About the Report
Cancer treatments have been advancing at an accelerated pace in recent years, offering notable improvements in clinical benefit to patients. This report highlights advances in cancer therapeutics, including the use of these drugs and their global spending trends, the pipeline of therapeutic innovation and associated clinical trial activity, and the outlook through 2022. The report aims to provide an evidence base that can be used in discussion about the broader implications for cancer patients and their families, providers and their institutions, public and private payers at the local and national level, as well as multinational organizations.
The number of approved cancer therapies continues to rise, with 63 cancer drugs launching within the past five years. The continued rise and impact of immuno-oncology has been largely centered on the PD-1 and PD-L1 checkpoint inhibitors, which have broad efficacy across solid tumors and are used across 23 different tumor types. Of the 14 New Active Substance cancer therapeutics launched in 2017 alone, all of them were targeted therapies and 11 of them were granted Breakthrough Therapy designations by the FDA.
Global spending on cancer medicines continues to rise with therapeutic and supportive care use at $133 billion globally in 2017, up from $96 billion in 2013. Spending on cancer medicines is heavily concentrated among a handful of therapies, with the top 35 drugs accounting for 80% of total spending, while over half of cancer drugs have less than $90 million in annual sales. List prices of new cancer drugs at launch have risen steadily over the past decade, and the median annual cost of a new cancer drug launched in 2017 exceeded $150,000, compared to $79,000 for the new cancer drugs launched in 2013.
Over one-third of trials are using biomarkers to stratify patients, pointing to even more personalized cancer treatments in the future. The pipeline of immunotherapies is particularly active and includes almost 300 molecules with 60 separate mechanisms being evaluated in Phase I or Phase II clinical trials. While many efforts are in place to accelerate the time it takes to bring a new cancer medicine to patients, the 2017 new drug approvals had a median time since patent filing of 14 years, slightly faster than for the prior 5-year cohorts. In Japan, long a country with significant delays before new medicines would launch, government initiatives over the past decade have roughly halved both the average development times for new molecules and regulatory approval times.
Advances in technology and the use of information will act as driving forces that will impact oncology treatment and costs over the next decade. This would include advances in drugs and medical devices, as well as the use of real-world data, artificial intelligence and mobile apps to drive better patient engagement. One example of advancement in technology is the increasing ubiquity of mobile apps across many countries, and the growing body of evidence that apps can improve diagnosis, treatment, adherence and other aspects of patient experience in cancer. Overall, the global market for oncology therapeutic medicines will reach as much as $200 billion by 2022, averaging 10—13% growth over the next five years, with the U.S. market reaching as much as $100 billion by 2022, averaging 12–15% growth.