers move large number of
employees to private exchanges
• Significant decline in healthcare
utilization for prevention and treatment
of chronic illness
• Decline in medicine demand volume
• Major reduction in formulary access for
insurance plans or major cost reductions
from manufacturers
• Limited acceptance of new medicines with
price premium
• Total spending on medicines in 2017: $300320Bn
Scenario
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The base-case scenario for the Top 5 European markets is for
spending growth to be flat through 2017
Top 5 Europe Spending and Growth, 2008-2017
Forecast
2013-17 CAGR, 0-3%
10%
180
160
8%
SPENDING US$BN
120
6%
100
4%
80
60
2%
40
0%
20
0
2008
2009
2010
2011
Sales
Source: IMS Health Market Prognosis, September 2013
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2012
2013
2014
Growth
2015
2016
2017
-2%
GROWTH CONST US$
140
The economic crisis has had a direct impact on the
number of launched products and their uptake
NCEs launched vs. market share achieved
6.0%
Countries with low # NCEs and strong
penetration
Countries with high # NCEs
and strong penetration
EUR average n46
Germany
NCE MARKET SHARE OF TOTALRX MARKET
5.5%
5.0%
France
4.5%
Norway
Luxembourg
4.0%
SUI
3.5%
Slovenia
Belgium
Greece
2.5%
EUR average 2.3%
2.0%
Portugal
Hungary
Czech Rep.
Countries with low # NCEs and low
penetration
1.5%
1.0%
Estonia
0.5%
Ireland
Netherlands
10
20
Spain
Sweden
Finland
France
30
Countries with high # NCEs and low
penetration
Italy
2008-2012
Poland
40
2003-2007
50
60
NUMBER OF NCEs (2008-12) LAUNCHED
Source: IMS Health MIDAS, September 2013
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UK
UK
Bulgaria
Latvia
Lithuania
Romania
0.0%
Austria
Italy
Slovakia
3.0%
Germany
Spain
70
80
90
The base-case scenario for Japan’s spending growth
is for a slight acceleration through 2017
Japan spending and growth, 2008-2017
Forecast
2013-17 CAGR, 2-5%
120
10%
8%
80
6%
60
4%
40
2%
20
0
2008
2009
2010
2011
Sales
Source: IMS Market Prognosis, September 2013
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2012
2013
2014
Growth
2015
2016
2017
0%
GROWTH CONST US$
SPENDING US$BN
100
Alternative scenarios for Japan’s efforts to
dramatically increase the use of generic medicines
Generics volume share of the unprotected market by country in 2003,
2008 and 2013
100%
90%
80%
70%
60%
50%
40%
30%
20%
Source: IMS Health MIDAS, September 2013
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2003
2008
2013
The base-case scenario for China’s spending growth
is a slowing trend and stability through 2017
China spending and growth, 2008-2017
Forecast
40%
180
35%
160
30%
140
25%
120
100
20%
80
15%
60
10%
40
5%
20
0
2008
2009
2010
2011
Sales
Source: IMS Market Prognosis, September 2013
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2012
2013
2014
2015
Growth
2016
2017
0%
GROWTH CONST US$
SPENDING US$BN
2013-17 CAGR, 14-17%
200
Alternative scenarios for the 2017 outlook are driven by
the depth of reform implementation in the next 5 years
2017 Implications for Medicine and
Spending Growth
Scenario
Reform implementation depth
Scenario 1:
Rapid rise of
private insurance
• The rise of private insurance (30-50% uptake in urban
areas) will fund >70% of cost for innovative drugs for
critical diseases.
• Substantial increases in private hospitals will provide both
higher quality healthcare and access to innovative drugs.
• The update of the NRDL in 2014 will increase the coverage
of international drugs with price cuts expected to be
<15%.
• The EDL usage ratio, which means more local generics in
Tier 2 and 3 hospitals, will remain limited.
• Single reimbursement price based on generic pricing will
not be implemented.
• CGMP guidelines widely implemented leading to an
improvement in the quality of local generics.
• Quality generics will enjoy strong representation in
primary care institutions and lower tier cities,
while international off patent drugs will retain a
price premium and will be widely used in large
hospitals and big cities.
• The rise of private insurance will fund on patent
branded products prior to their inclusion on the
state reimbursement list (which may take years
and be a relatively low level of access).
• The rise of private insurance together with a
faster regulatory system will result in an expanded
on-patent branded market for international
companies.
• Some private insurance (30% uptake or less) will fund
50% of the innovative drugs cost for critical diseases.
• There will be some increase in the number of private
hospitals to provide higher quality healthcare but access to
new innovative products will be contained.
• The NRDL list will be updated in 2014 but with some
delays in implementation and price cuts >15%.
• The actual usage ratio of EDL will increase to be closer to
governments targets.
• Single reimbursement price based on generic pricing will
be implemented in some provinces.
• CGMP guidelines will be implemented to a lesser degree
• Some private insurance (30% uptake or less) will
fund 50% of the innovative drugs cost for critical
diseases.
• There will be some increase in the number of
private hospitals to provide higher quality
healthcare but access to new innovative products
will be contained.
• The NRDL list will be updated in 2014 but with
some delays in implementation and price cuts
>15%.
• The actual usage ratio of EDL will increase to be
closer to governments targets.
• Single reimbursement price based on generic
pricing will be implemented in some provinces.
• CGMP guidelines will be implemented to a lesser
degree
Scenario 2:
Moderate
change in
medicine
reimbursement
CAGR 2013-17: 15-18%
CAGR 2013-17: 14-17%
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Alternative scenarios for the 2017 outlook are driven by
the depth of reform implementation in the next 5 years
Scenario
Scenario 3:
Delays and
limited change
Reform implementation depth
• Private insurance will not take off; negligible uptake
and funding of new products.
• The NRDL update will be delayed and coverage for
innovative products will be limited; The NDRC will
implement aggressive price cuts across the board for
branded products.
• Despite government efforts to encourage foreign
investment in private hospitals, barriers will remain
and only a small number of private hospitals will
emerge.
• The extensive use of the EDL will result in losses due
to tendering of international off-patent brands.
• Single reimbursement price based on generic pricing
will be widely implemented.
• CGMP is sparsely implemented to minimal effect.
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2017 Implications for Medicine and
Spending Growth
• China will fail to build a high quality locally
sourced off patent segment.
• Private insurance failure will perpetuate the
funding gap for innovative agents.
• International off-patent drugs will have a
significant drop in usage as the government
will only reimburse them at a price equivalent
to a local generic.
• The market will remain very difficult for
innovative agents, which will have to wait
years for a possible NRDL inclusion.
CAGR 2013-17: 12-15%
Generics will represent a larger share of the market
in volume and value terms
Global spending, 2012 and 2017
2012
Developed
Pharmerging
Rest of the
world
World
2017
72%
31%
16%
58%
57%
61%
12% $622Bn
11% $224Bn
27%
12% $965Bn
52%
Source: IMS Health Thought Leadership, September 2013
Generic
Other
21%
63%
52%
Brand
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26%
$120Bn
16%
27%
67%
31%
36%
12%
$650680Bn
11%
$370400Bn
17%
$125155Bn
$1,17012% 1,200Bn
Patent expiries on small molecule products will reduce brand
spending on developed markets by $113Bn through 2017
Developed Markets Patent Expiry Exposure and Impact
60
$149Bn
$123Bn
SPENDING SU$BN
40
50.3
20
21.0
22.3
-18.5
-15.3
26.9
28.4
-21.5
-22.6
19.1
31.7
28.8
20.3
22.6
0
-20
-17.2
-43.6
-40
-32.1
-$121Bn
-26.2
-22.5
-15.9
-$113Bn
-60
2008
2009
2010
2011
2012
Pre-Expiry Spending
Source: IMS Institute for Healthcare Informatics, September 2013
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2013
2014
2015
Lower Brand Spending
2016
2017
Spending on traditional pharmaceuticals will increase by 5% in
developed markets and by 69% in pharmerging markets over the next
5 years
Traditional Spending between 2012 and 2017
Developed Markets
500
$453
$448
$450
$459
Pharmerging Markets
$466
$476
SALES US$MN
400
$336
$302
300
$273
$199
200
$218
$244
100
0
2012
2013
2014
2015
2016
Source: IMS Health Thought Leadership, September 2013
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2017
2012
2013
2014
2015
2016
2017
Spending on specialty pharmaceuticals will increase
rapidly in both developed and pharmerging markets
Specialty Spending between 2012 and 2017
250
Developed Markets
$193
200
SALES US$MN
Pharmerging Markets
$180
150 $148
$153
$160
$169
100
50
$23
$26
$29
2012
2013
2014
$34
$38
2015
2016
$43
0
2012
2013
2014
2015
2016
Source: IMS Health Thought Leadership, September 2013
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2017
2017
Increasing numbers of innovative new medicines and
orphan drugs are expected to be launched
Global Launches of New Molecular Entities
GLOBAL NME LAUNCHES
40
35
30
25
20
15
10
5
0
2005
2006
2007
Novel Mechanism
2008
2009
Existing Mechanism
Source: IMS Institute for Healthcare Informatics, October 2013
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2010
2011
2012
Orphan
Average Per
Year 20132017
Treatment will be transformed by new and existing
mechanisms
Selected Product Launches 2013-2017
Disease area
Existing mechanisms
Rheumatoid Arthritis
• JAK inhibitor (adelatinib VX-509, baricitinib,
fostamatinib)
Cystic Fibrosis
• Transmembrane conductance regulator corrector
(Lumacaftor, VX-661)
Ribosome interaction for readthrough of
nonsense mutations (NM) in NM cystic
fibrosis (Ataluren )
Melanoma
• BRAF kinase inhibitor (dabrafenib)
• MEK kinase inhibitor (trametinib)
• Program cell death MAB (nivolumab, lambrolizumab)
• Oncolytic HSV vector (talimogene
laherparepvec)*
Breast cancer
• Mab (trastuzumab emtansine)
• Cyclin dependent kinase inhibitor (palbociclib)
Ovarian cancer
• Folate-targeted drug conjugate (vintafolide)
• VEGFR inhibitor (nintedanib)
Multiple sclerosis
• Lipophilic molecule (dimethyl fumarate)
Heart Failure
• Human peptide synthetic version (ularitide)
Hepatitis C
• NS3/4A proteinase inhibitor (asunaprevir, sofosbuvir,
simeprevir)
Malaria
Source: IMS Institute for Healthcare Informatics, September 2013
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New Mechanisms
• PARP inhibitor (olaparib)
• Human relaxin-2 hormone recombinant
(serelaxin)
• RTS,S Adjuvant System (P. falciparum
/ P.Vivax circumsporozoite protein)
Some of the diseases with highest global burden have fewer
new treatment options from recent or forthcoming launches
Global
High Income Countries
Disease
DALYs%
Disease
DALYs%
Pipeline
Launches
IHD
8.2%
IHD
5.2%
183
191
Stroke
4.7%
LRI
4.6%
53
73
Depression
4.3%
Stroke
4.2%
41
45
Lung Cancer
3.5%
Malaria
3.3%
17
6
COPD
3.2%
COPD
3.1%
48
24
Musculoskeletal
3.1%
Depression
3.1%
44
58
Diabetes
2.8%
Other HIV
2.7%
45
33
Alzheimer’s
2.3%
Tuberculosis
2.0%
53
5
Anxiety
1.9%
Diabetes
1.9%
120
89
Colorectal
1.8%
Neonatal Sepsis
1.8%
4
0
Alcohol Abuse
1.8%
Diarrhoea
1.6%
6
6
LRI
1.7%
Lung Cancer
1.3%
141
18
Breast Cancer
1.4%
Musculoskeletal
1.2%
7
6
Osteoarthritis
1.3%
Anxiety
1.1%
11
11
Other Circulatory
1.3%
Alcohol Abuse
1.1%
25
9
Migraine
1.3%
Meningitis
1.0%
12
21
Asthma
1.2%
Asthma
0.9%
67
29
Other Neoplasm
1.1%
Migraine
0.9%
21
19
BPH
1.0%
Liver Cancer
0.8%
53
4
Stomach Cancer
1.0%
Other Neurological
0.7%
14
9
Source: IHME Global Burden of Diseases, Injuries, and Risk Factors Study 2010; IMS Health R&D Focus, July 2013
Safety Value and Innovation Seminar JHU 022414
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The availability of new medicines varies widely by
country and disease
Global New Molecular Entities 2007-11 Available to Patients in 2012
Global
Total
% of Total
Anti-infectives &
Antivirals
Arthritis/Pain
Blood
Cardiovascular
CNS
Dermatology
Diabetes
Gastrointestinal
GU & Hormones
Immune System
Metabolic
Oncologics
Ophthalmics
Other
Respiratory
Vaccines
146
16
6
8
17
20
4
5
9
10
11
2
23
5
3
6
1
U.S.
Japan
Germany
France
Spain
Italy
UK
Canada
Korea
Brazil
Russia
India
China
94
59
88
65
70
65
88
63
52
45
42
38
37
64% 40% 60% 45% 48% 45% 60% 43% 35% 31% 29% 26% 25%
6
3
6
12
13
2
3
4
4
9
1
19
4
1
3
1
10
3
2
8
5
2
4
1
3
3
1
8
3
1
4
1
7
3
3
13
13
2
3
3
5
10
1
18
2
4
1
6
2
3
8
10
1
3
2
1
7
2
16
1
3
1
Source: IMS Institute for Healthcare Informatics, October 2013
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5
3
3
11
10
2
4
3
5
8
1
9
1
4
1
3
2
3
10
9
2
3
2
5
8
1
11
1
4
1
6
3
5
12
12
2
4
4
4
9
1
19
2
4
1
7
2
3
8
8
1
3
4
1
6
1
14
1
3
1
3
2
9
5
2
3
2
7
3
9
2
1
3
1
4
1
1
8
5
2
4
1
4
1
2
5
5
1
4
1
3
5
8
3
9
4
1
1
3
1
1
1
1
9
9
1
4
3
1
4
2
1
7
5
1
4
3
2
2
6
3
1
3
1
China will be the second largest market in 2017 and
approaching half the size of the U.S. market
Rank
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
2007
1
1
2
1
1
1
1
11
8
1
3
3
2
4
U.S.
Japan
France
Germany
China
Italy
UK
Spain
Canada
Brazil
Mexico
Australia
South Korea
Russia
Turkey
India
Netherlands
Greece
Poland
Belgium
Index
Rank
100
27
13
13
11
8
7
7
7
5
4
4
3
1
2
3
4
5
6
7
8
9
10
11
12
13
3
2
2
2
2
2
2
3
U.S.
Japan
China
Germany
France
Brazil
Italy
UK
Canada
Spain
Russia
Australia
India
14
3
Mexico
15
16
17
18
19
20
2
Change in ranking over prior 5 years
Source: IMS Market Prognosis, September 2013
Safety Value and Innovation Seminar JHU 022414
30
2012
2
2
4
1
1
2
3
8
2
1
9
South Korea
Venezuela
Turkey
Poland
Argentina
Belgium
Index
Rank
100
27
25
13
11
8
8
7
7
6
5
4
4
1
2
3
4
5
6
7
8
9
10
11
12
13
4
14
3
3
3
2
2
2
15
16
17
18
19
20
2017
Index
1
U.S.
China
Japan
Brazil
Germany
France
Italy
Russia
UK
Canada
India
Spain
Mexico
1
South Korea
4
Australia
Turkey
Venezuela
Argentina
Indonesia
Poland
4
3
2
2
2
2
1
1
2
1
1
3
1
1
2
2
3
1
1
1
8
2
100
45
29
13
13
10
8
7
7
7
6
5
4
Region and leading country spending
US$ billions
Global
Developed
U.S.
EU5
France
Germany
Italy
Spain
UK
Japan
Canada
South Korea
Pharmerging
China
Tier 2
Brazil
Russia
India
Tier 3
Rest of World
2012
965.4
621.6
328.2
148.7
36.7
42.1
26.2
19.9
23.9
111.3
22.0
11.3
223.9
81.7
59.6
28.5
17.1
14.0
82.6
120.0
Source: IMS Market Prognosis, September 2013
Safety Value and Innovation Seminar JHU 022414
31
2008-2012 CAGR
5.4%
2.9%
3.0%
2.4%
0.3%
3.8%
2.9%
1.7%
3.4%
3.0%
3.1%
6.3%
15.0%
22.3%
15.6%
14.6%
17.7%
15.1%
9.4%
4.7%
2017
1,170-1,200
650-680
350-380
140-170
30-40
41-51
23-33
13-23
20-30
90-120
20–30
10-20
370-400
160–190
90–110
38-48
23-33
22-32
100-130
125-155
2013-2017 CAGR
3-6%
1–4%
1–4%
0–3%
(-2)–1%
1-4%
0-3%
(-4)-(-1)%
1-4%
2-5%
1-4%
3-6%
10-13%
14-17%
10-13%
11-14%
8-11%
11-14%
5-8%
2-5%
Implications and discussion
• Medicine spending growth rebounding across developed economies and
tapering of “patent dividend” over next five years will bring new
dynamics to the medicines marketplace
• Spending growth of 10-13% CAGR across pharmerging countries brings
extraordinary stresses to funding and healthcare delivery systems
• Recent and future novel therapies bring new options and dynamics to
treatment of multiple therapy areas including diabetes, hepatitis C,
melanoma, multiple sclerosis and thrombosis/acute coronary syndrome
• Role and penetration of generic drugs remains very uneven across
developed markets even as policy levers are being applied
• Levels of spending on new NCEs are at historically low levels bringing
inadequate returns to investment capital
• Visibility of $1 trillion medicine cost is high – but not the context and
impact on healthcare systems or patients
Safety Value and Innovation Seminar JHU 022414
32
The Trillion Dollar Market for Medicines:
Characteristics, Dynamics and Outlook
Johns Hopkins Bloomberg School of Public Health
Center for Drug Safety and Effectiveness
Safety, Value and Innovation Seminar
Murray Aitken
Executive Director
www.theimsinstitute.org
[email protected]
February 24, 2014