3 Ways Pharma Could Jolt Health Care in 2023

3 Ways Pharma Could Jolt Health Care in 2023. Test tubes, beakers, a microscope, plants, molecules, and reactions all appearing on a lab bench and resulting in a new pharmaceutical drug.

The impact of high inflation and legislative changes allowing for Medicare to negotiate the price of certain drugs (beginning in 2026 for Part D and 2028 for Part B) have biopharma and life sciences companies facing an uncertain financial year ahead. But this hasn’t dimmed their optimism that positive developments are on the way that could affect a wide range of therapeutic areas.

Recent reports indicate that the market for biosimilar drugs to treat cancer, inflammatory diseases, diabetes and more will continue to expand, ideally resulting in lower prices as more pharmaceutical patents expire and competitors enter the market. Some believe regulatory approvals aren’t far off for potential blockbuster therapies to treat Alzheimer’s disease. And as these areas evolve, products developed by pharmaceutical companies have the potential to play a greater role in reducing health disparities.

3 Pharma Impact Areas to Watch

Biosimilars may reshape the market. Four pharmaceutical pills displayed like an Andy Warhol pop Iconophilia.1 | Biosimilars may reshape the market.

A recent Oliver Wyman analysis notes that biosimilar drugs could hit an inflection point this year as adalimumab biosimilars prepare to come to market. Adalimumab biosimilars will be the first to compete with AbbVie’s Humira, a blockbuster drug used to treat autoimmune diseases that generated more than $20 billion in 2021 sales. Adalimumab has had exclusivity in the market since 2002.

The Food and Drug Administration (FDA) has approved eight adalimumab biosimilars, with most expected to launch within a year, and 20 biosimilar versions of other branded products since 2015 across a range of categories. Amgen launched its adalimumab biosimilar Amjevita on Jan. 31. The company states it has 11 biosimilar products in market or under development, with five FDA-approved in the U.S.

Just how much money biosimilar drugs could save the nation’s health system is difficult to project because of complex pricing structures, opaque rebate mechanisms, changes to coverage, reimbursement and formulary policies by payers. The Oliver Wyman analysis notes: “The high degree of development activity, combined with early indicators that AbbVie is contracting to protect Humira access and share, indicates that an intensely competitive pricing environment will emerge over the next 18 months.”

Takeaway

Policy watchers say it may take time for savings to be achieved because the next Humira biosimilars aren’t expected to launch until midyear. Savings largely will depend on the level at which patients switch to these alternatives and whether health insurers adopt policies, like preferential formulary placement, that promote the use of these drugs.

Keep an eye on new Alzheimer’s therapies. A human head in profile divided up into four puzzle pieces in different colors.2 | Keep an eye on new Alzheimer’s therapies.

Lecanemab, the first drug to slow the destruction of the brain in Alzheimer’s patients, has been seen by many as a breakthrough, although its impact on patients’ daily lives still is being debated.

Oliver Wyman reports that research on Lecanemab represents a major milestone and further supports the argument that therapies targeting amyloid plaques in the brain represent a path forward. The consultancy states that regulatory approvals for new therapies with blockbuster potential are imminent and will represent the first step in societal changes to the way we think about and treat dementia, the seventh-leading cause of death worldwide and one of the major causes of disability and dependency among older people.

Takeaway

Alzheimer’s and dementia represent a staggering cost to health care worldwide, with $1.3 trillion in direct and indirect costs in 2019, according to the World Health Organization, which projects that these costs could balloon to $2.8 trillion by 2030 due to the increase in the number of people living with dementia and higher care costs. Finding ways to treat these conditions more effectively will be vitally important. It’s also worth noting that the costs associated with these new Alzheimer’s drugs is expected to be high but hopefully will be less than treating these patients.

Addressing health equity is an imperative. An image of a dark body with an arm and hand intertwined with a light body with an arm and hand.3 | Addressing health equity is an imperative.

Beyond developing new drugs, pharmaceutical companies also could have a growing impact on reducing health disparities, some suggest. Companies can expand the field’s base of knowledge by building more age, ethnicity, gender and racial diversity into the product life cycle, notes another Oliver Wyman report. In doing so, they can propel care toward more personalized medicine.

For this to happen, pharma company executives and boards must make health equity a corporate priority, the report states. Once elevated to the corporate level, a greater focus on health equity can be incorporated across the life cycle of pharma products more successfully.

Takeaway

Pharma companies need to have an enterprise strategy with measurable goals and must address such issues as increasing representation of women and nonwhite populations in clinical trials and addressing the research and development (R&D) spending gap on conditions where women and nonwhite populations are disproportionately affected. The pharma industry’s R&D pipeline reached an all-time high in 2022 with more than 20,000 drugs under development, nearly double that of 2014, according to an Informa report.

AHA Center for Health Innovation logo

Related Resources

Advancing Health Podcast
Public
AHA Center for Health Innovation Market Scan
Public
AHA Center for Health Innovation Market Scan
Public
Other Resources
AHA Center for Health Innovation Market Scan
AHA Center for Health Innovation Market Scan