艾昆纬-2023年美国药品的使用（英）-2023.4-72页_6mb

The Use of Medicines in the U.S. 2023: Summary

Healthcare Utilization

• Health services utilization recovered to pre-pandemic levels by Q4 2022 through the Health Services Utilization Index (HSUI), indicating a return to baseline despite ongoing disruptions.
• Telehealth's share of visits declined from 26% in April 2020 to 5% in 2022, signaling a move away from virtual care.
• Pediatric vaccination rates lagged during the pandemic, while adult rates returned to normal, influenced by policy changes and pharmacy-based administration.
• Antibacterial use decreased by 7% compared to pre-pandemic levels due to reduced infection transmission from public health measures.

Medicine Use

• Days of therapy grew by 2.6% in 2022, down from 4.7% in 2021, reflecting a post-pandemic slowdown.
• Biosimilars account for 25% of competitive molecule volume, with varying uptake across therapies—some achieved 82% volume share five years post-launch.
• Notable increases in prescriptions include:
  • Mental health: 567M new prescriptions in 2022 (up 9% since 2019).
  • GLP-1 agonists: Rapid growth for diabetes and obesity treatment, with shortages reported.

Medicine Spending and Growth Drivers

• Net manufacturer spending reached $429B, growing 5.3% in 2022, partially driven by COVID-19 vaccines and therapeutics.
• Specialty medicines (immunology, oncology) now account for 51% of spending at net prices, up from 32% in 2012.
• Biosimilars are projected to save $180B over the next five years, while losses from exclusivity expiries total an estimated $63B.
• Average net prices declined for most therapies (e.g., diabetes, immunology), reflecting increased competition and discounts.

Patient Out-of-Pocket Costs

• Total OOP costs increased $3B to $82B in 2022 despite declining per-prescription costs.
• Insulin costs decreased, with $35/month capping projected to save $561M by reducing patient exposure.
• Strategic abandonment of prescriptions by patients increased with rising costs, particularly for $125+ prescriptions.

Outlook 2024–2027

• Net spending growth is projected between -2% and 1% by 2027, returning to pre-pandemic estimates.
• Key changes from new policy include Medicare Part D reforms, insulin cost caps, and increased price negotiation, impacting manufacturers and payers.
• Biosimilars and GLP-1 inhibitors will drive significant growth, with specialty areas like oncology, neurology, and obesity as top spenders.
• Policy impacts may lead to slower net growth from 2026 onward, with continued pressure on drug pricing.