Medicines play a significant role in protecting, maintaining, and restoring people’s health. The provision of appropriate medication of assured quality, in adequate quantities and at reasonable prices, is, therefore, a concern of global and national policymakers and agencies implementing health activities and programs.
The global use of medicines is one of the key influencers of global health. The practical ability to measure it in a timely and granular way provides a unique window on health systems across the world.
How has the global usage of medicines been evolved?
Global use of medicine has increased at a 3% compound annual growth rate (CAGR) since 2014, slowing from a 4% rate seen 2009–2014. In 2019, patients globally received an estimated 1.8 trillion days of therapy or an average of 234 per person. The majority of medicine use is in pharmerging markets, which have large populations but have per capita rates of use still markedly lower than those in higher-income countries.
This rise demonstrates the value of medicines in addressing the needs of patients, prescribers, and health systems worldwide. Medicine consumption is closely tied to country income, though there is significant variation across countries with similar incomes. Given that the rate of increase in medicine use is currently outpacing population and economic growth, more patients are receiving treatment.
This expansion has mostly occurred in pharmerging markets, defined by IQVIA as countries with per capita income below $30,000 per year and pharmaceutical spending growth above $1 billion over five years.
Overall global use of medicine has increased over the past ten years in areas of high priority, including the treatment of non-communicable diseases, which were responsible for 71% of deaths worldwide in 2016.
The pharmerging markets are divided by tiers based on market size, with China as Tier 1, Brazil, India and Russia as Tier 2 countries, and Tier 3 countries including Mexico, Turkey, Poland, Saudi Arabia, Indonesia, Egypt, Philippines, Pakistan, Vietnam, Bangladesh, Argentina, Algeria, Colombia, South Africa, Chile, Nigeria, and Kazakhstan.
The appeal of the pharmerging markets, as significant growth opportunities based on pharmaceutical spending and GDP, is simple. Many governments in these markets are making substantial investments in healthcare.
As an example, China announced in 2009 that it would spend USD 124 billion over ten years to expand healthcare coverage for its 1.3 billion citizens. The investment includes projects such as upgrading and constructing new hospitals and health clinics in areas ranging from urban centers to remote villages.
Economic growth in these countries is another factor, creating a growing middle class with the means to afford private insurance and out-of-pocket payments for more expensive treatments. And as affluence grows, so does the prevalence of lifestyle diseases such as diabetes, hypertension, high cholesterol, and certain forms of cancer, which increases the demand for a broader range of drugs and treatments in the portfolios of pharmaceutical companies.
Access to safe, effective, and quality medicines and vaccines is one of the targets of the Sustainable Development Goals. Achieving universal health coverage requires access to safe, effective, quality, and affordable essential medicines and vaccines. Access is a global concern given the: rising prices of new drugs that place increasing pressure on the ability of all health systems to provide full and affordable access to health care; persisting problems of shortages and stock-outs of essential medicines, primarily for noncommunicable diseases, and vaccines; and increasing numbers of substandard and falsified medical products that pose an unacceptable risk to public health. Also, problems such as antimicrobial resistance and opioid misuse highlight the need to improve the appropriate use of medicines.
