The Covid-19 pan­dem­ic can't hold down glob­al drug spend­ing, IQVIA re­ports, with cash ex­pect­ed to keep flow­ing

De­spite its long-reach­ing ef­fects in glob­al mar­kets, the Covid-19 pan­dem­ic is not ex­pect­ed to broad­ly im­pact glob­al sales on med­i­cines in the near-term fu­ture, ac­cord­ing to a new re­port from IQVIA.

Michael Klein­rock

Over the next five or so years, through 2025, glob­al spend­ing will grow at an es­ti­mat­ed 3% to 6% rate an­nu­al­ly and reach $1.6 tril­lion in sales. No­tably, that fig­ure does not in­clude an ad­di­tion­al $157 bil­lion ex­pect­ed to be spent on Covid-19 vac­cines, which will most­ly come from now through the end of 2022.

Those growth rates are more or less in line with the pre­vi­ous five-year pe­ri­od, per re­port au­thor Michael Klein­rock, who serves as lead re­search di­rec­tor at the IQVIA In­sti­tute for Hu­man Da­ta Sci­ence. Though sales were sharply af­fect­ed at the be­gin­ning of the Covid-19 out­break in ear­ly 2020, pro­jec­tions have es­sen­tial­ly re­turned to their pre-pan­dem­ic lev­els.

“With­out the vac­cine spend­ing, out­side that, it’s on­ly re­al­ly moved [the com­pound an­nu­al growth rate] by about one-tenth,” Klein­rock told End­points News. “The rea­son was the shark bite tak­en out of ear­ly 2020, then the nor­mal trend re­sumes fair­ly close to that.”

For the world’s largest mar­ket in the US, where med­i­cines spend­ing sat at 4.2% an­nu­al growth from 2016 to 2020, IQVIA is pre­dict­ing a range of 2% to 5% for the next five years. Oth­er de­vel­oped na­tions will al­so see sim­i­lar­ly flat growth rates, IQVIA pre­dicts, with about 1.5% to 4.5% growth an­nu­al­ly on av­er­age af­ter clock­ing in at 3.8% in the pre­vi­ous five years.

It’s a bit of a dif­fer­ent sto­ry for emerg­ing phar­ma mar­kets — or as IQVIA refers to them, “pharmerg­ing” mar­kets — where an­nu­al spend­ing is ex­pect­ed to in­crease slight­ly. This group is large­ly head­ed by ef­forts in Chi­na, where es­ti­mat­ed spend­ing will in­crease by 4.5% to 7.5% each year, com­pared to 4.9% in the ear­li­er pe­ri­od.

These fig­ures, Klein­rock said, rep­re­sent the in­voice lev­els and don’t in­clude the re­bates and oth­er dis­counts some coun­tries might ne­go­ti­ate with phar­ma com­pa­nies. Typ­i­cal­ly, drug spend­ing makes up about 1% to 2% of any coun­try’s GDP, he added.

Spend­ing on the Covid-19 shots is no­table, with Klein­rock say­ing the prices rep­re­sent “tremen­dous val­ue.” He com­pared the dol­lar fig­ure to that of the wave of new he­pati­tis C drugs about sev­en years ago, not­ing that there was about $130 bil­lion spent on a much small­er pa­tient pop­u­la­tion.

Among the biggest growth ar­eas IQVIA pre­dicts are on­col­o­gy and im­munol­o­gy which, de­spite biosim­i­lar pres­sure, are con­tin­u­ing to see in­no­va­tion in nar­row­ing and more pre­cise pa­tient pop­u­la­tions. There’s al­so a lot of ex­cite­ment in neu­rol­o­gy, though Klein­rock is more cau­tious here giv­en the sheer amount of drug fail­ures in the past 25 years.

Much of IQVIA’s es­ti­mates re­ly on a mod­el of mass glob­al vac­ci­na­tions, where their best-case sce­nario sees the world reach­ing herd im­mu­ni­ty by the end of 2022. That would in­volve in­oc­u­lat­ing 5.5 bil­lion peo­ple, a tall task by any stan­dard. But Klein­rock is op­ti­mistic that this to­tal could be reached, or at the very least some­thing close to it.

The “straight-line” pro­jec­tion, or the es­ti­mate if every­thing held at the same pace it cur­rent­ly does, for vac­ci­na­tions, will see 2 bil­lion peo­ple reach­ing im­mu­ni­ty by the end of 2021. IQVIA’s base sce­nario projects the to­tal to be about 500 mil­lion high­er than that, par­tic­u­lar­ly if the US vac­ci­na­tion cam­paign con­tin­ues at its pace and then shares its ex­cess sup­ply with oth­er coun­tries.

There is po­ten­tial for con­tin­ued vac­cine hes­i­tan­cy and sup­ply dis­rup­tions, which would pre­vent Covid-19 from mor­ph­ing in­to some­thing that can be kept in an en­dem­ic state, Klein­rock said. But on the whole, he feels con­fi­dent in the IQVIA mod­el, say­ing it’s “very like­ly” the base case sce­nario will be re­al­ized.

Mov­ing Out of the Clin­ic with Dig­i­tal Tools: Mo­bile Spirom­e­try Dur­ing COVID-19 & Be­yond

An important technology in assessing lung function, spirometry offers crucial data for the diagnosis and monitoring of pulmonary system diseases, as well as the ongoing measurement of treatment efficacy. But trends in the healthcare industry and new challenges introduced by the COVID-19 pandemic are causing professionals in clinical practice and research to reevaluate spirometry’s deployment methods and best practices.

Paul Hudson (Getty Images)

Sanofi, Glax­o­SmithK­line jump back in­to the PhI­II race for a Covid vac­cine — as the win­ners con­gre­gate be­hind the fin­ish line

Sanofi got out early in the race to develop a vaccine using more of a traditional approach, then derailed late last year as their candidate failed to work in older people. Now, after likely missing the bus for the bulk of the world’s affluent nations, they’re back from that embarrassing collapse with a second attempt using GSK’s adjuvant that may get them back on track — with a potential Q4 launch that the rest of the world will be paying close attention to.

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SCO­TUS de­clines to re­view En­brel biosim­i­lar case, tee­ing up 30+ years of ex­clu­siv­i­ty and $20B more for Am­gen’s block­buster

As the House Oversight Committee is set to grill AbbVie CEO Richard Gonzalez on Tuesday over tactics to block competition for its best-selling drug of all time, another decision on Capitol Hill on Monday opened the door for billions more in Amgen profits over the next eight years.

The Supreme Court on Monday denied Novartis subsidiary Sandoz’s petition to review a Federal Circuit’s July 2020 decision concerning its biosimilar Erelzi (etanercept-szzs), which FDA approved in 2016 as a biosimilar to Amgen’s Enbrel (etanercept). Samsung’s Enbrel biosimilar Eticovo also won approval in 2019 and remains sidelined.

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No­var­tis' En­tresto takes its 2nd fail­ure of the week­end at ACC, show­ing no ben­e­fit in most dire heart fail­ure pa­tients

Novartis’ Entresto started the ACC weekend off rough with a trial flop in heart attack patients, slowing the drug’s push into earlier patients. Now, an NIH-sponsored study is casting doubt on Entresto’s use in the most severe heart failure patients, another black mark on the increasingly controversial drug’s record.

Entresto, a combination of sacubitril and valsartan, could not beat out valsartan alone in an outcomes head-to-head for severe heart failure patients with a reduced ejection fraction (HFrEF), according to data presented Monday at the virtual American College of Cardiology meeting.

How to man­u­fac­ture Covid-19 vac­cines with­out the help of J&J, Pfiz­er or Mod­er­na? Bi­ol­yse sees the dif­fi­cul­ties up close

When Biolyse, an Ontario-based manufacturer of sterile injectables, forged a deal with Bolivia last week to manufacture up to 50 million J&J Covid-19 vaccine doses, the agreement kicked off what will prove to be a test case for how difficult the system of compulsory licenses is to navigate.

The first problem: When Biolyse asked J&J, via a March letter, to license its Covid-19 vaccine, manufacture it in Canada and pay 5% royalties on shipments to needy, low-income countries, J&J rejected the offer, refusing to negotiate. J&J also did not respond to a request for comment.

Tim Mayleben (L) and Sheldon Koenig (Esperion)

On the heels of a sting­ing Q1 set­back, Es­pe­ri­on's long­time cham­pi­on is ex­it­ing the helm and turn­ing the wheel over to a mar­ket­ing pro

Just days after getting stung by criticism from a badly disappointed group of analysts, there’s a big change happening today at the helm of Esperion $ESPR.

Longtime CEO Tim Mayleben, who championed the company for 9 years from early clinical through a lengthy late-stage drive to successfully get their cholesterol drug approved for a significant niche of patients in the US, is out of the C suite, effective immediately. Sheldon Koenig — hired at the end of 2020 with a resume replete with Big Pharma CV sales experience —  is stepping into his place, promising to right a badly listing commercial ship that’s been battered by market forces.

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Matt Gline (L) and Vivek Ramaswamy

In­sid­er ac­count of Roivan­t's SPAC deal — and that $7.3B val­u­a­tion — re­veals a few se­crets as Matt Gline po­si­tions the com­pa­ny as the new ‘Big Phar­ma’

It was Oct. 7, 2020, and Matt Gline wasn’t wasting any time.

The CEO of Roivant had word that KKR vet Jim Momtazee’s SPAC had priced late the night before, triggering a green light for anyone interested in pursuing a big check for future operations and riding the financial instrument to Nasdaq. So he wrote a quick email congratulating Momtazee, whom he knew, for the launch.

Oh, and maybe Momtazee would like to schedule something with Gline and his executive chairman, Roivant founder Vivek Ramaswamy, to chat about Roivant and its business?

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Re­gen­eron's Evkeeza shows promise in curb­ing high triglyc­erides, but will ge­net­ic dis­par­i­ties lim­it use?

When Regeneron scored an early approval for lipid lowering antibody Evkeeza back in February, the drugmaker cracked open a new pathway to lower abnormally high cholesterol levels. Now, Regeneron is chasing high triglycerides as well with some promising mid-stage data — but will genetic restrictions limit the drug’s use?

Regeneron’s Evkeeza (evinacumab) cut median triglyceride levels by more than 800 mg/dL (57%) in patients with a rare disorder causing abnormally high triglyceride levels compared with an overall increase of 50 mg/dL (1.8%) in participants on placebo, according to Phase II data presented Sunday at the virtual American College of Cardiology meeting.

$DNA is once again on NYSE; FDA clears Soliris chal­lenger for the mar­ket; Flag­ship’s think­ing big again with eR­NA; and more

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I still remember the uncertainty in the air last year when nobody was sure whether ASCO would cancel their in-person meeting. But it’s now back again for the second virtual conference, and Endpoints News is here for it. Check out our 2-day event reviewing the landscape of cancer R&D and send news our way.

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