In 2020, the world experienced an extraordinary amount of change including the health care system. Before we look into what 2021 has to offer, let’s do a recap of some of the biggest pharmacy trends and advancements for 2020.

The main driver of trend in 2020 was specialty drugs. Specialty drugs accounted for 38% of $465 billion in total prescription dispensing revenues and are expected to grow to 47% by 2025. Specialty drugs are in high demand because of the manufacturing complexity and costs. These drugs are important in helping treat the symptoms of chronic diseases so patients can enjoy a better quality of life.

PBM’s also had unexpectedly larger profits in Managed Medicaid programs that triggered several larger states to move to carve-out pharmacy from fee-for-service Medicaid. California and New York will join a growing list of states that have opted to carve out prescription drug benefits from their Medicaid contracts.

As the coronavirus pandemic reached its height in 2020, patients’ willingness to experiment with home infusion instead of going to a hospital for infusion treatment significantly increased, especially for patients whose immune systems are compromised from treatment for cancer or other conditions.

The effects of the pandemic did not go unnoticed. There were fewer, new users of medications for silent conditions, such as hypertension, high cholesterol, diabetes, and cancer. There was also higher adherence to medications that prevent heart attacks and strokes and complications of diabetes, as well as increased use of mental health medications, as people sought and received treatment for depression, anxiety, and insomnia.

In 2020, the Center for Drug Evaluation and Research (CDER) approved 53 novel drugs. CDER has averaged about 40 novel drug approvals per year. Twenty-one of the 53 novel drugs (40%) were first-in-class with mechanisms of action different from existing therapies. Thirty-one of the 53 novel drugs (58%) were approved to treat rare or “orphan“ diseases that affect 200,000 or fewer Americans. CDER has approved a total of 29 biosimilars since 2015. In 2020, Riabni (Rituxan), Hulio (Humira), and Nyvepria (Neulasta) were approved.

Ongoing and Emerging Trends for 2021 and Beyond

One of the top pharmacy trends for 2021 is the growing spending for specialty medications; spending surpassed 50% of overall pharmacy spend among commercial plans. Potentially, specialty trend could increase 10-15% over the next few years. Also, revenue forecast assumes that brand-name list prices will grow by an average of 4% to 6% from 2020 to 2023. At the end of 2020, the FDA has approved 10 gene therapy products. By 2030, there could be 60 marketed cell and gene therapies treating about 50,000 patients per year.

Venture-Backed digital pharmacies have received substantial financing. The business strategies include:

  • Home delivery of individual prescriptions
  • Operating at least one brick-and-mortar retail location, allowing the pharmacy to remain in a PBM’s network
  • Dispensing 30-day prescriptions, not 90-day maintenance prescriptions
  • Offering a mobile app so consumers can manage their account, order prescription refills, and scheduled delivery
  • Providing telehealth consultations with prescribers

The evolution of the pharmaceutical industry will be a huge factor in the overall landscape of the world’s healthcare system. These top pharmacy trends in 2020 and for 2021 are a good way to kickstart another big year for the industry.