There are so many useful reports in health care that aid in understanding what kind of care is being utilized and what the costs are. In regard to pharmaceuticals, the regular IMS report on Global Use of Medicines is one of the best. (IMS Report) The headline catching number is that worldwide drug spending was projected to be over one trillion dollars in 2014, rising to $1.2 trillion in 2017. That is a huge industry by any standard. The global market is showing an interesting divergence, with most developed countries having only single-digit drug spending growth, while some newly developed and emerging economies provide opportunities for more rapid growth as they spend more on health care, both privately and publicly. For drug companies this has meant increased attention to these newer markets, which can be challenging from a regulatory and reimbursement perspective, but which may provide better returns than existing developed markets. In regard to the development of new therapeutics, innovation now and for the next few years is focused on specialty drugs which either treat less common diseases or new biologic approaches to somewhat common diseases that do not currently have treatments with high levels of clinician or patient satisfaction. The top therapeutic classes in developed markets in 2017 are projected to be oncology, diabetes, arthritis, and pain; and in emerging markets to be pain, CNS agents, antibiotics and oncology. As we are seeing in the United States, it is apparent that much of cost of drugs will be driven by expensive new biologic agents, which are harder to develop and manufacture and which tend to retain higher costs for a longer period of time due to difficulty of “genericizing” these drugs.
