The pharmaceutical industry faced a challenging period from 2008-2012 due to numerous major drug patents expiring, resulting in $30 billion in lost annual brand drug revenue. Another peak of patent expirations is projected for 2014-2015, equal to the prior period. Growth in overall drug spending declined 1% in 2012 but is predicted to rebound to 3-4% growth in 2014, driven by new drug approvals and healthcare reform, before slowing again as generics continue to capture a larger share of prescriptions. Demonstrating the value of new drugs through real-world evidence will be important for companies to sustain pricing levels in this challenging environment.