This blog is Part 1 of our ‘Asembia 2025 series’ and features original insights inspired by sessions we attended at Asembia's AXS25 Summit. You can continue exploring this series by reading Part 2 and Part 3.
The U.S. pharmaceutical market has reached a sales milestone of $821 billion in 2024, with growth accelerating to 12.8% year-to-date in 2025. Despite achieving record-breaking revenue, the industry faces a paradox of unprecedented growth alongside significant structural challenges that could reshape the landscape in years to come.
1. Volume Drives Growth, Not Price
Contrary to popular perception, price increases haven't fueled the market expansion. An impressive 78% of growth has come from increased prescription volume, while new product launches contribute additional gains. Price changes have actually had a negative impact on overall growth, reflecting the ongoing pressure from payers and policymakers to control healthcare costs.
"The shift toward volume-driven growth rather than price increases reflects a maturing market that's finally prioritizing patient access. At ConnectiveRx, we've long advocated that broader prescription fulfillment — not higher prices — is the sustainable path forward for both patients and the industry."
- Chris Dowd, ConnectiveRx, SVP, Market Development
2. The GLP-1 Revolution
Perhaps no trend has been more transformative than the rise of GLP-1 medications. With four of the top ten fastest-growing products in this category—including Ozempic, Mounjaro, Zepbound, and Wegovy—GLP-1s have created a $100 billion market. Yet this represents just the tip of the iceberg: only 10% of Americans have used these medications despite over 50% being classified as overweight or obese.
However, access remains challenging. Payers reject approximately 64% of new obesity drug prescriptions, highlighting the ongoing battle between innovation, efficacy, and cost control.
3. Infrastructure Under Pressure
The retail pharmacy landscape is undergoing dramatic transformation. Over 2,700 pharmacies closed in 2023-2024 alone, leaving 16 million Americans in "pharmacy deserts." This trend particularly impacts rural and marginalized communities, creating significant access barriers to essential medications.
Adding to these concerns, 94% of pharmaceutical products come from outside the United States, with 97% of antibiotics and 85% of top generic drugs sourced internationally. Reduced FDA inspections and persistent drug shortages—70% of which have lasted over two years—underscore the fragility of our medication supply chain.
4. Specialty Drugs Lead the Market
Specialty pharmaceuticals now command 52% of market value despite representing only 2% of prescription volume. Growing at 12% annually compared to traditional drugs at 8%, specialty products are driving both innovation and cost concerns.
5. A Challenging Path Forward
The pharmaceutical industry faces several regulatory and market pressures:
- Biosimilar Adoption: Despite potential savings, U.S. biosimilar uptake remains slow, with products like Humira maintaining market share until private label alternatives emerged
- Complex Patient Journey: Of 100 prescriptions written, only 65 get filled, and merely 31% of patients complete their therapy regimen
- Financial Strain: 83% of prescriptions are dispensed at a loss, creating unsustainable economics for many pharmacies
Looking Ahead
While 2025 brings continued growth, the industry must address fundamental challenges: ensuring reliable drug supply chains, improving patient access and adherence, and creating sustainable economics for all stakeholders. The intersection of innovation and access will likely define the industry's next chapter.
Navigating these complex dynamics, one thing remains clear: the pharmaceutical industry's ability to adapt and innovate will determine its success in serving patients while maintaining commercial viability in an increasingly challenging environment.