IQVIA Report Finds Disrupted Medication Use During COVID-19 Pandemic, Including Long-Term Challenges

A new report on global medication spending and usage trends from IQVIA has found a myriad of disruptions caused by the COVID-19 pandemic, although the investigators noted various levels of impact in developed and developing countries.¹

“While the pandemic has been extremely disruptive, the pre-pandemic forces of medicine use and spending remain significant drivers of the outlook, and these forces have only been modestly impacted by the immediate effects of COVID-19,” said Murray Aitken, MBA, senior vice president of IQVIA, in a press release. “The success of countries around the world in implementing a global vaccination program—unprecedented in speed and scope—will be key to the outlook for all medicine use through 2025 and beyond.”²

Especially during the early months of the pandemic, researchers from IQVIA found that significant uncertainties impacted a range of health care issues, perhaps most notably with supply chain concerns. Due to the concentration of raw active ingredient manufacturing in countries that experienced early impacts of the pandemic, the investigators saw abnormal purchasing patterns by both large providers and individual patients.¹

Some of these unusual purchases were driven by common intensive care unit (ICU) treatments, especially in countries with large waves of COVID-19 hospitalizations, whereas others were driven by fears of supply disruptions for patients without COVID-19 but who needed medications for chronic conditions. Existing medications for other diseases, such as hydroxychloroquine, were also widely used early in the pandemic, leading to shortages of these treatments.¹

In an analysis of 10 developed countries, the investigators found that demand for new or investigational treatments spiked by nearly 150% between February and April 2020, while demand for common ICU medications spiked by nearly 125% during the same period. Demand for chronic therapies and acute therapies in both retail and non-retail environments saw more modest increases, between 105% and 115% for spring 2020, respectively.¹

The investigators noted that among the broader population, societal shutdowns drove the reduction of acute therapies as common infections and hospitalizations became less common. For patients receiving long-term chronic therapies, shifts in demand were largely driven by stockpiling therapies and were followed by returns to normal demand levels later in the summer.¹

When looking specifically at stockpiling practices during the early months of the pandemic, the investigators found that medications for respiratory illnesses were stockpiled the most, with an approximately 120% change in medication use between February and May 2020 compared to expected rates. Respiratory treatments were followed by diabetes drugs, hypertension treatments, and mental health medications.¹

Notably, the investigators said hypertension treatments seem to be trending below expected volumes after their initial surge. This could mean that patients with untreated disease may have worse outcomes in the long term, according to the report.¹

Mental health therapies have seen a gradual increase in usage, although the investigators noted it is a more modest increase than some experts had predicted. This could be explained by barriers to beginning new treatments for mental health disorders, including social stigma. The investigators did, however, find a 14.3% increase in usage of OTC drugs for calming, sleeping, and mood.¹

Of the 10 OTC segments investigated for the report, 6 saw market growth in 2020, including eye care (0.7%); urinary and reproductive (0.7%); circulatory (1.2%); drugs for calming, sleeping, and mood (14.3%); anti-hemorrhoid (3.9%); and ear care (3.3%). Four segments saw a smaller market in 2020: herbal and homeopathics (-2.1%); smoking cessation (6.9%); weight loss (-6.2%); and other OTC products (-2.9%).¹

Globally, the researchers noted that most OTC treatments are affordable, with usage trends mirroring the change in overall spending growth, which was 2.6% through the 12 months ending in September 2020 (encompassing 6 months prior to the pandemic and 6 months during the pandemic).¹

“Patient behavior in adapting to COVID has been complex and varied and these self-medication trends illustrate some signs that many people globally are experiencing significant disruptions,” the report said.¹

The investigators said they anticipate new demands for therapeutics and vaccines related to the needs of COVID-19 survivors, as well as other patients. Small but important clusters of survivors have seen a myriad of multi-system symptoms, including extended periods of debilitation, and some patients who had asymptomatic COVID-19 have seen patterns of disease that are difficult to diagnose. These concerning trends could mean that millions of people have lingering effects for years, according to the report.¹

New therapeutics for COVID-19 and the use of existing treatments has been widespread and will likely shift as more than 1000 clinical trials started during the pandemic are completed and interventions are adopted based on new evidence. Similarly, with 11 COVID-19 vaccines approved globally, the global vaccine landscape is expected to shift dramatically.¹

Finally, the researchers cautioned that there will also be significant long-term consequences for people who did not have COVID-19 but whose chronic illness treatments were disrupted by societal and personal responses to the pandemic. These impacts could include greater rates of chronic lifestyle diseases and mental illness, as well as more advanced diagnoses for cancers or other diseases due to missed screenings.¹

“The COVID-19 pandemic has been the most impactful global health crisis in decades and its direct and indirect impacts are critical to understanding the global use of medicines,” the report said. “While the pandemic has been extremely disruptive, it is clear that other aspects of health care have continued and the immediate shocks in early 2020 have given way to patterns of adaptation and adjustment around the world.”¹

REFERENCE

1. IQVIA Global Medicine Spending and Usage Trends: Outlook to 2025. Accessed April 28, 2021. [Email].

2. Global Medicine Spending to Reach $1.6 Trillion in 2025 Excluding Spending on COVID-19 Vaccines, According to IQVIA Institute for Human Data Science Study [news release]. IQVIA; April 29, 2021. Accessed April 28, 2021. [Email]