POST SUMMARY: According to IMS Health Informatics: The global market for oncology drugs, including supportive care, reached $91 billion in 2013, as measured at ex-manufacturer prices and not reflecting off-invoice discounts and rebates. Although this is up from $71 billion in 2008, it represents a compound annual growth rate of 5.4%. The modest rate reflects a lack of breakthrough therapies for very large patient populations, patent expiries, reductions in the use of supportive care medicines and stronger payer management . This rate of growth is significantly lower than seen during the 2003-2008 period when growth each year exceeded 15%, driven by a small number of breakthrough therapies. Differences in incidence rates, access to medicines and treatment protocols are substantial between countries, but cancer is still a leading area of healthcare spend. In pharmerging markets, oncology is expected to be the fourth highest spend therapy class by 2017. While the U.S. and top five European markets have declined in their share of the global market, they still dominate it with 65% of total sales. Targeted therapies have dramatically increased their share of the oncology market, now accounting for 46% of total sales, up from 11% a decade ago.
Developers have brought innovation across cancer types and therapeutic approaches, including preventive vaccines. Pharmaceutical company investments remain high and cancer therapies account for more than 30% of all preclinical and phase I clinical developments, with 22 new molecular entities being launched and reaching patients in the last two years alone. These new medicines have increased the complexity of treating cancer, leading to more combination therapies and additional lines of therapy. Clusters of innovation based on similar underlying science but separate development paths have transformed patient care in areas such as advanced melanoma and sub-populations of cancers with higher prevalence. Commercial returns for some recently launched oncology drugs have been as high as earlier benchmarks such as bevacizumab or imatinib. Many new drugs, however, are for small patient populations and face strong competition, lowering their level of sales and therefore returns to manufacturers. Investment in near-term future innovation has shifted toward biologics, mostly concentrated in targeted treatments, though preclinical products are mostly small molecule. While much of the pipeline is focused on lung and breast cancer, tumor types with lower prevalence such as ovarian, leukemia, stomach, and liver cancers are also being actively pursued. Immunology therapy has become a strong focus of investment recently based on current success in clinical trials and a promising outlook.