The global market for oncology drugs reached $91 billion in 2013

 

IMS OncologyPOST 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.

Innovation

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.

graphic_Oncology   Value of treating cancer and pricing trends Oncology-graphic2-e1353422216979The high number of new targeted therapies launched and available for cancer patients has also escalated payer scrutiny of their value relative to their incremental benefits compared to existing treatments. The average cost per month of branded oncology drug treatment in the U.S. is now about $10,000, up from an average of $5,000 a decade ago. Judging the incremental value of these treatments for individual patients is fraught with challenges due to the high level of variability of patient response, the frequent changes to protocol needed for patient care, and underlying issues of equity and patient care. The American Society of Clinical Oncology recently issued recommended targets for meaningful clinical trial outcomes, a useful step to guide those investing in innovation as well as those paying for patient care.

U.S. specific oncology dynamics The U.S. market accounts for 41% of total oncology drug sales but reforms are impacting cancer treatment site of care, reimbursed fees and patient out-of-pocket costs. While the number of medical oncologists has been rising steadily over the past decade, they are rapidly changing their practice profile. Over 40% of oncologists are now in practices with seven or more physicians, up from 29% in 2012, as smaller practices are aggregated and/or acquired by hospital systems. Oncologists themselves attribute this trend to financial pressures and the desire to alleviate risk. spending oncology drugs

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