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While patients continue to benefit from increased product launches, the pandemic is still having an impact on caseload.
The 2022 Global Oncology Trend report, compiled by IQVIA Institute for Human Data Science, details how the cancer treatment space is succeeding and struggling. Companies are launching record numbers of new treatments and more patients are receiving cancer treatment globally. Unfortunately, the effects of the pandemic are still causing problems.
According to the report, a record number of new oncology drugs and treatments were launched in 2021. During that year, 30 novel active substances (NASs) were made available across the globe. The report notes, however, that not all of the new drugs were available in every country.
This number is notable, as 104 NASs were launched during the past five years. Going back to 2012, that number only reaches 159.
Another positive trend held in 2021, as oncology drugs continued to receive accelerated approvals (along with orphan and breakthrough designations). The average time from patent filing to product launch decreased to eight-and-a-half years. The report also states that the medicines launched in 2021 included “significant clinical advances across a range of tumors and mechanisms.”
Oncology trial starts during 2021 also hit “historically high levels,” with the number increasing 56% from 2016. In the past 10 years, the number of trials focused on metastatic or advanced cancers have more than doubled. Of the trials started during the previous year, the majority were focused on rare cancer indications.
While the number of starts increased, data show that smaller, more-focused companies are accounting for a larger share in the oncology pipeline. Large pharma companies, which are defined as ones that have more than $10 billion in annual sales, only comprise about 23% of the pipeline.
According to the report, “Of the emerging biopharma companies working in oncology, 78% are solely focused on oncology drug research and development and 72% are only developing a single drug.”
In 2011, only 870 products were listed in the Phase I to regulatory submission pipeline. By 2021, that number had risen to 2,197. While oncology trials are being conducted across the world, 19% of the current trials are occurring in China, continuing a growing trend in the country’s importance to the oncology space.
While the number of starts increased last year, the success rates for oncology trials continued a downward trend that has been occurring since 2015. The data show, however, that drugs intended to treat hematological cancers have a higher success rate than drugs for solid tumors. Also, rare cancer treatments actually increased in success when entering later drug trial phases.
“Drugs being investigated for rare cancers saw an increase in success in 2021 in regulatory submission and Phase III, and a sharp decline in Phase I resulting in a composite success rate across all phases that fell from 22% in 2020 to 16% in 2021,” the study states. “This highlights a higher degree of rare cancer drugs reaching the market.”
The report continues to detail the lingering impact of the COVID-19 pandemic. Oncologists are still showing a 20% to 29% decrease in their caseloads as compared to pre-pandemic numbers. While the numbers began to show a recovery in 2021, they are still significantly lower than where they were.
As countries across the globe were issuing lockdowns to prevent the spread of COVID, oncologists in the US, EU, and UK reported a decrease in caseloads of between 33% and 61%. During 2020, it appeared that the trend was correcting itself as caseload numbers improved. In Germany, the numbers briefly returned to pre-pandemic levels.
Unfortunately, the numbers dropped again, and the current caseload rate is still 20% to 29% lower than it was.
As the report explains, “Reductions in caseloads could point to undiagnosed patients who may later present with more advanced cancer requiring more aggressive treatment and potentially poorer prognosis.”
Not surprisingly, oncologists have reported seeing higher numbers of new patients than compared to pre-pandemic levels. This is likely due to patients not scheduling screenings and avoiding visits to the doctor’s office during the past two years. While the increase in patients with non-small cell lung cancer only rose about 1%, patients with cervical cancer rose about 20%.
The report indicates, “Of significant concern is the increase in patients presenting with metastatic disease across the pandemic in all but colorectal cancer, likely driven by the reduced number of screenings for these cancers throughout the pandemic.”
Fortunately, the report also includes that the global number of treated patients continued to grow and is expected to accelerate during the next five years. After dipping during the early days of the pandemic, the growth in use of oncology medicines has returned to pre-pandemic levels (except in the UK).
One reason attributed to the continued growth in this area is robust access to care, especially in lower-income markets. This, along with the increased durations for treatment, has caused the number of patients receiving treatment each year to grow.
Globally, the number of patients being treated grew at a slower pace during the start of the pandemic. As the healthcare industry adapted, however, growth returned to “historic levels of care and engagement” in 2021.
“There have been significant changes in treatment regimens for advanced non-small cell lung cancer in the past three years as more novel therapies have entered the market,” the report states.
Also, patient treatment regimens have increased by 8% during the past four years, and more patients are being switched to combination therapies that have greater efficacy.
As the number of treated patients continued to grow, so did the amount of money spent on oncology medicines. Globally, $185 billion was spent on cancer medicines, and this number is expected to grow to $300 billion by 2026. Major developed markets, such as the US, the UK and Japan, spent 74% of the global amount for cancer medicines.
In the US, spending rose from $50 billion in 2017 to $75 billion in 2021, and this growth is expected to remain around 10% in the coming years. Lower-income and pharmerging countries spent about $25 billion on cancer medicines in 2021, which was a significant rise over previous years.
Mike Hollan is an Editor for Pharm Exec. He can be reached at firstname.lastname@example.org.