Abstract
Introduction
The emergence of a new wave of oncology products has been one of the most
dramatic trends in the pharmaceutical market over the last decade. Both large
and small companies are making unprecedented investments in oncology R&D, in
an effort to emulate the success of new targeted therapies such as Herceptin,
Avastin, Glivec, Nexavar and Erbitux.
Underpinning that success have been real improvements in therapeutic options
for a range of cancers, including marked survival increments in areas of poor
prognosis, such as kidney cancer (e.g., Sutent); more effective therapies,
tailored to genetically defined subgroups, for widespread malignancies
(Herceptin for breast cancer); and innovations that have transformed fatal
into chronic diseases (Glivec for chronic myeloid leukaemia).
At the same time, success has come at a price. Not is the oncology marketplace
getting more crowded, raising the bar for differentiation in a category in
which many products are focusing on the same disease mechanisms, but the
premium prices charged for newer therapies are stretching healthcare budgets.
Increasingly cancer drugs are losing the special status that once guaranteed
uptake at any cost and are coming under the same cost-effectiveness scrutiny
as other components of healthcare.
In today' s payer' s market, oncology companies are being forced to re-assess
their strategies and build a compelling value equation for their products that
will meet the needs of a whole range of stakeholders, each with their own
agenda. And they must do this while finding a way to recoup R&D costs from
niche products without the patient volumes that have driven blockbuster brands
in the past.
Key findings
- " Worldwide sales of cancer drugs are forecast to increase at a compound
annual growth rate of 12-15% from 2008, reaching US$75-80 billion by 2012.
That would represent almost double the projected growth rate for the
pharmaceutical market as a whole over the same period.
- " At the same time, growth of the category is expected to slow over the
next five years, with a diminishing contribution from the existing top
oncology markets - the US, France, Germany, Italy, the UK and Spain. These
countries accounted for 71% of oncology product sales worldwide in 2007. By
2012, however, their share of overall sales could be down to 65%.
- " Increased cost-sensitivity among payers, market crowding and the loss
of cancer' s ' special status' will make the market much for challenging for
established oncology players and new contenders over the next few years.
Key features of this report
- " Detailed analysis of the new forces driving growth in the worldwide
oncology market.
" Overview of the cost pressures on healthcare systems and growing recourse
to health technology assessment that are complicating market entry for new
cancer drugs.
" Analysis of NICE decisions on premium-priced oncology products, the wider
political context in which these decisions are taken, and what they could mean
for oncology players in other markets.
" Detailed exploration of how a multi-faceted value proposition needs to be
constructed for new cancer therapies, including survival benefits,
cost-effectiveness and more personal components such as quality of life.
Use this report to
- " Detailed understanding of the new growth drivers in the world oncology
market and the emerging threats to continued growth
- " Insight into how healthcare systems are evolving in their efforts to
manage cost inflation and how these changes present significant challenges to
oncology market growth.
- " Compare approaches to health technology assessment in key markets such
as the UK and the US; understand how these raise the bar to entry for new
oncology products.
- " Detailed insight into the different components of value that will
enable new cancer therapies to carve out niches in the new payer-dominated
environment.
Discover
- " What will be the market trend for oncology products in the years to
2012 and beyond?
- " How has the treatment paradigm for oncology changed in terms of
targeted therapies, niche indications and payer influence?
- " What are governments, HTA agencies, health insurers and other
influencers/payers in key markets such as the UK and the US doing to address
budgetary pressure from pharmaceuticals in general and new oncology products
in particular?
Table of Contents
Oncology market analysis
The payor response
Addressing market challenges
Chapter 1 Oncology market analysis
- Introduction
- Oncology outpaces pharma sales growth
- Payor leverage
- Oncology growth drivers
- The growing importance of targeted therapy
- Establishing a presence in oncology
- Falling by the wayside
- How cancer is different
- Cancer is many diseases
- Room for growth in oncology
- How cancer is not so different
- Budgetary pressure prevails
- Summary
Chapter 2 The payor response
- Introduction
- HTAs are here to stay
- Health technology assessment in the US
- Volume versus price
- Pharma moves to head off coercive action
- More comparative effectiveness research
- Growing momentum for government involvement in CER
- Already some restrictions
- Shifting Costs to the Patient
- Shifting the cost to the patient
- Health technology assessment in Europe
- Different countries, different values
- Comparing Uptake
- NICE' s record on cancer drugs
- Cancer drugs recently turned down by NICE
- Tykerb
- Erbitux
- Nexavar
- Yondelis
- Hycamtin
- Making space for cancer drugs
- Higher threshold for end-of-life therapies
- Concerns about the new criteria
- Flexible pricing
- Skirting NICE
- Not Just The UK
- NICE is not the final hurdle
- Hard sell
- Biosimilars on the horizon
- Summary
Chapter 3 Addressing market challenges
- Introduction
- It' s all about value
- Establishing a strong value proposition
- Selecting endpoints
- Adding to the gold standard
- Using subgroups
- Post-marketing studies
- From efficacy to effectiveness
- Getting marketing involved
- What price innovation?
- Pricing for access
- Prioritizing the correct indication
- Integrated treatment packages
- New markets, new opportunities
- Getting the launch right
- Lack of access for sales representatives
- Quality trumps quantity
- Increasing patient power
- Using the media
- Index
List of Figures
- Figure 1.1: Oncology growth contribution
- Figure 1.2: Targeted therapies driving oncology growth
- Figure 1.3: The rush to invest in oncology R&D
- Figure 1.4: Number of phase II - IV clinical trials by disease class,
2005-2007
- Figure 2.5: Cost, LE and CE in metastatic colorectal cancer
- Figure 2.6: Cancer drug sales in Western Europe per 100,000 inhabitants,
€ thousands
- Figure 2.7: Avastin Uptake in E13 Countries
- Figure 2.8: Erbitux uptake in E13 Countries
- Figure 2.9: Breast Cancer - Cost of Innovation (20-year horizon)
- Figure 2.10: Disparities in European supply of medical oncologists
- Figure 2.11: Oncology brand patent expiries, September 2007-2012
- Figure 3.12: The changing status of oncology products
- Figure 3.13: Innovation stakeholders
- Figure 3.14: Finding the right level in industry-gatekeeper partnerships
List of Tables
- Table 1.1: Top 10 global therapeutic classes 2007/08
- Table 1.2: Leading biologics, global sales, 2008
- Table 1.3: Estimated UK costs for targeted cancer therapies
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