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Spending on prescription medicines in the United States will increase 4 percent to 7 percent through 2021, reaching $580 billion to $610 billion, according to a report released by QuintilesIMS Holding on Thursday that lowered its prior long-term forecast.
QuintilesIMS, which compiles data for the pharmaceutical industry, had previously forecast average spending growth of 6 percent to 9 percent through 2021. It reduced its projections due to fewer new medicines approved in 2016 than prior years and as drugmakers face increasing pricing pressure and competition.
Taking likely manufacturer discounts and rebates into account, spending would grow 2 percent to 5 percent to $375 billion to $405 billion in 2021, as net price increases for patent-protected branded drugs slows, the report said.
Under pressure from politicians and insurers over the cost of many branded medicines, several drugmakers have pledged to limit annual price hikes to under 10 percent.
"We're forecasting moderation in pricing reflecting what ... we expect will be a continuing trend of single-digit price increases," said Murray Aitken, executive director of the QuintilesIMS Institute which compiled the report.
Some of the expense of new medicines will be offset by expanded use of cheap generics as several big-selling prescription drugs lose patent exclusivity and more biosimilars - less expensive versions of pricey biotech medicines - enter the market.
The U.S. Food and Drug Administration approved just 22 new medicines last year, down from 45 in 2015, which will also contribute to lower spending growth this year and next, the report said.
That is seen picking up in 2019 and beyond as QuintilesIMS estimates 40 to 45 new brand launches per year through 2021 based on a review of experimental medicines in drugmaker pipelines.
The report found more than 2,300 novel products in later stage development, including more than 600 drugs for cancer, which remain able to command very high prices.
"Numbers (of approvals) are already running well ahead of where they were a year ago," Aitken said.
U.S. spending on prescription medicines in 2016 increased by 5.8 percent over 2015 levels to $450 billion based on list prices, and by 4.8 percent to $323 billion when adjusted for discounts and rebates.
The biggest drivers of prescription growth came from large chronic therapy areas, such as hypertension and mental health.
Overall use of pain medicines declined 1 percent with restrictions on prescribing and dispensing becoming more common as healthcare providers attempt to address the growing epidemic of addiction to opioid pain drugs.