Global medicine use and spending continue to rise, with innovative therapies driving a structural upgrade. As the share of specialty drugs and biologics increases, improved access and cost efficiency will jointly shape the market landscape over the next five years.
Significant usage shifts and spending growth acceleration that is taking place in some geographies and slowing in others became apparent in 2024 and have contributed to an outlook for medicine spending through 2029 unchanged at 5–8% CAGR, bringing global spending on medicines at invoice prices to $2.4Tn. In aggregate, global health systems have demonstrated remarkable resilience in the face of the pandemic, global inflation, and regional conflicts, and have moved forward to adopt novel therapies and increase usage. Overall, global use and spending on medicines is exceeding pre-pandemic growth rates and is expected to continue significantly above those trends through 2029.
A total of 1,005 novel active substances (NAS) were launched globally over the past 20 years including 394 in the past five years, but the number launching varies considerably by region, with the U.S. having launched 81% of the global total compared to 65% in leading European countries, 60% in Japan, and 59% in China. Notably, many of the drugs launched in the U.S. are not available in Europe, and 40% of the China launches were for drugs launched only in China and no other markets. These variations in available medicines have an impact on the usage and spending trends in various geographies.
Biologic medicines have reached 42% of global novel drug launches in the past five years, which is similar across many developed countries except for China, where only 33% of launches took place in the same period. Additionally, low- and middle-income countries (LMICs) have approved fewer recently launched global drugs in the past decade, limiting patient access to recent advances. These LMICs have approved more of the established medicines — older medicines included on essential medicine lists — but still lag developed markets in terms of availability.
Beyond the initial approvals and launches of a medicine, many drugs are subsequently researched and approved for multiple indications. In the U.S., indication expansions accounted for 1,092 additional approved uses for the more than 500 NAS approved in the U.S. in the past decade. For U.S. patients, expanding the approved uses for medicines in the years following initial approval has had significant impact on treatment options and has influenced the applications and approvals in other countries where launches are typically later than in the U.S.
Read the full report “The Global Use of Medicines Outlook” (PDF)
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