Spending on cancer medicines totaled $107 billion worldwide in 2015 and is projected to exceed $150 billion by 2020, reflecting adoption of newer, pricier therapies, according to a report from the IMS Institute for Healthcare Informatics.
Price hikes on older medicines as well as increasing numbers of patients receiving treatment, and for longer durations, are also driving up spending, IMS reported Thursday. The total increase for 2015 was 11.5 percent from the previous year, on a constant dollar basis.
The price of drugs has dominated national conversation amid the U.S. presidential election and weighed on pharmaceutical stocks. It's been a major theme at the American Society of Clinical Oncology meeting the past several years, as researchers discuss what they call a newer side effect of many cancer medicines: financial toxicity. This year's conference kicks off Friday in Chicago.
"Not surprisingly, payers are seeking assurance of the value that results from their expenditure on these drugs," the IMS report's authors, Murray Aitken and Michael Kleinrock, wrote in their summary. "This tension can be expected to intensify over the next five years as a strong pipeline of clinically distinctive therapies reaches a growing number of patients around the world."
Drugmakers are increasingly providing concessions, such as discounts and rebates, that limit how much they recognize of drug price increases. The report found that while invoice price growth in the U.S. totaled 6.4 percent last year, net price growth was just 4.8 percent.
They're also providing more assistance to patients directly, in the form of coupons and other programs. Some type of this assistance was used for more than a quarter of retail prescriptions for cancer drugs filled by patients covered by commercial insurance in the U.S. last year, up from 5 percent in 2011. The average amount of assistance: $750 per prescription.
That number reflects the large out-of-pocket costs that fall to cancer patients in the U.S.: an average of $7,000 for the year for patients taking drugs by injection or infusion with commercial insurance, or $3,000 for patients taking oral medicines.
Access to new medicines is a problem worldwide, the report found. Forty-nine new cancer drugs were introduced between 2010 and 2014, but only six countries had access to more than half of them. Access was worst in Vietnam, with just one of the 49 available, and South Africa, with just five. It was best in the U.S., with 41 available, and Germany, with 38.
The U.S. is seeing shortened regulatory timelines for new medicines. The median time from patent filing to approval for cancer drugs that entered the market last year was 9.5 years, down from 10.25 years in 2013, the report found. IMS suggested programs like the Food and Drug Administration's Breakthrough Therapy Designation, aimed to speed important drugs to market, are likely spurring the change.
The projected growth in cancer drug spending through 2020 also reflects a large number of potential new drugs yet to be introduced; IMS says the pipeline of cancer drugs in clinical development has expanded by 63 percent in the last decade. There are currently 586 experimental cancer drugs in the mid-stages of clinical trials or later, by 511 companies, the report shows.
Many of these will be on display at ASCO this weekend, where cost is sure to continue to be a part of the conversation.