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Biologic, Biosimilar Spending Expected to Grow in the Next Decade

The launch of adalimumab biosimilars are expected to affect spending in the immunology space.

Pharmacy Times is excited to be joined by Scott Biggs, the director of Supplier Services at IQVIA, at the National Association of Chain Drug Stores (NACDS) Total Store Expo, August 12 through 14, 2023, in San Diego, California. Biggs, a leading expert on pharmacy trends and issues, discusses key players in the biosimilar space, how consumers and the industry are playing catch-up following the COVID-19 pandemic, and opportunistic classes of medication that have immense growth potential in the next decade.

PT Staff: How can technology be used to optimize pharmaceutical market insights?

Scott Biggs: I think the biggest thing right now is artificial intelligence (AI). And I think IQVIA is really embracing AI. They're using it for their clinical to their manufacturer customers. They're using it to help in evaluating clinical trials. They're using it to help and understand— and potentially recognize, identify— disease earlier. So they're really embracing any way they can use it to really advance pharmaceutical market insights.

PT Staff: Can you discuss the expanding biosimilars market? How is it forecast to impact spending?

Scott Biggs: Well, I think the biggest thing this year right now we're seeing is the release of the adalimumab (Humira; AbbVie) biosimilars. Adalimumab-atto (Amjevita; Amgen) launched earlier this year, we're watching the sales for that one. And then at the end of June, beginning of July, several other biosimilars for adalimumab launched. It’s still too early to kind of see how they're doing but they're taking hold as we speak. Adalimumab-atto has actually been the largest product launch of 2023. So—and I think with the spend part of it, immunology being a very large category—we expect to see this spend in immunology decrease as these biosimilars for adalimumab launch. I think we see a very similar decrease [to] what we saw with the oncology market in the biosimilar space a few years ago.

PT Staff: Could the generics market be impacted in a similar way?

Scott Biggs: The generic market is beginning to stabilize; we've seen a lot of generic compression which isn't necessarily good. Some of the generic compression that we've been seeing has actually been harmful to the market. We saw earlier this year, Akorn Pharmaceuticals, a generic manufacturer, went out of business. And when they went out of business, they didn't have a large portfolio, but in 1 particular area they had 86% of the market share within hospitals. That left a big gap to fill and was not able to fill so it caused a shortage in that particular segment.

So there's been a lot of challenges within the generic markets, in the generic area, and generic space. And Douglas referred to it as the race to the bottom. And if we can't do something more for the generic segment, we're going to have some more challenges with drug shortages.

PT Staff: What pressures had COVID-19 put on vaccinations, access to medications, and the general pharmaceutical market?

Scott Biggs: Lockdown really put a lot of pressures in the overall market. Together, we saw at the beginning—[what] we saw with the lockdowns]—was less doctor's visits. Less doctor visits means less new scripts, those people starting out on medications; [There were less] health screenings (with colonoscopies and mammograms) and things like that. We saw people did not get out and get the routine screenings they needed. We saw [less] elective procedures. With elective procedures comes prescriptions for preparing for the procedure. It [also] comes with pain medications and things like that afterwards, and we saw a large decrease in that. I think dental visits as well. Some people with dental visits may need antibiotics beforehand and then pain medication afterwards. So [lockdown] really impacted the pharmaceutical market space.

PT Staff: How are these factors being affected by the decline in COVID-19 pressures?

Scott Biggs: So as the pandemic has eased and we've moved further away from 2020 and 2021, what we've seen is people going back to the doctor. We've seen those new scripts begin to increase, people getting those routine screenings that were missing. So things are starting to return to some sort of a normalcy; people started getting the normal health care routine, but then there's been this backlog of all the individuals who did not get them during the pandemic [who] are getting it, so a lot of catch-up to be made in the industry.

PT Staff: In the next decade, what trends could we observe regarding medication use worldwide?

Scott Biggs: Well, we believe that we'll definitely continue to see increases in the biosimilars, but also the biologic spending will be the biggest thing we'll see there. And we're keeping a specific eye on the Alzheimer space. There's been some talk about some releasing of Alzheimer drugs, so we're going to see how that works. One of the things we are watching very closely [that] has been very impactful this year on the overall sales is the glucagon-like peptide 1 (GLP-1) category. Year to date, the GLP-1s have actually contributed to about 40% of the overall growth we've seen in 2023. They are just going crazy. The diabetic space for the GLP-1 and weight loss been really [current]— obesity is such a problem here in this country that the products for weight loss have been heavily prescribed and people are wanting to take them.

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