US Prescription-Drug Market Rebounds

The US pharmaceutical industry rebounded in 2009 despite concerns over slowing pharmaceutical growth, according to an analysis issued by IMS Health on Apr. 1, 2010. Although growth was more robust that had been projected, it was still below historical levels.

US sales of ethical pharmaceuticals and insulins through retail and nonretail channels increased 5.1% in 2009 to $300.3 billion, compared with growth of only 1.8% in 2008. “In 2009, demand for pharmaceuticals proved stronger than in the prior two years, yet remained at historically low levels,” said Murray Aitken, senior vice-president of Healthcare Insight for IMS.

IMS identified several factors contributing to US market growth in 2009, which included stronger demand for prescription drugs despite macroeconomic conditions. Dispensed prescription-drug volume in retail channels increased 2.1% in 2009 to reach 3.9 billion dispensed prescriptions. In 2008, dispensed-prescription volume in retail channels increased only 1%. The uptick in 2009 was primarily due to increased volume for existing drugs. Although the volume of new-therapy starts in 17 major chronic disease areas declined by approximately 1% in 2009, the volume for add-on therapy starts, switches, and refills increased by nearly 2% in 2009.

Specialty pharmaceuticals, broadly classified as drugs to patient-specific populations that may involve complex and chromic conditions, also contributed to positive growth in 2009. US sales of specialty pharmaceuticals increased 7.5% in 2009 and now constitute 21% of US market value, according to IMS.

IMS also attributes better-than-expected growth in 2009 to sustained pricing practices by pharmaceutical companies and inventory-management actions by retail pharmacies at the beginning of 2009 to bring stocking levels in line with demand. Also, IMS also points to a lack of major product-safety issues and a reduced impact of patent expiries in 2009 compared with recent levels.

However, generic drugs continue to play a significant role in the US prescription drug market. IMS reported that generic products, including branded generics, now represent 75% of all dispensed prescriptions in the US, up from 57% in 2004. The total number of generic prescriptions dispensed in the US increased 5.9% in 2009 while the number of branded prescriptions dispensed decreased 7.6%.

New US rankings
The three mega mergers of 2009—Pfizer’s (New York) $68-billion acquisition of Wyeth (Madison, NJ), Merck & Co.’s (Whitehouse Station, NJ) $41-billion acquisition of Schering-Plough (Kenilworth, NJ), and Roche’s (Basel, Switzerland) $47-billion acquisition of Genentech (South San Francisco, NJ) have shifted the rankings of the top pharmaceutical companies as measured by US prescription-drug sales. Pfizer retains the number position with US prescription-drug sales of $27.8 billion in 2009, giving the company an 9.3% share of the US prescription-drug market, according to data from IMS Health. Merck & Co. moves into the number two spot with US prescription-drug sales of $19.8 billion or 6.6% of the US market. In 2008, prior to its acquisition of Schering-Plough, Merck & Co. held the number five spot in the US prescription-drug market.

The rise of Merck comes at the expense of GlaxoSmithKline (GSK, London), who dropped from the number two position in 2008 to number four in 2009. GSK posted US prescription-drug sales of $15.0 billion in 2009, down from $18.4 billion in 2008. AstraZeneca (London) maintained the third spot in the US prescription-drug market. In 2009, it posted sales of $18.3 billion for a 6.1% share of the US market, only slightly below Merck’s share of 6.6%.

With its acquisition of Genentech, Roche moved up two spots from number seven in the US prescription-drug market in 2008 to number five in 2009. In 2009, Roche reigned in a market share of 4.8% with US prescription-drug sales of $14.3 billion.

The 2009 rankings of US pharmaceutical companies saw the rise of one generic-drug company, Teva Pharmaceutical (Jerusalem). Teva jumped from the twelfth spot in 2008 to number 10 in 2009 with a 4.0% share of the US prescription-drug market with sales of $12.1 billion. Those sales put Teva in close proximity to four innovator-drug companies: Novartis (Basel), which had 2009 US prescription-drug sales of $13.4 billion, Eli Lilly (Indianapolis, IN) with US sales of $13.2 billion, Johnson & Johnson (New Brunswick, NJ) with US prescription-drug sales of $12.8 billion, and Amgen (Thousand Oaks, CA) with US prescription-drug sales of $12.5 billion. Amgen was the only mostly pure-play biopharmaceutical company to make the top 15 companies based on US prescription-drug sales.

Teva was the only generic-drug company to make the listing of the top 15 US pharmaceutical companies, and it eclipsed five major innovator-drug companies: sanofi-aventis (Paris), Abbott Laboratories (Abbott Park, IL), Bristol-Myers Squibb (BMS, New York), Takeda Pharmaceutical (Osaka, Japan), and Boehringer-Ingelheim (BI, Ingelheim, Germany). sanof-aventis was ranked eleventh with US prescription-drug sales of $11.1 billion, and Abbott was twelfth with sales of $9.5 billion. BMS came in thirteenth with sales of $8.9 billion, Takeda fourteenth with US prescription-drug sales of $7.9 billion, and BI with US sales of $7.6 billion.

Product rankings
The top-selling prescription drugs based on value in the US market also underwent some change in 2009 compared with 2008, according to data from IMS. The top five spots were unchanged as Lipitor (atovastatin) by Pfizer retained the number one ranking, followed by Nexium (esomprazole) by AstraZeneca. Plavix (clopidogrel) from BMS and sanofi-aventis ranked third, and GSK’s Advair Diskus (fluticasone and salmeterol) came in at number four. AstraZeneca’s Seroquel (quetiapine) was ranked fifth in US prescription-drug sales.

Three products earned a spot among the 15 top-selling prescription drugs in the US in 2009 that did not make the top rankings in 2008. The three newcomers to the top rankings were AstraZeneca’s Crestor (rosuvastatin), Avastin (bevacizumab) from Genentech/Roche, and oxycontin. Crestor came in at number 12 with US sales of $3 billion, and Avastin followed with US sales of $3.0 billion. Oxycontin was ranked fifteenth with US sales of $2.9 billion.

Three products fell out of the top-selling products in 2009. Prevacid (lansoprazole) from Takeda, Effexor XR (venlafaxine) from Wyeth (now part of Pfizer), and Lexapro (escitalopram) from Forest Laboratories (New York). Several products moved up in their rankings. BMS’s Abilify (aripiprazole) moved to the sixth spot on US sales of $4.0 billion in 2009, up from number 12 in 2008. Takeda’s Actos (pioglitazone) moved up one notch to number eight with US sales of $3.4 billion. Remicade (infliximab) moved to the eleventh spot in 2009 from thirteenth in 2008 on 2009 sales of $3.2 billion. Remicade is from Johnson & Johnson, Schering-Plough (now part of Merck & Co.), and Mitsubishi Tanabe Pharma (Osaka, Japan).

The other drugs among the top-selling 15 products in 2009 also made the top rankings in 2008. These include Merck & Co.’s Singulair (montelukast), ranked seventh in 2009; Enbrel (etanercept) from Amgen, Wyeth (now part of Pfizer), and Takeda, ranked ninth in 2009; and Neulasta (pegfilgrastim) and Epogen (epoetin alfa) from Amgen, respectively ranked fourteenth and tenth. The rankings also showed that five biologic-based drugs were among the top-selling 15 products in 2009: Enbrel, Epogen, Remicade, Avastin, and Neulasta.