Oncology Drug Market: A Spotlight on the Dynamics

Cancer is one the most dreaded diseases worldwide and is spreading like a pandemic in Asia- Pacific region. The high rate of occurrence is largely due to a growing middle class, control of other causes of early mortality such as infection as well as adoption of a sedentary lifestyle. Amongst the many types of cancer, lung cancer is the most prevalent due to high smoking rates and pollution in industrialized areas.

Non-communicable diseases account for over 65% of the overall burden of disease in APAC markets. Within non-communicable diseases, cancer continues to be one of the leading causes of morbidity and mortality worldwide, responsible for 8.8 million deaths globally in 2015. In APAC, cancer accounts for 15.5% of the burden of non-communicable diseases and 21.7% of non-communicable disease mortality, second only to cardiovascular disease.

Oncology/Cancer Drug Market

Global demand for cancer drugs is primarily for incidences of lung, breast, and cervical cancer. Other major contributors are factors such as increased R&D on biological and targeted drug therapies, or expiration of earlier patents. However, high cost of drug development as well as strict regulation, further accentuated by a high likelihood of failure, may put a spanner in market growth. However, an increasing focus on personalized medicine along with significant global investment in research may also open up future avenues for the cancer drugs market.

Cancer drugs market is segregated along therapeutic segments – such as immunotherapy, targeted treatments, chemotherapy, hormone therapy and so on. Amongst these, immunotherapy is expected to grow at the fastest rate globally, in short to medium term.

Sanjeev Kumar, Industry Manager, Transformational Health, Life Sciences, Frost & Sullivan says, "Major drivers for APAC cancer diagnostics market are: increased adoption of technology platforms, access to targeted cancer therapeutics and higher demand from patients for affordable and quality care. Furthermore, a global push towards precision medicine has gradually propelled the uptake of innovative platforms such as NGS, liquid biopsy for gradual adoption into mainstream clinical diagnosis. "

Given the high demand for quick and affordable diagnostic tests in APAC for early cancer diagnosis, multiplexed immunoassays are expected to be instrumental in exploring and validating novel biomarkers that are highly adopted in combating cancer. This is despite the emergence of molecular diagnostics and liquid biopsy tools. Further, growing incidence of cancer in the region has necessitated development of low-cost screening devices as part of imaging, for accurate early-stage diagnosis. POC Medical Systems Inc. has developed a portable breast cancer screening test MammoAlert™ based on its Pandora CDx™ microfluidics-based platform – it provides for simultaneous molecular test for presence of 90 serum markers. Average test costs for patients is less than US$5. Plans are in progress to expand the test menu to oral, prostate, and cervical cancer, targeting emerging countries. This could be a game changer for cancer diagnosis in such geographies.

Mr Kumar believes that there is a huge price cut across pathology segments in countries like Japan, Australia – owing to increasing healthcare expenditure. "As a result, uptake of innovative molecular diagnostics solutions is hampered. Moreover, there is a high need for demonstration of clinical utility and cost-effectivity over existing standard diagnostic tests", he adds.

Emerging countries are a target for oncology drugs, shifting from conventionally focussing on US, EU and Japan. As of 2013, ~75% of total oncology drugs are contributed by US (~41%), EU-5 (~24%) and Japan (~10%). Real-term scenario of price deflation in medical devices industry along with a high rate of product turnover and disruptive technologies entering the oncology landscape, has widened the competitive landscape. Three important cancers – stomach, oesophagus and liver – accounted for 34% of cancer incidence and 42% of mortality in cancer related deaths in China alone. In comparison, in USA this was 4% and 8% respectively, whereas in Japan and Korea its halfway between 20-30%. This huge disparity in patient outcomes, coupled with rising incidence of new cases, fuels the uptake of new diagnostic modalities (drugs and diagnostic tests) for increased market adoption.

Key Players in Global Cancer Drug Market

There is a rapid increase in the number of companies with late phase oncology molecules. Amgen Inc., Johnson & Johnson, GlaxoSmithkline, Eli lilly & Co., Roche diagnostics, Novartis AG, Pfizer, Merck & Co., Sanofi, and Celgene Corporation are key players. Amongst these, Roche, Novartis and Celgene Corporation are the leaders, with a wide range of cancer drugs portfolio. The three companies contribute to ~60% of total market share.

Dr Carl Firth, CEO of ASLAN Pharmaceuticals says, "There has been a rise in oncology biotechs, with around 50% of all biotechs now in oncology space. This is for good reason – advances in underlying science and understanding of the disease, together with an ability to harness body’s immune system and a willingness of regulators to get life-changing drugs to patients faster – all means that the way we treat cancer is changing and will continue to change in decades ahead."

Late phase pipeline of oncology drugs has increased by 61% from 2006 to 2016, driven by an increased number of targeted therapy products. Also, number of late phase oncology drugs in pipeline has increased from 392 molecules in 2006 to 631 molecules in 2016. Of these, 90% are targeted therapies, including small molecule protein kinase inhibitors and biologic monoclonal antibodies.

Focus is on targeted therapies that either use biomarker tests to indicate greater likelihood of tumour response, or amplify patient’s immune response to target cancer. With 6% of late phase pipeline in pre-registration or registration phase, and 22% of pipeline in phase III trials, new and improved oncology medicines are expected to shortly enter the market.

"Increased focus on oncology has also led to intense competition amongst companies offering such products. As of December 2017, there were 544 companies with late phase oncology molecules. Reduced duration of phase III trials also means that new oncology drugs will enter the market at a faster pace, and these treatments will be superseded by newer treatments within a few years", said Mr Amit Backliwal, Vice President, Consulting Services & Technology Solutions, IQVIA Asia Pacific while commenting on market trends.

Challenges

While novel treatment options have improved oncology care globally, access to these treatment options in APAC continues to be limited, especially in emerging APAC markets.

"Globally, we have seen improved survival rates for various cancers – partly due to increased screening and early diagnosis, as also because of increased approval of new oncology drugs", says Mr Backliwal. From 2011-16, 68 different agents have been approved for over 22 indications. Immuno-oncology drugs, in particular, have seen rapid uptake due to durable response across multiple cancer types.

However, access to new oncology drugs in APAC is limited. Japan and Australia have the highest number of new cancer drugs available in APAC, but they still continue to lag behind US and EU5. Accessibility to new oncology treatment is an even larger problem in emerging countries across APAC. For instance, India, Indonesia and China have access to ~10% of new oncology drugs, while countries like Vietnam have access to only ~2%.

Dr Carl while commenting on high price of oncology drugs says, "Though great strides have been made recently in advancing treatment of several tumour types, high price of these drugs is putting them beyond the reach of many patients and governments. At the same time, we are also seeing a number of regulatory changes, in China and in Japan, which may accelerate the launch of innovative drugs. Industry should work closely with governments and other stakeholders to manage the resultant increase in healthcare costs."

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