Cancer drugs - the way forward

Between 2000 and 2020, the World Health Organisation (WHO) is predicting a 50% rise in the global incidence of cancer. Currently the world's third largest therapeutic market, worth $35bn in 2003, a new report from independent market analyst Datamonitor predicts the oncology market will grow to be $60bn by 2010, yielding a compound annual growth rate (CAGR) of 8% during this time.

Fortunately for those diagnosed with cancer between now and 2020, a rise in prominence for treatment approaches employing molecular-targeted drugs, improved diagnostics, the emergence of more personalised treatment regimes and cancer's perpetually high profile in shaping government healthcare policy will help ensure continued improvement in cancer treatment, says Datamonitor senior oncology analyst Nish Saini.

'Conversely, for pharmaceutical manufacturers, there are various pharmacoeconomic constraints to contend with including increasing r&d costs, restrictive pricing and reimbursement policies and reduced periods of market exclusivity. This means that drug lifecycle management strategies will play an increasingly prominent role in maximising product revenues and ensuring an adequate return for the significant financial risks incurred in developing new drugs.'

In 2004, the top 20 drugs in the seven major pharmaceutical markets¹ generated combined sales approaching $27bn, with the US accounting for a 66% share of this total, Japan 13% and the EU 21%². Collectively, sales of the top 20 cancer drugs in each of these markets represents 77% of total global oncology revenues, demonstrating the industry's heavy reliance on these individual products and specific markets for income. While the economic value of these brands is undisputed, the looming threats of therapeutic competition and of even greater significance, patent expiry, provide a considerable commercial and clinical challenge to the industry, Saini says.

The supportive care class of drugs are those that are given to patients to prevent or treat the toxicities associated with chemotherapy, Saini says. 'Currently supportive care drugs like recombinant growth factors and serotonin antagonists constitute a significant proportion of oncology drug revenues and Datamonitor anticipates sustained sales growth within this class.'

Recombinant growth factors are used to accelerate blood cell count recovery following the administration of chemotherapy and also to treat the symptoms of cancer-related anemia. Serotonin antagonists have a role in preventing chemotherapy-induced nausea and vomiting.

'In fact over the course of the next decade, Datamonitor predicts that of the current cancer drugs that maintain a top 20 position in one or more of the seven markets, only those in the innovative and supportive care classes will maintain a positive CAGR (5.1% and 3% respectively).'

'Conversely, existing members in the cytotoxic and antihormonal categories will experience declining sales over the period 2004-14, with patent expiries having the greatest influence on reducing market share.'

In the US for example, patent expiration will affect six of the seven cytotoxic drugs in the current top 20, the latest genericization occurring in 2011, Saini says. 'Similarly, all three antihormonal drugs currently featuring in the US top 20 will face patent expiry by 2009.'

Therefore, Saini says, strategies to mitigate the challenge of patent expiry, generic incursion and therapeutic competition will rely on innovative approaches to lifecycle management and sustained r&d productivity to maintain a commercially productive pipeline. 'This is well evidenced in the cytotoxic market where reformulated second-generation "super-generic" versions of Bristol Myers Squibb's Taxol, such as Cell Therapeutics' Xyotax and Abraxis Oncology's Abraxane, are expected to be launched from 2005. The higher returns achievable from these super-generics should allow companies to make a higher up-front investment in product development, commercialisation and marketing.'