BMJ  2004;328:727 (27 March), doi:10.1136/bmj.328.7442.727

News

Drug spending in North America rose by 11% in 2003

Washington, DC

Spending on drugs in the United States and Canada rose 11% last year, according to new figures released last week by a leading market analyst firm, Intercontinental Marketing Services (IMS).

The IMS World Review shows that global drug sales rose 9% in 2003, to almost $500bn (£270bn; 400bn).

Almost half of the world's drug sales occur in the United States and Canada, which spent almost $230bn. The increase in sales is less than in recent years but confirms a longer term trend of rising pharmaceutical costs.

In the biggest market, the United States, the federal government estimates that drug spending will continue to soar, rising from an estimated $184bn last year to $519bn a year by 2013.

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Higher drug prices, a continuing switch to newer drugs, and an overall increase in prescriptions are all contributing to the rises.

According to IMS, the top selling classes of drugs were cholesterol lowering drugs, antiulcer agents, and antidepressants. The world's biggest selling drug is atorvastatin (Lipitor), Pfizer's cholesterol lowering drug, with sales in excess of $10bn. AstraZeneca's acid reflux treatment esomeprazole (Nexium) generated sales of $3.8bn, and Pfizer's antidepressant sertraline (marketed as Lustral in the United Kingdom and as Zoloft in the United States) $3.4bn.

The rise in drug costs continues to drive up total healthcare spending, which now accounts for 15% of the United States economy, almost twice the amount spent in many European nations.

While pharmaceuticals remain only a small part of the total health bill, they are causing a large part of the rise in personal healthcare costs for elderly Americans, who are increasingly angry about soaring health costs. The issue of rising spending on drugs has moved to the centre of the domestic political debate and is likely to be a key issue in this year's presidential race.

IMS figures show growth of drug spending of about 8% in the European Union, 3% in Japan, and 6% in Latin America.

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"The global pharmaceutical industry continued to grow at a solid pace in 2003, despite difficult economic conditions," said Graham Lewis, IMS's vice president for strategic consulting.

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More information and details of how to buy the IMS World Review are at www.imshealth.com and US federal health statistics are at www.cms.hhs.gov/statistics

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Drug Spending contributes to Unsustainable Healthcare Costs

Andrew D Lynk
bmj.com, 25 Mar 2004 [Full text]