Total global spending on cancer medicines reached the $100 billion mark last year, as patients and doctors embraced earlier diagnosis and more effective therapies requiring longer treatment durations, the IMS Institute for Healthcare Informatics said today in a report.
The global market for oncology drugs—including those used in supportive care—increased 10.3% last year and has risen from $75 billion five years earlier, the report found.
“The increased prevalence of most cancers, earlier treatment initiation, new medicines and improved outcomes are all contributing to the greater demand for oncology therapeutics around the world,” Murray Aitken, IMS Health svp and executive director of the IMS Institute for Healthcare Informatics, said in a statement.
The compound annual growth rate in spending over the past five years has been 6.5% globally on a constant exchange rate basis. U.S. spending growth has been slower at 5.3% CAGR, yet the nation still accounts for about half of all spending on cancer treatments at $42.4 billion in 2014, according to the institute.
Oncology drug spending has risen slightly as a percentage of total drug spending over the past five years worldwide, the IMS Institute said—most notably in the “EU5” countries (Germany, France, Italy, U.K., and Spain), where oncology now represents 14.7% of total drug spending, up from 13.3% in 2010.
The U.S. and EU5 account for a combined 66% of the total cancer drug market—even though within the U.S., the spending increase has been more modest, rising to 11.3% last year from 10.7% in 2010.
Targeted therapies now account for nearly half of total spending and have been growing at 14.6% CAGR since 2009, the study noted. At the same time, payers and national health systems have intensified their scrutiny of the value of these medicines relative to their incremental benefits over existing treatments, with cost effectiveness assessments frequently resulting in limited patient access to these drugs.
As a result, IMS Institute said, access and reimbursement issues will likely become “more complicated” in coming years as individual and combination oncology medicines address multiple cancer types and patient populations with varying dosage and clinical value.
The study observed that the availability of new oncology medicines varies widely across major developed countries—patients in Japan, Spain, and South Korea, for example, had access last year to fewer than half of the new cancer drugs launched globally in the prior five years. Availability of newer targeted therapies is low but increasing, however, in emerging markets, which according to the institute accounted for 13% of the total cancer drug market. Even in the most affluent countries, the institute said, new drugs may only reach a very small number of patients as payers have balked at reimbursement for them.
In the U.S., according to IMS Institute, average therapy treatment costs per month have increased 39% over the past 10 years after adjustment for inflation. Over the same period, patient response rates have improved by 42% and treatment duration has increased 45%, reflecting improved survival rates.
Within the U.S., patient out-of-pocket costs have risen sharply for intravenous cancer drugs, surging 71% from 2012 to 2013, reflecting changes in plan designs and increased outpatient facility costs. However, two-thirds of Americans diagnosed with cancer now live at least five years, compared to just over half in 1990, the institute added.
Survival rates in the U.S. and elsewhere should improve in coming years, the study predicted, since the pipeline of cancer medicines in clinical development include immunotherapies and combination therapies that can address multiple pathways in a tumor. Therapeutic effectiveness in multiple subpopulations is also being improved through evidence from biomarker data linked to treatment information—though only one-third of new oncology drugs have an identified biomarker at time of launch.
Public discussion boards, followed by Twitter, are the most dominant channels used by patients for conversations and information regarding treatment options and financial concerns, according to the institute.
“Innovative therapeutic classes, combination therapies and the use of biomarkers will change the landscape over the next several years, holding out the promise of substantial improvements in survival with lower toxicity for cancer patients,” Aitken added.