During the height of the COVID-19 pandemic, health systems and other providers across the globe were forced to take drastic actions as utilization reached capacity. Hospitals and governments halted elective procedures. Imaging services were prioritized for the most critical patients. Staffing resources were redirected to COVID-stricken patients.
The impact of these actions rippled across the industry. In England and Wales, roughly 2.4 million operations were estimated to have been cancelled in 2021. During three-month period in 2020, US hospitals were projected to have lost $22.3 billion from the cancelation of elective surgeries.
Life sciences companies felt the pinch as well. The global pharmaceutical market saw its compound annual growth rate dip from 7% to 4%. Some therapeutic sectors were knocked further off course, declining more than 10% and deviating significantly from their long-term trends. Our analysis of global drug sales found four areas where lockdowns took a particular toll: Medications used in anesthesia, contrast media during diagnostic imaging, medications to treat non-COVID infectious diseases, and medications for non-urgent treatments or lifestyle-related care.
Although sales are rebounding as utilization normalizes, some interesting trends emerged as we sifted through the data. For instance, the industry showed a tremendous ability to maintain therapeutic treatments for patients with chronic conditions. Below we take a closer look at how these four areas were impacted by lockdowns and project their return to normal.
Elective surgeries saw the sharpest decline during the pandemic, falling 38.6% in England and Wales, for instance. In the US, following a federal mandate that halted elective procedures, surgical volume plummeted 48% over a seven-week period in the spring of 2020. With procedure volumes down, the sale of medications used during surgery drop sharply. A recovery is in process as hospitals resume normal operations. General anesthetics and wound-healing agents are seeing the most dramatic uptick in sales.
Imaging Contrast Media
Although not as dramatic as surgical activity, diagnostic imaging also slowed during the pandemic. Imaging volume was down 22% in 2020 in the southern part of Saudi Arabia for instance, with drops of more than 40% occurring between both April to June and July to September. Meanwhile, CT cancer screening fell by 82% in the US, researchers from Massachusetts General Hospital and Harvard Medical School found.
Still, the impact on global sales for imaging contract media was buffered somewhat by the steady need for chest radiology and CT during the pandemic.
Fertility treatment, Aesthetic Treatment, and More
Not surprisingly, drugs used for non-urgent and lifestyle procedures took a dip in 2020. Everything from anti-obesity agents to fertility treatments were impacted. During the early days of the pandemic, the American Society for Reproductive Medicine issued guidelines to its members urging them to suspend new fertility treatment cycles, largely to prevent healthcare-acquired infections and to minimize the impact on an already strained supply chain. Dispensing of all contraceptives in France decreased compared to expectations: -2.0% for oral contraception, -8.6% for IUDs, and -16.4% for implants. Treatments requiring injection such as Botox and Dysport (botulinum toxin) dropped significantly as clinics were not able to see patients. As restrictions have loosened, many of these areas are seeing a return to their previous growth trajectories.
Infectious Disease Medications
One of the few positives stemming from the pandemic was the impact on other infectious diseases. Due to lockdowns, masking, and social distancing, there was a solid decline in non-COVID infectious diseases. One study found a 65% drop in the Netherlands in respiratory, gastrointestinal, and travel-related diseases between mid-March and mid-October 2020 compared to the previous three years. In Germany, cases of infectious diseases were down 86% compared to 2016. While a net positive on public health, this led drops in sales for antibiotics, antifungals, and therapies for other infectious diseases.
Maintaining Essential Treatments
Despite the headwinds that healthcare encountered during the pandemic, health systems were largely able to maintain care for patients with other chronic conditions. Our analysis shows that sales for drugs to treat diabetes, hypertension, as well as the total oncology market, did not deviate from their pre-pandemic trendlines. The rapid adoption of telehealth likely helped patients stick with their disease management regimen, including cancer care.
It is encouraging to see that most therapeutic areas, based on total sales, only showed a minor disruption during the pandemic. Sales should return to normal growth trajectories as backlogs in procedures continue to clear out. We also hope to see the industry build on the experience of sustaining care for patients with chronic conditions during a crisis.
Tobias Handschuh Partner