BMI View: The US pharmaceutical market will continue to display robust growth over the medium term despite efforts from the public and private sectors to reduce drug spending. Many newly launched patented drugs that have clear efficacy and safety benefits are able to command premium prices from payers. This external validation provides buoyancy to the industry, which has been recently accused of price gouging.
Headline Expenditure Projections
Pharmaceuticals : USD309.9bn in 2014 to USD326.9bn in 2015; +5.5% growth. Historic m arket size revised downwards significantly since Q 3 15 due to adoption of new data source .
Healthcare : USD3,006.4bn in 2014 to USD3,121.0bn in 2015; +3.8% growth. Forecast unchanged since Q315 .
|f = BMI forecast. Source: WHO, National Sources, BMI|
|Pharmaceutical sales, USDbn||289.097||309.861||326.903||337.320||348.166||359.430||371.092|
|Pharmaceutical sales, % of GDP||1.72||1.78||1.82||1.80||1.78||1.76||1.74|
|Pharmaceutical sales, % of health expenditure||10.1||10.3||10.5||10.3||10.1||10.0||9.8|
|Health spending, USDbn||2,872.401||3,006.435||3,121.028||3,276.844||3,439.659||3,607.163||3,775.294|
The US has a Pharmaceutical RRI score of 82.9 out of 100 for Q116. This is unchanged from Q415 and Q315, an increase from the 81.7 in Q215, and an increase from the 80.5 recorded in Q115.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.
US Democratic presidential nominee Hillary Clinton stated that she has 'serious concerns' about mergers between large health insurance companies Anthem and Cigna and Aetna and Humana, and called for more scrutiny to check whether these mergers would be beneficial for consumers. In July 2015, Anthem agreed to acquire Cigna for USD54bn, which would create an entity covering 53mn members. In the same month, Aetna agreed to buy Humana for USD37bn, which would result in a new company with 33mn members.
Pfizer's CEO Ian Read stated that rising prices of drugs in the country is not the fault of drugmakers, and is instead an insurance issue. Highlighting the cost-benefit analyses showing that Lipitor (atorvastatin calcium) and other statin medications cost USD305bn between 1987 and 2008, Read stressed that they generated USD1.3trn in economic benefits, by preventing heart attacks and strokes, and their costs to the healthcare system.
The Pharmaceutical Research and Manufacturers of America (PhRMA) expressed disappointment over ministers' failure to secure 12 years of data protection for biologics during the Trans-Pacific Partnership (TPP) discussion held in Atlanta, Georgia. PhRMA President and CEO John Castellani stressed that the figure is not a random number, but the result of a long debate in Congress, which determined that this timeframe captured the appropriate balance that would not only stimulate research but also make biosimilars accessible in a timely manner.
The decision by Turing Pharmaceuticals to raise the price of one of its drugs by more than 5,000% elevated the issue of high healthcare costs into the US presidential election race. Hillary Clinton joined industry commentators in condemning the move, saying on social media that, 'price gouging like this in the specialty drug market is outrageous'. The company's CEO Martin Shkreli backtracked and assured that the price of Daraprim (pyrimethamine), a treatment for toxoplasmosis in HIV/AIDS patients, would be reduced.
The majority of US residents believe that prescription drugs costs are very high with around 75% favouring government action to control drug prices, according to a survey. The survey by the Kaiser Family Foundation follows two earlier surveys this summer where pharmaceutical firms were blamed for high costs and that Medicare should be able to negotiate costs. This is even as 62% think that prescription drugs have improved peoples' lives in the country. According to the latest poll, 86% of respondents are in favour of drugmakers disclosing their process for setting prices and 83% favour allowing Medicare negotiating with drugmakers.
BMI Economic View
We continue to expect that real GDP growth in the US will gradually rise from the 2.4% reported in 2014, forecasting growth of 2.5% in 2015 and 2.6% in 2016. Following a series of data revisions by the US Bureau of Economic Analysis (BEA), seasonally-adjusted annualised Q115 growth is now being reported at 0.6% (up from the previous estimate, which reported a contraction of 0.7%) and Q215 growth came in at 3.7% (initially reported as an expansion of only 2.3%). These upward revisions suggest that the risks to our 2015 forecast are now weighted slightly to the upside. We expect that many of the dynamics underpinning the stronger Q215 print will continue into the coming quarters, supporting continued modest acceleration in 2016.
BMI Political View
The 2016 presidential election cycle is starting to take shape. Key issues include economic growth, expanding the middle class, foreign policy (particularly the Middle East), immigration, college affordability and student debt, income inequality and taxation (particularly taxes paid by the wealthy), police misconduct (particularly with regards to alleged racial biases), and foreign trade agreements (such as the TPP). 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.