Cancer Drug Spending Hits $100 Billion Worldwide

Nick Mulcahy

May 06, 2015

Total global spending on oncology drugs, including those used in supportive care, reached the $100 billion mark in 2014, according to a report issued yesterday.

The noteworthy threshold was reached even though the share of total spending for cancer drugs increased "only modestly" from 2013, according to the report from IMS Institute for Healthcare Informatics.

The factors driving the spending are well known to clinicians.

"The increased prevalence of most cancers, earlier treatment initiation, new medicines, and improved outcomes are all contributing to the greater demand for oncology therapeutics around the world," said Murray Aitken, executive director of the organization, in a press statement.

The United States and the five largest European countries account for 66% of the total cancer drug market.

Cancer drug spending represents 10.8% of all drug spending globally. The spending is only going to increase, and could rise as high as $147 billion in 2018, IMS forecasts.

During the past 5 years, growth in global spending on cancer drugs has increased at a compound annual growth rate of 6.5%.

However, highly similar cancer immunotherapies — such as nivolumab (Opdivo, BMS), pembrolizumab (Keytruda, Pfizer), and others in development — might create competition that could help moderate costs, according to experts cited in other media accounts of the report.

Notably, in the future, fewer cancer drugs will be limited to use in just one tumor type, according to the IMS report.

Of 88 cancer drugs marketed in 2014, 40 were for single indications and 48 were for multiple indications. But by 2020, "most" oncology drugs will carry multiple indications, which reflects the mechanisms of action of drugs that have genetic targets across multiple tumors and the rise of immunotherapies, according to the report.

Access to cancer drugs varies by country. For example, in 2014, patients in Japan, South Korea, and Spain had access to fewer than half the new cancer drugs launched globally in the previous 5 years.

In the United States, there has been an ever-rising ceiling in the cost of cancer drugs, as has been extensively reported by Medscape Medical News.

The IMS report notes that average monthly cancer drug costs have increased 39% in the United States over the past 10 years in inflation-adjusted terms. In addition, out-of-pocket costs for Americans have risen sharply for intravenous cancer drugs, increasing 71% from 2012 to 2013, "reflecting changes in plan designs and increased outpatient facility costs," according to IMS.

The cost increases borne by patients have given rise to a new adverse event in oncology, described by oncologist Amy Abernathy, MD, from Duke University in Durham, North Carolina, as "financial toxicity."

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