Australia's Top 20 cancer drugs

Australia's Top 20 cancer drugs to reach sales of $1 billion by 2018

The Australian oncology market's high value and growth opportunities have made it an attractive arena for drug developers to enter. Top 20 cancer therapy brands sales totaled $545m in Australia in 2008, growing at a CAGR of 30% since 2005. Although this growth is expected to slow down considerably during the next 10 years mainly due to maturing markets and the entry of generic products, revenues are expected to reach $1 billion in 2018, according to a new report* by independent market analyst Datamonitor.

Cancer therapy brands are divided into three main drug classes: molecular targeted therapies, cytotoxic therapies and antihormonal treatments. The molecular targeted therapies were the leading class of cancer treatment in the Top 20 in Australia with sales of $320m in 2008. The class has been responsible for most of the overall growth seen between 2005 and 2008, driven by the increased uptake of high-priced products and a lack of generic competition.

Before the advent of targeted therapies, patients with cancer were largely restricted to cytotoxic and antihormonal treatment, both of which are associated with varying levels of toxicity. "It is an increasingly common school of thought that tumor-targeted agents could become some of the most powerful tools in the fight against cancer due to their ability to discriminate between cancerous cells and other healthy cell types" says Lisette Oversteegen, Datamonitor senior healthcare analyst.

Datamonitor forecasts that molecular targeted therapies will continue to drive growth in the Australian Top 20 cancer market during the next 10 years, reflecting its potential for increased uptake in existing indications and further indication expansion. While revenues of the other two classes will reach $200m combined, the targeted therapies class is set to grow to $750m in 2018.

Breast cancer drug Herceptin was the highest-selling Australian treatment in 2008. Indeed, molecular targeted therapy Herceptin (trastuzumab; Roche) stood at the top of the Australian oncology market with sales of $120m and a 2005-2008 CAGR of 61%. This drug is well positioned in the human epidermal growth factor receptor 2 (HER-2), positive breast cancer market where it received an exceptional reimbursement status both within and outside the Pharmaceutical Benefits Scheme (PBS).

"Although Herceptin's sales will continue growing in the near future due to its popularity in the breast cancer market and an approval in HER-2-positive gastric cancer, its revenues will be somewhat dampened by the uptake of Tykerb/Tyverb (lapatinib; GlaxoSmithKline). Tykerb/Tyverb, also a molecular targeted treatment, has the advantage of oral administration, while Herceptin is only available as an intravenous drug. Furthermore, its continued development is expected to result in an approval and PBS listing for first-line and adjuvant treatment, placing it in direct competition with Herceptin," comments Lisette Oversteegen based in Sydney .

Roche expands its successful oncology portfolio with targeted therapy Avastin (bevacizumab). While reaching sales of $2.5 billion in 2008 in the US alone, its uptake in Australia has so far been low due to a lack of reimbursement in three of its four indications, leading to sales of just under $8m. Its only PBS listing so far is for the first-line treatment of metastatic colorectal cancer, which took place in mid-2009. An earlier submission had been rejected over concerns that Avastin would be used off-label and would therefore have an unacceptably high cost effectiveness ratio.

Avastin sales are predicted to reach $190m by 2018 due to aggressive indication expansion. Besides colorectal cancer, the drug is also approved by the Therapeutic Goods Administration (TGA) for breast cancer, non-small lung cancer and renal cell carcinoma. "Assuming the Pharmaceutical Benefits Advisory Committee (PBAC) will not create too many hurdles on its path to reimbursement for these additional indications, Avastin is expected to become the second-highest selling cancer drug in Australia by 2018 behind Rituxan/MabThera (rituximab; Roche) the Australian Top 20 leader with revenues of $225m," concludes Mrs Oversteegen.


30.3.2010