Through 2020, the Pharmaceutical Industry's Support for the U.S. Affordable Care Act Will Total Approximately $90 Billion

Market Access Analysis for the United States Now Available from Decision Resources

BURLINGTON, Mass.--(BUSINESS WIRE)-- Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that annual fees related to the U.S. Affordable Care Act which will be levied on drug manufacturers will cost the pharmaceutical industry approximately $30.8 billion from 2011 through 2020. Also, measures to close the Medicare Part D coverage gap will add an additional $30 billion to the industry’s expenses and Medicaid rebate increases are projected to cost the industry $20 billion over the next ten years. In total, the pharmaceutical industry's support for this healthcare reform will add up to approximately $90 billion through 2020.

The United States: Market Access Tracker service finds that, in return for its support of the Affordable Care Act, the pharmaceutical industry stands to gain some significant benefits that include:

  • An additional 32 million patients will have health insurance, including prescription drug coverage
  • The narrowing and eventual closure of the Medicare Part D coverage gap which will reduce the risk that patients will switch from branded drugs to generics or discontinue therapy altogether
  • Twelve years of marketing exclusivity for biologics which will delay the launch of biosimilars

“Additionally, health plans will be banned from imposing annual or lifetime caps on reimbursement, they will not be able to deny coverage to patients with preexisting conditions and will be prohibited from cancelling the policies of members in poor health,” said Decision Resources Market Access Tracker Director Neil Grubert, M.A. “These factors are expected to significantly increase the demand for prescription drugs in general and for high-priced therapies in particular.”

The prospects for full implementation of the act’s provisions are by no means certain, however. The major reforms contained in the Affordable Care Act are not scheduled to take effect until 2014, but the legislation faces formidable legal and political challenges in the meantime. In March 2012, the U.S. Supreme Court heard three appeals related to the legislation and publication of the court’s ruling is expected in June. Whatever the court’s verdict, healthcare reform will be a key issue in the November 2012 presidential and congressional elections as Republican Party representatives have proposed various strategies for dismantling the changes contained in the Affordable Care Act.

“The pharmaceutical industry is anxiously awaiting the outcome of the Supreme Court’s decision and the November elections,” Mr. Grubert said. “Although drug manufacturers have already made significant financial contributions toward the costs of healthcare reform, it remains to be seen if they will receive all of the benefits that were promised when the Affordable Care Act was signed into law by President Obama in 2010.”

About Decision Resources’ Market Access Tracker Service

Market access is critical to a drug’s commercial success, but it presents many challenges as payers are increasing prelaunch and post-marketing obstacles, causing the market access environment to be in constant flux. Market Access Tracker’s timely analysis of key events, regular webinar updates and access to our team of experts will equip biopharmaceutical companies with the insight they need to evaluate the implications of the latest changes for their business and to assess the commercial outlook in each market.

Key benefits include:

  • Three international regions comprising 17 countries
  • Evergreen, rapid updates
  • Event-driven analysis of the market access environment
  • In-depth, web-based country profiles
  • Concise national overviews in PowerPoint format

Geographic services:

  • Americas: United States, Canada, Mexico, Brazil, Argentina
  • Europe: France, Germany, Italy, Spain, United Kingdom, Russia, Turkey
  • Asia-Pacific: Japan, China, India, South Korea, Australia
  • Global: all 17 countries

About Decision Resources

Decision Resources ( is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources Group company.

About Decision Resources Group

Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources Group at

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Decision Resources
Christopher Comfort, 781-993-2597
[email protected]

KEYWORDS:   United States  North America  Massachusetts

INDUSTRY KEYWORDS:   Health  Biotechnology  Pharmaceutical  Managed Care