Market Conditions that Impact New Oncology Product Uptake
By Jackie Ilacqua, Global Head of Oncology, Ipsos Healthcare
Although there have been more drug approvals in the oncology space than in any other—as many as 49 drugs have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of cancer over the past five years1—time to reach peak share has shortened due to new products launching in more targeted subsets of patients over the last decade. Looking back on the last five years of new oncology product launches, it becomes clear that the impact of new products is dictated not only by clinical trial data but also by the tumor market characteristics.
Since 2009, the greatest influx of new product launches across tumor types have been seen in melanoma, breast cancer, chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL), and non-small cell lung cancer (NSCLC). Melanoma has witnessed the largest number of new entrants, with five products approved (Mekinist, Tafinlar, Yervoy, Zelboraf, and Sylatron); followed by breast cancer with four (Kadcyla, Perjeta, Afinitor, and Halaven), and three drugs each in CML (Synribo, Iclusig, and Bosulif), CLL (Zydelig, Imbruvica, and Gazyva), and NSCLC (Xalkori, Zykadia, and Gilotrif).
The Change in Speed of Product Uptake Over Time
Overall, the speed of uptake of cancer drugs has increased dramatically in the past ten years, with products reaching peak share much earlier now than in the past. Biologic agents also have a faster speed of uptake compared to cytotoxic drugs, and drugs approved for solid tumors will have a faster uptake than drugs approved for hematologic malignancies (Source: Ipsos Oncology Analog Uptake Tool). This is assuming that the cancer drug even makes it to market, as half of all phase III clinical trial failures in 2013 were cancer drugs.2
The impact of a product on the market is heavily dictated by market conditions: uptake curves at launch differ according to order of entry, unmet need in the area the drug is approved for, presence of a companion diagnostic, regimen type, testing results, specificity of the approval, and more. To illustrate this point, let’s consider some drug launches in more detail across 3 tumor types.
Non–small Cell Lung Cancer
Looking at the launch pattern of Xalkori (crizotinib) for NSCLC (Figure 1), Ipsos Healthcare data show that the product reached its peak share 29 months after its U.S. launch in August 2011, but also, that it was very close to its peak directly after launch. This is indicative of the need in the market and the anticipation for this drug’s approval, most likely reinforced by the fact that its indication is limited to a small and very specific subset of patients—those that test positive for the ALK fusion gene. After its initial positive reaction, share of the drug dropped about a year after launch before returning to hit its peak share of 77%.