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    Shifting trends in the pharmaceutical marketplace: What to watch

    From changes in the regulatory and reimbursement landscape to decelerating sales, the U.S. pharmaceutical market is undergoing important changes, reported Douglas M Long, BS, MBA, vice president for industry relations at QuintilesIMS, at the AMCP Managed Care & Specialty Pharmacy Annual Meeting in Denver.

    Long spoke during the March 29 session, “AMCP Headline Session: 2016-2017 Pharmaceutical Marketplace Trends.”

    “Well, 2016 was an interesting year,” Long said. “We’ve seen more regulation of opiate drugs. That’s going to happen more and more in the future. Medicare Part B reform was rescinded. We have a shortage of doctors. The Rite Aid/Walgreens merger is up in the air.”

    Noteworthy 2016 trends

    The past year saw below-average flu and allergy seasons, declining revenues from generic drugs, new FDA and DEA guidelines on controlled substances, and the launch of generic versions of Crestor, Gleevec, Tamiflu, Nuvigil and other lucrative brand drugs, Long said.

    “Generics are experiencing price deflation since early 2016, according to Barclays Price Monitor,” he said. Generics represented a smaller market share in terms of dollars but a growing proportion of total prescribing. “Unbranded generics have captured 84.3% of scripts,” he noted.

    The U.S. healthcare system saved nearly $1.5 trillion over the past decade thanks to low-cost generics, Long noted.

    The FDA approved a record number of abbreviated new drug applications for generic drugs, with 651 approvals in 2016, compared to 492 in 2015 and 409 in 2014, he reported.

    Public debate and downward pressure

    Last year also brought election-year headlines and attention from policymakers to dramatic drug price hikes by Turing, Valeant, and Mylan. Ensuing public anger, congressional inquiries and a U.S. Department of Justice investigation “put a big chill” on generics pricing, leading to generic price declines, Long reported.

    Public debate over drug costs is driven in part by confusion over list prices versus prices actually paid, Long noted. But public anger over pricing has helped drive price deflation for generics, he said—as has competition from manufacturers in India and building “consortium bid pressures.”

    “EpiPen was a really interesting one,” he said. “They talked about a list price of $600. I can tell you that very few people pay $600. The negotiated price was less than $300—so who were the people paying $600? People in high-deductible insurance plans.”

    The continuing crisis in opioid overdose deaths brought more headlines and policymaker scrutiny. Narcotics sales in 2016 also dropped by $1.6 billion compared to 2015, due in part to continuing declines in hydrocodone prescribing.

    Next: Deceleration in pharmaceutical sales growth



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