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Evidence-based predictions on health care’s future

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DANBURY, Conn. — The types of medicines being developed, the way technology contributes to health and how the value of health is calculated are all changing dramatically, according to a new report from the IQVIA Institute for Human Data Science.

The IQVIA study, “2018 and Beyond: Outlook and Turning Points,” looks at several health care trends in which stakeholders and decision makers are increasingly using real-world evidence and technology to solve the problems of human health. The institute’s analysis made predictions that promise to transform health care cost and spend, drug development and delivery, and approaches to determine the societal value of medicines.

“This report focuses on the most recent real-world evidence and analysis to balance emotional issues and intuition that can sometimes overshadow critical health care decisions,” said Murray Aitken, IQVIA’s senior vice president and executive director of the IQVIA Institute for Human Data Science. “Based on that analysis, we’re convinced these evidence-based predictions will begin to come to pass later this year.”

Among the predictions for health care transformation ­are:

• The Food and Drug Administration will guide the use of real-world evidence (RWE) to support the regulation of medicines. In 2018, the FDA will issue its first framework addressing the potential for RWE to support regulatory submissions and monitoring for drug safety.

• Use of telehealth will continue to expand. Nearly every privately insured patient in the United States will have some form of access to telehealth this year, although few will use it. In 2018, telehealth will account for 3% to 3.5% of doctor visits, up from 2.6% in 2017. Over the next five years telehealth will grow to between 4% and 7.5% of visits as patients’ concerns about being treated by a random doctor are outweighed by the dramatically lower co-payments offered by their insurers. Advocates of telehealth argue that most of the reasons to see a provider in person can be supported remotely. For payers, concerns about measurable benefits or potential fraud are being addressed by the use of technology and are outweighed by cost savings relative to the inappropriate use of emergency or urgent care.

• Spending on branded medicines will dip. In 2018, net brand spending will decline in developed markets by 1% to 3%. This has the effect of reducing net spending overall on brands in developed markets by approximately $5 billion, to a total amount of $391 billion for this year. Manufacturers will continue to develop and launch drugs, but the inherent unpredictability of these novel medicines will drive greater caution among payers regarding reimbursement and access.

• Specialty brands will drive developed market growth. In 2018, the $297 billion specialty medicines market will represent 41% of developed market spending, up from $172 billion in 2013; in fact, specialty drugs will contribute all of the growth in medicine spending in 2018. Those increases, however, will be offset by declines in traditional therapies. The growth of spending on specialty medicines will be constrained by cost and access controls and a greater focus on assessments of value. Despite these trends, specialty brands are expected to reach 48% of total spending in developed markets by 2022.


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