According to a recent report by the Iqvia Institute for Human Data Science, the global oncology drug market is expected to average an annual growth of 10-13% through 2022, while the US market is predicted to grow 12-15% annually during the same time period.
"For drug manufacturers, this report is a reminder of the tremendous progress that has been made in the past few years in bringing new cancer therapies to patients,” said Murray Aitken, Iqvia senior vice president and executive director of the Iqvia Institute for Human Data Science.
“It also reinforces the rapid changes in treatment guidelines and pathways, the complexity for providers and patients, and the promise of much more to come within the next five years based on clinical development activity and progress," he told us.
The pipeline
In 2017, the industry’s pipeline reached more than 700 molecules in late-stage development, which is up more than 60% from a decade ago.
The immunotherapy pipeline specifically includes nearly 300 molecules with 60 separate mechanisms being evaluated in Phase I or Phase II clinical trials against 27 different tumor types.
Yet, while the industry continues efforts to accelerate the time-to-market, new drug approvals in 2017 had a median time span of 14 years from patent filing – which is only marginally faster than 2013 estimates, according to the report.
"The surge in innovation brings new dimensions of complexity, even as the availability of predictive biomarkers and diagnostic tests can help bring a more precise course of treatment to an individual patient," Aitken said.
Last year, 34% of oncology clinical trials used biomarkers – the use of which, according to a study by Amplion, BIO, and BioMedTracker, triples the success rate of clinical drug development programs.
The costs
Global spending on cancer medicines for both therapeutic and supportive care reached $133bn globally in 2017, up from $96bn in 2013, with the 35 drugs accounting for 80% of the total spend. This, as an estimated 87% of oncology drugs were used by fewer than 10,000 patients last year.
"Payers continue to be challenged as they seek value and fund access to the latest oncologic treatment options," said Aitken.
Since 2012, spending on cancer medicines has doubled in the US, in 2017 reaching nearly $50bn – a number expected to double again by 2022.
Trump's drug pricing blueprint
In response to drug price increases, the Trump Administration recently released the President’s blueprint to lower costs. According to the speech delivered by the US Secretary of Health and Human Services (HHS) Secretary Alex Azar, the blueprint outlines four “strategies for reform,” including improved competition, lowering out-of-pocket costs, enhanced negotiation, and incentives for lower list prices.
BIO President and CEO Jim Greenwood issued a statement following the announcement noting concerns that some of the proposed ideas could potentially hurt patient access to “the medicines they need today and the future cures and treatments they’re desperately waiting for America’s biopharmaceutical innovators to discover.”
Greenwood said: “We look forward to working with the administration on solutions that help provide all patients access to prescription drugs with out-of-pocket costs they can afford.”
Last year, the median annual cost of US-launched cancer drugs topped $150,000, compared to $75,000 for new cancer treatments launched 10 years ago. However, according to the report by Iqvia, the average patient with commercial insurance paid less than $500 per year for outpatient non-retail medicines in 2017.
The outlook
Technology advances and the use of information will be “driving forces” affecting oncology treatment and costs throughout the next decade, according to the report.
"There are also a number of disruptive technologies that will reshape healthcare and cancer specifically, including data science that incorporates artificial intelligence and real-world data, as well as advances in patient engagement through mobile apps," Aitken said.
Notably, mobile cancer apps have increasingly been used to engage with patients, with 15 studies published last year reporting “positive impacts of cancer apps across a range of uses.”
For example, Bristol-Myers Squibb is conducting a pilot program using GRYT Health’s Stupid Cancer app to collect real-world data to help improve clinical trial design and patient wellbeing.