Report: Oncology, Immunology Projected to Lead Global Spending From 2024 to 2028


The IQVIA Global Use of Medicines report for 2024 predicts that loss of brand exclusivity will negatively impact global market growth.

The IQVIA Institute for Human Data Sciences has released their Global Use of Medicines report for 2024, with an outlook until 2028. Due to loss of brand exclusivity, the 10 leading developed markets are projected to lose $59.1 billion in biologics and $133 billion in small molecule-based drugs, according to the report.

The global medicine market size and growth, including COVID-19 vaccines and therapeutics, is projected to steadily increase from 2024 to 2028, with the percentage growth constant decreasing until 2027 and slightly increasing in 2028. In the 10 leading developed markets, new brand spending (excluding COVID-19 vaccines and therapeutics) is projected to peak at $45 billion in 2024 and decrease to $33 billion in 2028. IQVIA also projects an average of 65 to 75 launches per year from 2024 to 2028, with 325 to 375 within the 5-year period. The total forecast of spending is projected to be $193 billion from 2024 to 2028.

Money and pill, pharmacy concept

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Globally, the 2024 to 2028 compound annual growth rate (CAGR) is projected to be from 6% to 9%, with North America also having the same projection. Spending in 2028 in North America is predicted to be between $1050 billion and $1080 billion.

In the United States, the medical spending and growth (excluding COVID-19 therapeutics and vaccines) is predicted to have a net CAGR of 2% to 5% and a net 47% below invoice to net difference, according to the report. Additionally, from 2024 to 2028, existing brands will lead pending and growth as driving factors, followed by new brands, while loss of exclusivity will negatively impact spending and growth, with a total loss of approximately $145.5 billion. Biologics will contribute to a loss of $17.6 billion and small molecule drugs will contribute to $14.5 billion, according to the report. Biologics are expected to be most impacted in 2025 and 2026, while small molecule drugs are expected to be most impacted in 2027 and 2028.

Furthermore, globally, biotech spending is projected to rapidly increase from 2024 to 2028, according to the report. Total spending growth will increase by approximately 77%, with brands being impacted by $59 billion from biosimilars. The top 10 categories for global spending products in 2028 are projected to include oncology, immunology, diabetes, cardiovascular, central nervous system, respiratory, mental health, infectious diseases, obesity, and genitourinary sexual health.

According to the report, global oncology spending is projected to increase by 104% in global spending growth, reaching $224 billion, with approximately 100 new oncology drugs. For immunology, IQVIA estimated an increase of 12% per year volume growth, at an increase of $32 billion total. Average cost per day of defined daily doses (DDD) is projected to be $11 to $23.

Notably, global obesity spending is projected to increase by $212 billion in total of spending growth thanks to new treatment modalities and improvements in reimbursing. Furthermore, cell, gene, and RNA therapeutics are expected to rapidly increase from 2024 to 2028, according to the report.

IQVIA also estimated that the projected use of medicines from 2024 to 2028 will increase globally from 3460 billion DDD t0 3778 billion, which is a CAGR increase of approximately 2.3%.

In North America, the increase is projected to be from 294 billion DDD to 309 billion. The largest increase is projected to be in China, which has a CAGR of 3.7%. The projected per capita increase from 2024 to 2028 is 1.2% CAGR, with North America increasing from 0.8%, which is lower than the past 5 years at 0.9%. For select therapeutics, IQVIA reported that immunology/allergy and endocrinology had the highest DDD, with the lowest for non-oncology hematology, eye/ear care, and pain care.


IQVIA Institute for Human Data Sciences. Report: Global Use of Medicines 2024: Outlook to 2018. January 2024. Accessed January 15, 2024. Email.

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