Key trends in the oncology market

The demand for oncology drugs will continue to grow as healthcare systems worldwide emphasize cancer detection and treatment.

By Anonymous (not verified) on Aug 6, 2009

The demand for oncology drugs will continue to grow as healthcare systems worldwide emphasize cancer detection and treatment. The global market will expand from around $48 billion in 2008 to more than $85 billion in 2013.


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Victory at all costs, victory in spite of all terror, victory however long and hard the road may be; for without victory, there is no survival.
Winston Churchill


Cancer. This very powerful six letter word translates into a $48 billion drug market (2008 global estimated sales), personal and family tragedies as well as exceptional survival stories but also and foremost, a terrifying disease. It is the second leading cause of death in the US and according to the American Cancer Society (ACS), 50% of men and 30% of women will develop some form of cancer in their lifetime.


Cancer was first diagnosed 3000 years BC as found in Egyptian papyrus but has certainly been around since the beginning of life. Findings from Hippocrates, who coined the term karkinos-later becoming cancer- for the crab claw-like design of the swollen blood vessels around the malignant tumors, Galen, Louis Leaky, Giovanni Morgagni, Stephen Paget, Wilhelm Conrad Roentgen, John Hunter, just to name a few, pioneered the early definitions, detection methods and tentative cures of the disease. 


Since then, the scientific dedication of the pharmaceutical industry, medical and academic fields combined with advances in research methodologies and technology have produced scores of successful cancer treatments and long lasting controlled disease state for yet-to-be-cured cancers. Advances in knowledge, treatment options and prevention awareness has been astonishing over the last 20 years but as Winston Churchills quote conveys, there are still much efforts and breakthroughs to be made before we can call victory over cancer.


Companies are spending billions of dollars in research, development and testing of potential cancer drugs, leading to many promising candidates. Below, I share some of the findings from a Cutting Edge Information study conducted on the oncology market.


 


Key Trends in the Oncology Market


There are more than 200 types of cancer in adults and children, and different sources estimate that at least one of these forms will strike between 20% and 33% of the globes population.   Worldwide, an estimated 25 million cases of cancer have been reported in the past five years. The American Cancer Society estimated 1.5 million new cases of cancer in the US alone in 2008 along with predicted 565,650 deaths from the disease. To treat this range of diseases, there are more than 150 cancer drugs approved for use across the world.


Drug labs are producing an array of weapons for the war on cancer. The biopharmaceutical industry has entered a new period of innovation and productivity, led by exciting new biologics that more effectively target tumors while diminishing the unpleasant side effects commonly associated with cancer treatments.


Standard treatments for cancers many forms include surgery, chemotherapy, radiation therapy and hormone treatment. The new biological products hold the most promise for changing treatment paradigms, however. Drugs such as monoclonal antibodies allow for the targeting of specific cells in order to reduce unwelcome side effects.


To guide oncologists, improved diagnostics, some of which focus on genetic characteristics, make it easier to identify appropriate therapies. At the same time, older drugs developed in past decades treatments that were once cutting-edge are increasingly available as generics. In short, physicians and patients have never had access to the many anti-cancer options that they do now.


 


The Market for Oncology Drugs


The demand for oncology drugs will continue to grow as healthcare systems worldwide emphasize cancer detection and treatment. The global market will expand from around $48 billion in 2008 to more than $85 billion in 2013.


Continued innovation will drive both this growth and market success among drug makers. Unlike brands in other disease areas, gold-standard oncology drugs are not vulnerable to generics. The opposite is true: although generics now erode sales for traditional treatment regimens such as the cytostatic therapies that have long been oncologists main anti-tumor options the surge in innovative new treatments means an unprecedented period of cancer drug development and market launches.


In reality, the costs of novel cancer therapies may prove to be a limiting factor in market growth and a potentially troubling problem for patients seeking access to lifesaving new drugs. Oncologists are increasingly comfortable using expensive new therapies in treating a range of tumor types. They are also using these drugs to treat tumors at earlier and earlier stages. Subsequent demand for new therapies has helped to keep costs high. Health care payers are not designed to accommodate broad use of costly next-generation therapies. Their outdated cost assumptions include narrowly defined patient populations, late-stage cancer timeframes and marginal outcomes improvements.


 


Market Leaders in the Next Decade


The continuing growth of the market is reflected in Table 1, which orders major cancer drugs by their predicted 2012 sales. These products, poised for explosive growth over the next five to six years, will either surpass or near the $1 billion mark in sales in 2012. 




















































































































Table 1: Forecasts for the Top Ten Major Cancer Drugs (in millions)


Drug 

Company 

Drug Class 

2008 

2009 

2010 

2011 

2012

 


Avastin

Roche & Genentech

Monoclonal Antibody

4,562

5,735

6,773

7,289

8,391

 


Rituxan

Roche & Genentech

Monoclonal Antibody

4,940

5,442

5,883

6,328

6,731

 


Herceptin

Roche & Genentech

Monoclonal Antibody

4,730

4,947

5,262

5,583

5,835

 


Gleevec

Novartis

T. Kinase Inhibitor

3,787

4,171

4,465

4,704

4,932

 


Neulasta

Amgen

Adjunct

3,335

3,541

3,721

3,910

4,114

 


Revlimid

Celgene

Other

1,334

1,863

2,441

3,015

3,512

 


AMG-162

Amgen

Monoclonal Antibody

 

 

385

1,015

3,423

 


Aranesp

Amgen

Adjunct

3,189

3,003

3,100

3,209

3,314

 


Erbitux

Merck & BMS

Monoclonal Antibody

1,587

1,976

2,472

2,912

3,277

 


Gardasil

Merck

Vaccine

1,392

1,616

1,870

2,003

2,167

 


With a few exceptions, the blockbuster drugs outlined in the preceding table all have significant 2008 sales. Several drugs not yet cleared for launch stand ready, however, to join the ranks of prominent cancer treatments.


There are more than 5,300 oncology clinical trials being conducted in the US alone, according to FDA data, with 75% of trials dedicated to cancer treatment. Of the total Phase I, II and III trials, 96% consist of treatment trials, whereas Phase IV trials other than treatment are generally conducted for supportive care.


Table 2 shows the breakdown of clinical trials currently underway for five of the major indications. There are more than 2,500 trials conducted for these cancer categories, with nearly 1,400 trials in Phase II and 250 trials in Phase III.






 


Table 2: Number of Clinical Trials



































































   

Breast


Colorectal

Prostate

Lung

Leukemia


Phase IV

 

6

2

3

0

1


Phase III

 

90

18

54

47

38


Phase II

 

392

117

195

311

370


Phase I

 

101

76

59

119

204


Unclassified

95

34

28

57

98


Total

 

685

246

339

534

710

               

Although the number of trials seems promising, we clearly see a slowdown in the number of Phase I trials, compared to the number of Phase II trials. Pharmaceutical companies are under pressure to reduce attrition rates and reform their business strategies to make up for fewer blockbuster drugs going to market. As a result, companies need to safely ramp up the amount of trials more than ever before in order to get more products on the market.


Many factors play against the development of new drugs in the US but the main concerns are, in our experience, the FDA and M&A activities. The FDA approval process is being slowed down by its almost constant state of restructuring.   Months ago, the government body admitted many weaknesses in the areas of skills (not having the appropriate personnel) and scope (not enough ex-US reach). The agency is working on those issues and hopefully be up to the game within the next year or so.  Also, mega, mid-sized and small M&A activities are forecast to pick up steam in the next year, creating bigger companies and synergies. But, M&A does not in itself contribute to development of science; it consolidates scientific efforts and temporarily slows down regular business operations and most importantly, innovation.


Although life science companies show no sign of slowing down the research and development of promising oncology drugs, they should ensure emphasizing and maintaining their competitive energies on the innovation front.


Contributions by Yanis Saradjian, Director of Consulting, Eric Bolesh, Research Manager, Jeremy Spivey, Research Team Leader and Shaylyn Pike, Research Analyst Cutting Edge Information. Access study summary here - http://www.cuttingedgeinfo.com/oncology-forecast/