Lung cancer and lymphoma markets set to grow

NEW YORK & LONDON—A pair of cancers; a pair of reports—and in both cases growth on the horizon for treatment revenues. According to New York-based GBI Research, the global non-small cell lung cancer (NSCLC) treatment market value will increase from $5.1 billion in 2013 to slightly over $7.9 billion by 2020, expanding at a compound annual growth rate (CAGR) of 6.6 percent. And from London-based GlobalData comes the prediction that the B-cell non-Hodgkin’s lymphoma (NHL) treatment market value will experience moderate growth across six major markets (the United States, France, Italy, Germany, Spain and the United Kingdom), from $4.59 billion in 2013 to $5.41 billion by 2018.

According to the GBI report “Non-Small Cell Lung Cancer Market to 2020 – New Therapies to Enhance Treatment Segmentation and Drive Growth in an Increasingly Competitive Market,” growth will be driven primarily by the introduction of numerous premium therapies, particularly in second-line and squamous cell treatment settings, which either replace or combine with generic chemotherapies.

Other key drivers will be the increased uptake of currently marketed therapies, such as Gilotrif, and the lack of marked drug patent expirations until the end of the forecast period.

“There will be numerous new drug market entries by 2020, and while some will only have a low impact in crowded sectors, other new approvals will benefit patient subpopulations that are untreated by targeted therapies,” said Joshua Libberton, an analyst for GBI Research. “Most notably, the squamous cell patient population, which currently relies on generic chemotherapy regimens only, will have access to immunotherapies such as Yervoy (ipilimumab), necitumumab and nivolumab.”

Libberton adds that while some of these drugs' safety profiles are a concern, they have clinically demonstrated improvements or non-inferiority to the efficacy of current segment leaders. Therefore, while GBI Research forecasts that these drugs are unlikely to dominate the market and replace chemotherapy, they will offer suitable alternatives and help to diversify treatment options.

Despite considerable growth through to 2020, the report states that the NSCLC market’s upcoming patent cliff will mean limited further expansion.

“Over the forecast period, the market environment will not allow premium entrants to be offset by the availability of efficacious generics,” Libbeton explained. “As treatment quality improves, physicians will be expected to prescribe expensive targeted therapies over generic chemotherapy options. However, leading drugs Avastin and Tarceva will lose patent protection in 2019 and 2020, respectively, followed by Alimta in 2021, all of which will hinder future market growth.”

Meanwhile, GlobalData’s report “OpportunityAnalyzer: Non-Hodgkin’s B-Cell Lymphoma: Opportunity Analysis and Forecast to 2018” states that “the global NHL treatment paradigm will undergo a dramatic shift” that will carry it away from chemoimmunotherapy regimens with the launch of targeted B-cell receptor inhibitors, Imbruvica (ibrutinib) and Zydelig (idelalisib), in the relapsed/refractory setting across multiple indications.

“The U.S. Food and Drug Administration gave the green light to Imbruvica for use in Rituxan-refractory mantle cell lymphoma (MCL) patients in November 2013,” noted Dr. Brooke Baker, GlobalData’s senior analyst covering oncology and hematology. “Meanwhile, Zydelig recently received approval for the treatment of relapsed/refractory follicular lymphoma patients who have received at least two prior therapies. Imbruvica has set the bar for pricing in the NHL market with an annual cost of therapy (ACOT) calculated at approximately $133,000. On the other hand, Zydelig will be priced very competitively, at an average ACOT of around $87,000, in anticipation of its future combination with Roche’s Rituxan.”

GlobalData forecasts that Zydelig will emerge as the overall NHL treatment revenue leader across all indications, with total sales reaching $888 million in 2018. This will be primarily due to Imbruvica’s smaller target patient population, as MCL comprises approximately 6 percent of all NHL diagnoses only.

Baker added: “From 2017, we anticipate that Zydelig will also be utilized in combination with Rituxan, and the potential to combine with the gold-standard backbone therapy will further drive the drug’s uptake in this setting. However, both Zydelig and Imbruvica’s opportunities for premium pricing will be limited in cost-conscious European countries, and this will limit revenue growth in these markets despite the strong uptake among patients.”