Pharmaceutical industry experts from IQVIA delivered a comprehensive analysis of market trends reshaping managed care at the Academy of Managed Care Pharmacy's annual meeting, AMCP 2025. Their presentation highlighted how pharmacy deserts, biosimilar adoption, and emerging therapies are creating both challenges and opportunities for healthcare stakeholders.
Doug Long, vice president of industry relations at IQVIA, and Scott Biggs, director of supplier services at IQVIA, identified several critical forces driving transformation in the pharmaceutical sector, from policy pressures to evolving pharmacy roles.
Pharmacy Deserts Threaten Healthcare Equity
A concerning trend highlighted during the session was the closure of over 2,700 retail pharmacies in the past two years, creating "pharmacy deserts" across the country. These low-access communities face significant barriers to obtaining medications and pharmacy services.
"The problem is that many of these pharmacy deserts exist in already disadvantaged communities facing significant health inequities. Many individuals in these areas have a high school education or less, lack health insurance, have limited English proficiency, experience ambulatory disabilities, and identify as racial or ethnic minorities," Biggs explained.
Rural areas are particularly affected, with thousands of towns lacking a pharmacy within 10 miles. Even in urban settings, disparities exist, with fewer pharmacies in minority neighborhoods compared to predominantly White areas. This disparity reduces access to immunizations, medication adherence programs, and preventive healthcare services.
Biosimilars and Specialty Pharmaceuticals Drive Market Growth
The pharmaceutical market experienced substantial growth between 2022 and 2024, driven primarily by new product launches and line extensions. Specialty pharmaceuticals now represent 52% of the total market value, with strong performance in immunology and oncology.
Biosimilars were identified as a key driver of future cost savings, particularly as 116 biologics are expected to lose patent protection by 2034. While the introduction of adalimumab biosimilars has demonstrated the potential for increased competition, barriers such as pharmacy benefit manager practices and prescriber hesitancy continue to hinder broader adoption.
GLP-1 Medications Emerge as Major Market Force
The rapid expansion of glucagon-like peptide-1 (GLP-1) drugs has been particularly notable, influencing diabetes care and contributing to shifting prescription patterns.
"Obesity is now a $20 million category, and we expect [sales for GLP-1 products will] accelerate from there, as [these medications] pick up new indications for sleep apnea, heart conditions, chronic kidney disease, and more," predicted Long.
Economic and Policy Influences
Long and Biggs outlined how the Inflation Reduction Act's (IRA) pricing measures could impact the development of non-biological products and reshape market incentives. The IRA's influence on insulin pricing has led to decreased market value, complicating the financial landscape for manufacturers.
Supply chain vulnerabilities were another focal point. The speakers highlighted the US market's reliance on imports from Europe, Switzerland, and Asia, which creates risks for drug availability. While US manufacturing capacity remains underutilized, only 2 of the top 37 sites operate at full capacity.
Retail Pharmacy Landscape Shifts
Retail and mail-order pharmacies have experienced significant changes. The non-retail sector has accelerated, partially due to COVID-19–driven shifts in healthcare delivery. However, mass retailer growth has placed pressure on chain pharmacies, many of which have struggled with increasing operational demands and staffing shortages.
The IRA's potential effects on long-term care facilities and independent pharmacies were discussed, alongside the growing role of pharmacists in vaccine administration and patient education. The opioid dispensing rate has significantly decreased since 2019, and flu season vaccination efforts have continued to shift toward pharmacies, reflecting broader trends in pharmacy-based healthcare delivery.
Looking Forward
As the pharmaceutical landscape continues to evolve, industry stakeholders must adapt to these changing dynamics. The growth of biosimilars, the expansion of specialty pharmaceuticals, and the challenges posed by pharmacy deserts will require innovative solutions to ensure patient access to medications and services.
Long concluded the session by reflecting on his long career with IQVIA, from which he will retire this year after over 40 years of work in the managed care pharmacy space.
The insights provided at AMCP 2025 underscore the critical need for adaptation as payers, providers, and manufacturers navigate an increasingly complex healthcare landscape shaped by policy changes, market forces, and evolving patient needs.
