As the global market for pharmaceuticals surpasses $1 trillion this year, a new study has identified 10 “harbingers of disruptive change” which, it says, represent turning points in the role of medicines in advancing healthcare.

These 10 events could be “a threshold reached, a decision made or an action taken,” and will have significant long-term impact on the role or use of medicines in the future and will affect all healthcare stakeholders, says the study, published by the IMS Institute for Healthcare Informatics.

The 10 harbingers of change for 2014 identified by IMS Health include:

- consumer technology companies are rushing to healthcare to transform patient engagement: Google, Apple and Samsung have announced major investments and initiatives that will bring mobile, cloud and wearable technology to healthcare. Their entry into this space will encourage other players, and the new technologies will generate new streams of information that can be used to increase the understanding of drug use, effectiveness and risks;

- governments are unshackling data to aid research and spark medical innovation: in the past year, the US and Korean governments have advanced healthcare data availability by public releases of granular health utilisation and cost data in a way that protects public privacy. They join the UK, which previously provided broad access to prescriber-level information, and this represents a paradigm shift as governments acknowledge that data saves lives and as restrictions on data are being eased through robust methods that protect patient privacy, says IMS;

- medicine spending growth is returning to developed countries, signalling a new phase in the life sciences innovation cycle: as this new phase takes hold, payers will be planning for increased spending levels, rebalancing budgets and seeking new approaches to control costs, while life sciences companies will intensify efforts to demonstrate clinical differentiation for their products and their economic value;

- US clinicians are being encouraged to consider costs in clinical treatment decisions: in early 2014, the American Society of Clinical Oncology (ASCO) announced a value initiative, with an on-line tool and mobile app for doctors, which represents the first time that cost has been explicitly called out as a factor that will influence clinical treatment decision-making. The goal is to help inform physicians about the relative value of drugs and to facilitate cost discussions with their patients around medicine use;

- China has loosened the price caps of 530 low-cost essential drugs: after a series of high-profile drug shortages: this unprecedented move marks a reversal of actions previously taken to fix the cost of such drugs at low levels, and has allowed prices to rise to a level that provides sufficient incentive for companies to continue offering those medicines at acceptable quality standards; and

- the recent formation of mega trans-Atlantic supply-chain purchasing groups has radically shifted the balance of power between wholesalers, chains, generics makers and branded drugmakers, particularly in the US and Europe. For the first time, these buyers are exercising leverage on the global market.

The other events noted in the report are: - a wave of innovation in hepatitis C drug development which is challenging the way health systems respond to new therapies; - new breakthrough vaccines which are foreshadowing a new era of improved public health for low- and middle-income countries; - the growing use of biologics is bringing new treatment options and expanded markets in “pharmerging’ countries; and - US payment and delivery systems are shifting their focus to outcomes and performance.