Beyond the Peak: Four Levers to Address Quickly Plateauing Oncology Drug Sales
By Sean Walter and Maria Whitman
With the oncology market estimated to soon reach $100 billion, it is no wonder biopharma manufacturers hold high expectations for their cancer pipelines. However, many oncology products that launch today face the new challenge of quickly plateauing sales. Brands now reach peak sales as soon as 12 to 18 months after launch. This is counter to conventional expectations of high growth for at least 36 to 48 months. With sales plateauing faster at potentially lower levels in these launches, marketers must question what they know about historical launch success and adopt new mindsets to drive long-term organic growth.
What is Driving the Change in Time to Peak?
The change is being driven by a combination of the science, the competition and the evolving oncology landscape.
The science. Oncology has seen incredible advances in drug discovery in recent years, especially in targeted and biomarker-based therapies. The number of clinical trials that included a biomarker in 2014 more than doubled from 10 years earlier. These therapies provide specific, identifiable patient populations a better chance of response and therefore, improved clinical outcomes.
The majority of an eligible patient population receives a new biomarker-based therapy rapidly following launch, particularly if it is first-in-class. These therapies spike in sales, and then plateau quickly. As a result, manufacturers and marketers need to focus on incremental growth and the pursuit of new indications or other product launches to reach a product’s full potential.
The competition. Non-targeted therapies also face significant sales challenges to growth, due to competition. Zydelig launched in July 2014 as a first-in-class therapy and the only approved PI3-kinase inhibitor for chronic lymphocytic leukemia (CLL). Zydelig launched into a space that was already highly competitive – only four months after Imbruvica approval, two months after an Arzerra label expansion and one week before an Imbruvica label expansion, all in CLL. Further, Gazyva received a label expansion in CLL in January 2015. Looking at the pipeline, there are at least 21 PI3Ks in active phase 2 and phase 3 developments for a wide variety of indications (Figure 1). Though not all will compete in CLL directly, oncologists clearly will have multiple treatment options in addition to Zydelig, within and outside the class. And let’s not forget – in spite of significant innovation in categories such as CLL – oncologists still consider “watch and wait” a viable treatment strategy.
This pace of innovation is a boon to patients and gives oncologists more options. However, this also means manufacturers face a significant risk that unless marketers can adequately convey the patient and usage scenario, oncologists could limit treatment choices to manage complexity.
The landscape. This dynamic means marketing communication to oncologists is more important than ever, yet changes in the health care landscape raise barriers to conventional promotional tactics. ZS’s AccessMonitor™ report, which examines sales rep access to over 400,000 U.S. physicians, identifies oncologists as specialists with very restrictive access: Seventy-three percent of U.S. oncologists restrict time with sales representatives. This limits the ability to deliver the right messages about the right patients for the right products. Add to this the continued consolidation of oncology clinics and more aggressive adoption pathways, and manufacturers are left to target an increasingly concentrated layer of treatment decision-makers who may not be reachable through conventional promotional channels.
 "Cancer drug market looms toward $100B, thanks to costly targeted therapies," FiercePharma, June 8, 2014.