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Institute Report
Global Medicine Spending and Usage Trends
Outlook to 2024
Mar 05, 2020
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About the Report

The global use of medicines is one of the key influencers of global health and the practical ability to measure it in a timely and granular way provides a unique window on health systems across the world. This report reviews trends in medicine use and spending from 2009 to 2019 and provides projections to 2024. In this, our ninth global forecast publication, we again bring forward insights to inform stakeholders globally on the amounts spent on which types of medicines, compare countries and gain a better understanding of the current and future state of attempts to improve global health.

Report Summary

Overall, 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 in higher income countries. Areas identified as global health priorities, such as diabetes and cardiovascular diseases, have seen significantly increased use of medicines. Global medicine spending is projected to increase at 2–5% annually and exceed $1.1 trillion in 2024. Most developed and pharmerging markets will see slowing rates of growth in the next five years compared to the last five, with rates between 1–4% and 5–8%, respectively.

New brands will contribute $165 billion in spending growth through 2024, up from $126 billion in the past five years, with brand LOEs projected to have a $139 billion negative impact on brand sales from 2020–2024, compared to the $107 billion impact seen from 2014–2019. Manufacturer net prices are expected to grow between 1% and -2% in the United States over the next five years, significantly below historic levels, while in other developed markets, net price declines of -2 to -5% are expected as a result of continued payer and government actions. Payers’ approaches to managing overall cost growth trends will face challenges due to uncertainty around the prices and impact on spending of an increasing number of specialty, niche and rare disease medicines.

Key Findings

Global use of medicine has increased at a 3% compound annual growth rate since 2014.

Global Medicine Defined Daily Doses in Billions 2009-2019
  • In 2019, patients globally received an estimated 1.8 trillion days of therapy; an average of 234 per person.
  • Overall, global use of medicine has increased at a 3% compound annual growth rate (CAGR) since 2014, slowing from a 4% rate seen 2009–2014.
  • The majority of medicine use is in pharmerging markets, which have large populations, but have per capita rates of use still markedly lower than in higher income countries.


Areas identified as global health priorities have seen significantly increased use of medicines.

Audited Markets Medicine Use in Defined Daily Doses by Therapy Types and Areas
  • Therapy areas comprising most of the use include diabetes, respiratory, cardiovascular and cancer treatments, which account for 71% of deaths worldwide.
  • In 2018, priority NCDs represent 35% of global DDD volume, growing by a 4.7% CAGR since 2008.
  • Over the past ten years, these four priority diseases have increased by 200 billion DDDs.



Global medicine spending is projected to increase at 2–5% annually and exceed $1.1 trillion in 2024.

Global Medicine Net Market Size and Growth 2009-2024, Constant US$Bn
  • Most developed and pharmerging markets will see slowing rates of growth in the next five years compared to the last five, with rates between 1–4% and 5–8%, respectively.
  • Pharmerging spending and growth are slowing as healthcare access expansions of the last decade begin to slow.
  • Developed markets are expected to see slowing brand growth despite increases in specialty medicine spending, as greater brand losses of exclusivity (LOE) offset higher new brand product spending, and price and volume growth both slow.


New brands will contribute $165 billion in spending growth through 2024, up from $126 billion in the past five years.

New Brands Invoice Spending Growth in Developed Markets, Constant US$Bn
  • Brand LOEs are projected to have a $139 billion negative impact on brand sales from 2020–2024, compared to the $107 billion impact seen from 2014–2019.
  • Manufacturer net prices are expected to grow between 1% and -2% in the United States over the next five years, significantly below historic levels, while in other developed markets, net price declines of -2 to -5% are expected as a result of continued payer and government actions.
  • Specialty spending is projected to account for 40% of global spending in 2024... and is expected to reach 52% in 2024 in developed markets.
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