Pricing and Reimbursement in the US - Non-LIS Beneficiaries Not Covered by Medicare Coverage Gap to Gain from Reduction in Out-of-Pocket Expenditure for Generic Drugs
- Language: English
- 75 Pages
- Published: February 2012
- Region: United States
Business Monitor International's USA Pharmaceuticals and Healthcare Report provides industry professionals and strategists, corporate analysts, pharmaceutical associations, government departments and regulatory bodies with independent forecasts and competitive intelligence on the US pharmaceuticals and healthcare industry.
BMI View: Healthcare spending in the US will continue to account for a disproportionately large percentage of its GDP. Citizens of the world's largest economy are accustomed to regular health checkups, access to the latest diagnostics and therapeutics, choice of provider and outlet, insurance premium contributions from employers, a culture of end-of-life prolongation and extensive regulation. While this is not necessarily the 'best' form of healthcare, it is certainly the most expensive, both for individuals and the state.
Headline Expenditure Projections
- Pharmaceuticals: US$327.0bn in 2010 to US$331.3bn in 2011; +1.3% growth in local currency terms. BMIs forecast is unchanged from Q411.
- Healthcare: US$2,346bn in 2010 to US$2,449bn in 2011; 4.4% growth in local currency terms. BMIs forecast is unchanged from Q411.
- Medical devices:US$127.6bn in 2010 to US$133.0bn in 2011; 4.2% growth in local currency terms. BMIs forecast is unchanged from Q411.
Business Environment Rating: The US Pharmaceutical Business Environment Rating score increased from 77.9 out of 100 in Q411 to 79.1 in Q112, reinforcing the country's status as the most attractive pharmaceutical market globally. The rise was due to an upgrade in their assessment of the country's healthcare policy and reimbursement system.
Key Trends & Developments
In September 2011, BMI maintained its long-term US healthcare expenditure forecast despite the proposed cuts to Medicare and Medicaid. BMI expect spending on medical services to post a compound annual growth rate (CAGR) of 4.77% over the next decade. While this is slightly below the 2005-10 CAGR of 4.84%, it is still a very steep trajectory for a developed economy. The government will invariably act again to constrain spending on medical services, but given the underlying fundamentals - an ageing population, free pricing for pharmaceuticals and litigious society that supports high insurance costs - any significant reduction in the current growth projection is unlikely. A key risk to this outlook is another economic downturn.
BMI Economic View: Their US growth forecast for 2011 remains unchanged at 1.6%, but they have downgraded the 2012 outlook to 1.6% from 2.4%. Incoming data have been poor, but not recessionary. BMI see consumer activity continuing to grow at a weak pace, though business investment should continue to outperform. There are also major downside risks to the 2012 and 2013 outlook, with external concerns over the health of the European and Chinese economies, and domestic concerns over the expiry of tax cuts and the reduction in government spending.
BMI Political View: The US's poor economic outlook makes it increasingly unlikely that President Barack Obama will be elected to a second term in office. Economic growth remains sluggish at best, consumer confidence is at 30-year lows, and the labour market is very weak. Historically, unemployment rates well above 7.0% (the rate is currently above 9.0% and projected to stay there until mid-2012) have spelled failed re-election bids for past presidents, including for Presidents Gerald Ford, Jimmy Carter and George H.W. Bush. However, BMI maintain Obama's re-election as their core scenario until it becomes clear which Republican Party candidate will oppose him.
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US Pharmaceuticals And Healthcare Industry SWOT
US Political SWOT
US Economic SWOT
US Business Environment SWOT
Pharmaceutical Business Environment Ratings
Table: Americas – Regional Pharmaceutical Business Environment Ratings, Q112
US - Market Summary
Innovative Drug Regulations
Generic Drug Regulations
OTC Medicine Regulations
Medical Device Regulations
Intellectual Property (IP) Regulations
Pricing & Reimbursement Environment
Research and Development Sector
Contract/Clinical Research Organisations
Medical Device Industry
Industry Forecast Scenario
Overall Market Forecast
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Key Growth Factors – Industry
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Macroeconomic Forecast Scenario
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Patented Drug Market Forecast
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Generic Drug Market Forecast
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OTC Medicine Market Forecast
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Medical Device Market Forecast
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Pharmaceutical Trade Forecast
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Key Risks to BMI's Forecast Scenario
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Research-Based Industry – Key Quarterly Developments
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Drug Distribution Sector
Pharmacy Retail Sector
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Leading Local Companies
Merck & Co
Leading Foreign Companies
How We Generate Our Pharmaceutical Industry Forecasts
Pharmaceuticals Business Environment Ratings
Risk/Reward Ratings Methodology
Table: Pharmaceutical Business Environment Indicators
Table: Weighting Of Components
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