The growing cancer burden

Cancer remains one of the most pressing health challenges, and its global burden is expected to increase by 2050^1,2 . As populations grow and age, the number of cancer cases is projected to rise, placing immense pressure on healthcare systems worldwide. In parallel, research advancements have ushered in a new era of lifesaving therapies, particularly in the realm of precision oncology. These targeted therapies are tailored to the unique molecular profiles of patients—increasing treatment efficacy and minimizing side effects. As oncology therapies continue to evolve from broad systemic therapies to precisely targeted interventions, innovative modalities—including antibody drug conjugates (ADCs), bispecific antibodies (bsAbs), cell and gene therapies, and immune checkpoint inhibitors—are poised to become the standard of care for multiple indications.

Groundbreaking innovations in oncology are available today, and further advancements are on the horizon. Yet a critical issue threatens their impact: geographical disparities in accessibility. Without efforts to improve access, existing gaps in treatment availability could widen as oncology therapies continue to become more biologically complex - leaving patients in certain regions underserved.

Continuing the discussion on oncology care access

Research by the IQVIA Institute in 2024 revealed geographical differences in the availability of oncology novel active substances (NASs) across select EU countries, Australia, Canada, and Brazil, influenced by factors such as country-level variations in clinical data acceptance, health technology assessment (HTA) processes, clinical endpoint priorities, and manufacturer strategies³.

Building on these insights, IQVIA Institute is conducting a similar study in 2025 examining oncology therapy access in two Gulf Cooperation Council countries (United Arab Emirates and Saudi Arabia) and three African nations (Algeria, Egypt, and South Africa). The research is focused on quantifying trends in oncology therapy availability through the assessment of regulatory approvals and reimbursement. The study is taking a deep dive on targeted treatments like ADCs, BsAbs, Chimeric Antigen Receptor T-cell (CAR T) therapies, immune checkpoint inhibitors, and monoclonal antibodies (mAbs).

How many oncology novel active substances were registered from 2014 to 2023 in these countries? What is the level of reimbursement of these therapies in the countries of scope? How long does it take for oncology therapies to be reimbursed once they have gained market authorization? What key factors contribute to delays in oncology therapy access within these regions? What country-level initiatives are designed to address these challenges? Answers to these questions are currently being assessed. In the meantime, here are four key takeaways from the ongoing analysis:

1. Interim data analysis shows that while multiple oncology drugs have launched globally from 2014 to 2023, most are not registered in the public marketplace.

+ Of 183 oncology novel active substances globally launched between 2014 and 2023, only 52% have received market authorization in the EU. Just 31% have registered in the UAE and Saudi Arabia in the same time frame.

+ Registration is even lower in selected countries in Africa, with only 17% registered in Egypt and South Africa and 5% in Algeria.

2. Precision oncology medicines, such as immunotherapies, monoclonal antibodies, and ADCs, are available in the GCC and, to a lesser extent, in the selected countries in Africa.

+ Availability of these therapies—including registration and reimbursement—is anticipated to continue growing. That is especially true in the GCC given initiatives such as VISION 2030 in Saudi Arabia and the Emirati Genome Program in the UAE.

3. After global launch, registering an oncology product takes up to 27 months in the GCC and 67 months in selected countries in Africa. Reimbursement rates vary.

+ UAE and Saudi Arabia have comparable time to registration following global launch with a median of 23 and 27 months, respectively. However, median reimbursement time in the UAE is much faster at six months compared to 23 months in Saudi Arabia.

+ In the selected countries in Africa, it takes Egypt a median of 29 months, South Africa 49 months, and Algeria 67 months to register oncology products. Reimbursement takes a median of 43 months in Egypt and 26 months in Algeria. We are still assessing time to reimbursement in South Africa.

4. Despite multiple barriers, including variations in clinical evaluation methodologies and healthcare budget constraints, progress has been made in approving and reimbursing oncology therapies over the past five years.

+ Proactive measures by governments, including investment, patient-level engagement, and recognition of the shift from systemic therapies to more personalized treatments, are changing the cancer care landscape in the regions.

Addressing barriers to access

Watch for our upcoming report, Oncology therapy access in the era of personalized medicine for select Middle East and African countries, which will be published this summer.

Download our 2024 report here

_{¹ Sung H, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer J Clin. 2021;71(3):209-249. Available from: https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21660}

_{² World Health Organization. Global cancer burden growing, amidst mounting need for services. 2024 Feb 2024. [Internet] Available from: https://www.who.int/news/item/01-02-2024-global-cancer-burden-growing--amidst-mounting-need-forservices#:~: text=Projected%20cancer%20burden%20increase%20in%202050&text=Tobacco%2C%20alcohol%20and%20 obesity%20are,driver%20of%20environmental%20risk%20factors.}

_{³ IQVIA Institute for Human Data Science. Hematologic Cancer Opportunities for Patient Equality (HOPE). Jun 2024. Available from: https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/hematological-canceropportunities-for-patient-equality/iqvia-institute-hematological-cancer-opportunities-for-patient-equality.pdf}