The future level of global spending on medicines has implications for healthcare systems and policymakers across developed and emerging economies, and these issues are even more important in light of the ongoing global COVID-19 pandemic. Stakeholders share common goals of improving health outcomes while controlling costs and expanding access to medicines, which is made more challenging with the numerous uncertainties surrounding the progress of the pandemic.

Past spending growth typically offers some clues to the level of growth to expect in the future and broadly that will still be true, despite the unprecedented dynamics at play with the COVID-19 pandemic. Medicine spending growth will continue to be driven by traditional factors including patent expiries, launches of new medicines as well as changing volume demand particularly in pharmerging and lower income countries.

In this report, we quantify the impact of these dynamics and examine the spending and usage of medicines in 2020, globally and for specific therapy areas and countries. We intend this report to provide a foundation for meaningful discussion about the value, cost and role of medicines over the next five years in the context of overall healthcare spending. Medicine spending in this report, is based on audited spending data at prices reported in IQVIA audits of pharmaceutical spending that are, in general, reported at the invoice prices wholesalers charge to their customers including pharmacies and hospitals. As this level does not reflect the true spending level net of discounts and rebates, it is more helpful when focused on growth trends or volume metrics. As in last year’s report, analyses include a measure of days of therapy, essentially turning counts of pills, vials, patches, creams, etc., into normalized days of therapy through the use of defined daily dose (DDD) assumptions per product. Interpreting drug shipment data as normalized days of therapy puts a useful patient lens on otherwise dissimilar volumes.

The study was produced independently by the IQVIA Institute for Human Data Science as a public service, without industry or government funding. The contributions to this report by Aurelio Arias, Onil Ghotkar, Urvashi Porwal, Sarah Rickwood, Durgesh Soni, Alan Thomas, and dozens of others at IQVIA are gratefully acknowledged.

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