15 new cancer drugs debuted in 2018—along with one big leap in drug spending

Cancer experts from around the world are descending on Chicago this weekend for the annual ASCO confab. (Pixabay)

Last year delivered two double-digit stats to the cancer drug world: A record number of new drugs launched in the U.S., at 15 all told, and global spending on oncology treatments leapt by almost 13%.

Which leads us to a couple of triple-digit stats: That spending leap pushed the cancer drug outlay to nearly $150 billion for 2018—a figure that's expected to hit $240 billion in 2023.

That's according to a new report from IQVIA, unveiled as people stream into Chicago for the annual American Society of Clinical Oncology meeting. Those 15 oncology drugs scored U.S. approval last year in 17 indications, IQVIA found. And that figure brings the approval tally between 2014 and 2018 to 57 new oncology medicines across 89 indications.

But the new drugs aren’t coming cheap. IQVIA found that median new cancer drugs cost $149,000 per year in 2018, down $13,000 from 2017. Drug costs ranged from $90,000 annually to $300,000 before discounts.

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Last year marked the fifth straight double-digit increase in cancer drug spending. And that spending is “heavily concentrated” among a small number of therapies; the top 38 drugs commanded nearly 80% of the total, IQVIA said.

Drugs that launched last year utilize “diverse mechanisms” to target a range of cancers, the team wrote. Of the drugs that scored FDA approvals in the last 5 years, nearly a third treat nonsolid cancers.  

The researchers have tracked at least one recent “paradigm shift” in cancer approvals: a move to tumor-agnostic drugs that target disease based on genetic profile rather than the tumor’s location in the body. Last year, Bayer and Loxo Oncology scored an approval for Vitrakvi to treat patients whose tumors feature a neurotrophic receptor tyrosine kinase gene fusion. That approval followed a nod for Merck’s Keytruda to treat microsatellite instability-high cancers. 

IQVIA called Virakvi's approval "pivotal," and also singled out Verastem’s Copiktra in that category. That drug demonstrated a 42% response rate in follicular lymphoma and 74% in chronic lymphocytic leukemia, the team said. 

It’s not only brand-new medicines that are racking up the numbers, though. Checkpoint inhibitors continue to gain steam and last year reached 200,000 patients, more than double the number they treated in 2016.

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Looking ahead, next-gen drugs are all the craze. IQVIA tracked 98 in development using 18 different approaches. A couple are already approved in cancer.

More than 700 companies are involved in cancer R&D, including nearly 500 that are active exclusively in oncology. Twenty-eight medium and large pharma companies are active in the field, IQVIA found.