Spending on cancer medicine in the US doubled during 2012-17

On the eve of the Am. Soc. of Clinical Oncologists meeting (June 1-5, Chicago), IQVIA has released its annual review of drug development and spending in oncology, Global Oncology Trends 2018. The topline finding is that global spending (therapeutic and supportive care) was $133 billion in 2017, up from $96 billion in the previous year; US spending was $61 billion, just under half of the global market. On the R&D side, 10 of the 14 new active substances (NASs) approved in the US in 2017 were approved following Phase I/II trials only; and 11 were approved under “breakthrough” status—evidence both of the new mechanisms being refined by research, and FDA’s accelerated pathways to approvals.

There are 710 late-phase oncolytics in development globally, finds IQVIA, with the great majority of them either targeted small molecules or targeted biologics. Interestingly, these efforts are being made by 700 companies or organizations that have one or more oncology drugs in late-stage development. “This represents a remarkably diverse set of entities from academic centers and companies with a single drug candidate, to large companies with wide portfolios encompassing a range of tumors and treatments.”

A “yes, but…” conclusion from IQVIA’s analysis of spending and reimbursement for oncolytics is that price increases for branded products in the US have been relatively subdued, averaging 4.7%-6.4% over the past five years, while all branded products’ average was 6.9%. On the other hand, the average price for newly introduced drugs has increased substantially, averaging $150,000 (median) for 2017’s batch of NASs, versus $79,000 in 2013. And while “Most cancer drugs – including those with high annual costs – are used by relatively few patients, with about 87% of drugs being used by fewer than 10,000 patients in 2017,” some of those drugs’ cumulative costs will rise as broader cancer types are approved for use.

The full report is available from the IQVIA Institute for Human Data Science.