IQVIA: US Cancer Med Spend Doubled 2012-17, to Double Again by ’22 to $100B

The IQVIA™ Institute for Human Data Science found in its latest report, Global Oncology Trends 2018: Innovation, Expansion and Disruption, that spending on cancer drugs in the U.S. has doubled since 2012, reaching almost $50 billion in 2017, with two-thirds of the growth tied to drugs launched within the past five years. Those drug costs are expected to double again by 2022. Outside the U.S., oncology drug costs exceeded $60 billion in 2017, driven by new product launches and increased use of existing brands.

The study also showed wide differences in final out-of-pocket costs for U.S. patients paying for cancer medicines based on drug choice, manufacturer prices and insurance plans. While outpatient drugs often result in high costs for payers, the patient responsibility averages less than $500 per year for commercial plans and patient costs for retail drugs are often reduced by extensive use of coupons, which offsets high-cost exposure.

“Payers continue to be challenged as they seek value and fund access to the latest oncologic treatment options,” said Murray Aitken, IQVIA senior vice president and executive director of the IQVIA Institute for Human Data Science.

“The surge in innovation brings new dimensions of complexity, even as the availability of predictive biomarkers and diagnostic tests can help bring a more precise course of treatment to an individual patient,” Aitken said. “There are also a number of disruptive technologies that will reshape healthcare and cancer specifically, including data science that incorporates artificial intelligence and real-world data, as well as advances in patient engagement through mobile apps.”

Additional highlights of the Global Oncology Trends 2018 report include:

• Advances in Cancer Therapeutics: 14 new cancer therapeutics were launched in 2017. All of them were targeted therapies and 11 received “Breakthrough Therapy” status from the FDA — demonstrating substantial improvement over existing therapies on one or more clinically significant endpoints. Since 2012, a total of 78 approved therapies have been launched — relating to 24 different tumor types — with some treating multiple tumor types. Last year, PD-1 and PD-L1 inhibitors were used to treat patients with 23 different tumor types, of which the primary use was lung cancer. The new medicines launched in 2017 represented significant clinical advances and contributed to patients’ overall survival across a range of tumors and mechanisms.
• Use and Spending Levels for Cancer Treatments: Global spending on cancer medicines — both for therapeutic and supportive care — rose to $133 billion globally in 2017, up from $96 billion in 2013. Spending on cancer medicines is heavily concentrated among the top 35 drugs, which account for 80 percent of total spending. List prices of new cancer drugs at launch have risen steadily over the past decade, and in the U.S. the median annual cost of a cancer drug launched in 2017 exceeded $150,000, compared to $75,000 for new cancer treatments launched 10 years ago. Most cancer drugs — including those with high annual costs — are used by relatively few patients. An estimated 87 percent of oncology drugs were used by fewer than 10,000 patients last year.
• Pipeline of Therapeutic Innovation: The industry’s pipeline reached an historic level of more than 700 molecules in late-stage development in 2017, up more than 60 percent from a decade ago. Trials using biomarkers to stratify patients susceptible to response made up 34 percent of oncology trials in 2017. The pipeline of immunotherapies is particularly active and includes nearly 300 molecules with 60 separate mechanisms being evaluated in Phase I or Phase II clinical trials. These drugs are being tested against 27 different tumor types, indicating the broad-based application of this new approach to cancer treatment. While many efforts seek to shorten the “molecule-to-market” timeline, new drug approvals in 2017 had a median time span of 14 years from patent filing, only slightly faster than 2013.
• Outlook for Oncology Through 2022: Advances in technology and the use of information will be driving forces that affect oncology treatment and costs throughout the next decade. Most notably, mobile cancer apps are being used — albeit in small numbers — across the patient journey, from prevention to survivor support. Apps are also being incorporated into clinical trials as an adjunct to other interventions or for validation. In fact, last year there were 15 published studies that found positive impacts of cancer apps across a range of uses. The global market for oncology therapeutic medicines is projected to reach $200 billion by 2022, averaging 10-13 percent growth during that time, while the U.S. market is expected to reach $100 billion with an average growth rate of 12-15 percent for the same period.

The full version of the report, including a detailed description of the study methodology, is available at www.IQVIAInstitute.org.The study was produced independently as a public service, without industry or government funding.

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