BMI View: The US pharmaceutical market is, and will continue to remain, the most attractive globally. Due to ongoing challenges in Western Europe and emerging markets, drug companies should increasingly prioritise the US for commercialisation efforts, as well as R&D and manufacturing investments . The key downside risk to this positive outlook is increased pricing pressure from the government and other payers.
Headline Expenditure Projections
Pharmaceuticals : USD333.4bn in 2015 to USD349.9bn in 2016; +4.9% growth. Market forecast revised upwards since Q116 due to consideration and incorporation of new company sales data.
Healthcare : USD3.1trn in 2015 to USD3.3trn in 2016; +5.0% growth. Forecast unchanged since Q315.
|f = BMI forecast. Source: WHO, National Sources, BMI|
|Pharmaceutical sales, USDbn||309.861||333.403||349.865||361.115||372.797||384.893||397.380|
|Pharmaceutical sales, % of GDP||1.78||1.86||1.87||1.85||1.82||1.80||1.78|
|Pharmaceutical sales, % of health expenditure||10.3||10.7||10.7||10.5||10.3||10.2||10.1|
|Health spending, USDbn||3,006.435||3,121.028||3,276.844||3,439.659||3,607.163||3,775.294||3,946.594|
The US has a Pharmaceutical Risk/Reward Index (RRI) score of 82.8 out of 100 for Q216. This is slightly below the 82.8 recorded in Q116. The high RRI score recorded by the US underlines the pharmaceutical market's unassailable status as the most lucrative globally. This is due to unparalleled healthcare access, considerable spending power, a high burden of disease, minimal market access barriers and intense company activity. The key risks to this positive outlook are the increasing influence of pharmacy benefit managers and greater regulation, such as the Branded Prescription Drug Fee.
The top 15 pharmaceutical companies generated aggregate sales of more than USD210bn in the US during 2015. Pfizer was the leading company with annual sales of USD21,704mn, closely followed by Gilead Sciences (USD21,200mn). A further five firms - Roche (USD18,350mn), Johnson & Johnson (USD18,333mn), Novartis (USD18,079mn), Amgen (USD16,523mn) and Merck & Co (USD16,238mn) - generated more than USD15bn in annual sales in the US in 2015.
The Boards of Directors of Shire and Baxalta reached an agreement under which Shire will combine with Baxalta. Under the agreement, Baxalta shareholders will receive USD18 in cash and 0.1482 Shire ADS per Baxalta share. The value of the offer, as of Shire's January 8 2016 closing ADS price, represents a premium of approximately 37.5% to Baxalta's unaffected share price on August 3 2015, the day prior to the public announcement of Shire's initial offer for Baxalta. This will provide Baxalta shareholders with approximately 34% ownership in the combined company. The parties expect the transaction to close mid-2016.
The election of Hillary Clinton as US President could lead to downward pressure on medicine prices. Drug sales would be constrained, and the attractiveness of the world's largest pharmaceutical market would be diminished. R&D budgets and investment plans of both domestic and foreign firms would be reviewed as a consequence.
BMI Economic View
The risk that the US economy could enter recession in 2016 is higher than surface level indicators show. Industrial output has declined for 12 consecutive months and capacity utilisation has headed consistently lower as well. The former is mainly a reflection of weakness in the oil industry, a trend we expect to continue throughout 2016. These two factors could lead to layoffs in manufacturing employment and weaken the US consumer outlook, helping to tip the economy into recession.
BMI Political View
A Trump presidency could radically shake up the US-led international system, leaving Washington more at odds with both its allies and adversaries. In addition, a more unilateralist US could expose Eastern Europe and East Asia to greater Russian and Chinese assertiveness, respectively. Consequently, we would expect the US foreign policy and defence establishment to subtly resist some of Trump's more controversial policies, although Trump would press ahead regardless. While healthcare in general is still a significant concern since the implementation of the Affordable Care Act, the cost and sustainability of medical services has diminished as a leading issue among the public.
The United States Pharmaceuticals & Healthcare Report features BMI Research's forecasts for drugs and healthcare expenditure and imports and exports, focusing on the growth outlook for the prescription, OTC, patented drugs and generics market segments.
BMI's United States Pharmaceuticals & Healthcare Report provides industry professionals, strategists, company executives, investors, analysts and sales/marketing heads with independent forecasts and competitive intelligence on the United States pharmaceutical and healthcare industry.
- Benchmark BMI's pharmaceutical and healthcare market forecasts for United States, to test other views - a key input for successful budgeting and strategic business planning in the American pharmaceutical and healthcare market.
- Target business opportunities and risks in the American pharmaceutical and healthcare sector through our reviews of latest industry trends, regulatory changes and major deals, projects and investments in United States.
- Assess the activities, strategy and market position of your competitors using our company profiles (including SWOTs, KPIs and latest activity) and competitive landscape tables.
BMI Industry View
An at-a-glance perspective on the latest regulatory developments, key forecast indicators and major corporate developments, covering the prescription, OTC and generics markets. The pharmaceuticals and healthcare SWOT outlines strategic factors that affect the basic assumptions underpinning BMI’s forecast analysis, and taken together with BMI’s political, economic and business environment SWOTs, it gives a complete overview of market climate.
BMI Industry Forecast Scenario
Industry forecasts to end-2019 for all key indicators, supported by explicit assumptions, plus analysis of key downside risks to the main forecasts:
- Healthcare: Total healthcare expenditure (USDbn), healthcare expenditure (% of GDP), healthcare expenditure per capita (USD), hospital beds, doctors, and birth & mortality rates (all per ‘000 population).
- Pharmaceutical Market: Drug expenditure in USDbn, % of GDP and per capita (USD).
- Patented Drug Market: Prescription drug sales (USDbn & % of total sales).
- Generic Drug Market: Generic product sales (USDbn), generic sales (% of total sales).
- OTC Drug Market: OTC sales (USDbn & % of total sales).
- Macroeconomic Forecasts: Nominal and real GDP, % real GDP growth, % private consumption growth, % industrial output growth, % consumer price index, % GDP price deflator, exports, imports, trade balance, current account balance, foreign direct investment, exchange rate against USD, government expenditure and external debt.
BMI’s Pharmaceuticals and Healthcare Risk Reward Index
BMI’s Risk Reward Index provides investors (both national and multinational) looking for opportunities in the region with a clear country-comparative assessment of the market’s risks and potential rewards. Each of the country markets are scored using a sophisticated model that includes more than 40 industry, economic and demographic data points to provide indices of highest to lowest appeal to investors, with each position explained.
A snapshot of key market characteristics, including total size of the pharmaceuticals and healthcare segments, growth drivers, leading therapeutic areas and the competitive landscape
A focus on government healthcare reforms, epidemiological trends, mergers and acquisitions, product launches, market entries, FDI activity, R&D, biotechnology, clinical trials and supply chain issues.
Details of the industry regulatory framework and key legislation covering the licensing of new products/services, pricing and reimbursements, intellectual property, taxation and advertising, as well as analysis of the overall regulatory burden.
The competitive landscape section provides comparative company analyses and index by USD sales and % share of total sales – for the total pharmaceutical sector, as well as the OTC, generics and distribution sub-sectors.
Examines the competitive positioning and short- to medium-term business strategies of key industry players. Strategy is examined within the context of BMI’s industry forecasts, our macroeconomic views and our understanding of the wider competitive landscape to generate Company SWOT analyses. The latest financial and operating statistics and key company developments are also incorporated within the company profiles, enabling a full evaluation of recent company performance and future growth prospects.
*Company profiles are not available for every country. Those reports instead contain information on the current activities of prominent companies operating in the market.