US sales of ethical pharmaceuticals and insulins grew 5.1% last year, compared to 2008’s rise of just 1.8%, say new figures from research firm IMS Health.

Drug sales through both retail and non-retail channels reached $300.3 billion last year and demand was higher than in the previous two years, but it remains at historically low levels, says the firm.

“While the 32 innovative products launched last year brought important new treatment options to patients in a number of disease areas, including cancer, thrombosis and atrial fibrillation, they drove only a limited increase in drug spending,” said Murray Aitken, senior vice president, Healthcare Insight, at IMS. “Access for the first time to lower-cost generic treatment options in the areas of epilepsy, migraine, and immune system disorders had a more moderate impact on market growth than generic launches in previous years. Stronger patient demand for prescription drugs throughout 2009, both for new therapy starts and refills, underscores the resilience of pharmacotherapies in today’s health care equation,” he added.

According to the report, key factors contributing to US market growth last year included: - stronger demand, with dispensed prescription volume in retail channels rising 2.1% to 3.9 billion dispensed prescriptions compared to growth of just 1.0% in 2008. Also, while the volume of new therapy starts in 17 major chronic disease areas declined around 1%, volume for add-on therapy starts, switches and refills rose nearly 2%; - drugmakers’ sustained pricing practices, competing on the basis of clinical evidence and value; - inventory management actions by retail pharmacies at the start of the year to bring stocking levels in line with market demand; - greater use of specialty pharmaceuticals, which grew 7.5% last year and now comprise 21% of US market value; and - the lower impact of patent expiries, as well as no significant product safety issues occurring during the year.

Antipsychotics remained the top-selling class of medications in the US in 2009, with prescription sales of $14.6 billion, equal to the previous year’s level. Lipid regulators continued as the largest therapy class in terms of dispensed prescription volume, growing 5% to 212 million prescriptions dispensed, but their sales fell 10% to $13.1 billion, reflecting an ongoing shift toward generic alternatives, and they slipped to third place for overall sales, losing the second-place spot to proton pump inhibitors (PPIs), says IMS.

However, sales of PPIs fell 2% last year, to $13.6 billion, although their dispensed prescription volume rose 5%, while antidepressants rose from fifth to the fourth largest therapeutic class in terms of prescription sales, advancing 3% to $9.9 billion.

Sales of antineoplastic monoclonal antibodies, a leading oncology class that includes the Genentech drugs Avastin (bevacizumab), Rituxan (rituximab) - with Biogen Idec - and Herceptin (trastuzumab), grew 9% last year and ranked in sixth place in terms of sales.

Use of generics, including branded generics, continued to rise in 2009 and they now represent 75% of all dispensed prescriptions in the US, up from 57% in 2004, notes IMS. The total number of generic prescriptions dispensed in 2009 grew 5.9%, while the number of branded prescriptions dispensed declined 7.6%.

“Greater availability of generic options, growing differentials in co-pays between brands and generics,and efforts by patients, insurers and employers to encourage appropriate use of lower-cost alternatives were all factors in the changing mix of medicines used in patient treatment last year,” commented Mr Aitken.