Entry of eleven novel therapies expected to drive NSCLC market's growth to $12.7 billion in 2024

Decision Resources Group finds that the entry of eleven novel therapies into the non-small-cell lung cancer (NSCLC) market will drive the market's growth from $5.4 billion in 2014 to $12.7 billion in 2024. In addition to the recently approved programmed death-1 inhibitors Opdivo (Bristol-Myers Squibb) and Keytruda (Merck & Co.), three more immune checkpoint inhibitors are slated to enter the NSCLC market: atezolizumab (Roche/Genentech), durvalumab (AstraZeneca/MedImmune) and avelumab (Merck KGaA/Pfizer). Robust uptake of these agents across treatment settings, as well as their premium pricing, will be the main drivers of growth. Prescribing of seven novel therapies will be biomarker driven, in line with physician and payer desire for increased personalized drug use in NSCLC. Decision Resources Group also finds that availability of a validated biomarker of response to therapy will have a positive impact on pharmacoeconomic and HTA evaluations across the five major pharmaceutical European markets. Payers note that manufacturer-funded testing, and testing costs included in the total drug cost is an additional advantage.

Other key findings from the Pharmacor report entitled "Non-Small-Cell Lung Cancer":

• Zykadia (Novartis) and Alecensa (Genentech/Roche/Chugai) have quickly become the standard of care for Xalkori (Pfizer)-treated patients in the markets where they are commercially available. Similarly, we expect AZD-9291 (AstraZeneca) and rociletinib (Clovis Oncology/Celgene) to be the treatments of choice for metastatic, EGFR TKI-treated, EGFR-T790M-mutation-positive NSCLC patients.
• Nine current and emerging therapies expected to enter the first-line setting, including immune checkpoint inhibitors, ALK and EGFR TKIs. Notably, the significant unmet need for efficacious therapies for treatment-naive, metastatic squamous-cell patients will be partly addressed by Eli Lilly's necitumumab and the entry of four immune checkpoint inhibitors.

Other key findings from the European Physician and Payer Forum report entitled "The dynamic NSCLC market: How will European payer and physician attitudes shape this highly lucrative market?":

• Interviewed payers across the EU5 countries indicate that if novel NSCLC therapies demonstrate an overall survival benefit over the standard of care, such data can have a significant impact on cost-effectiveness, and ultimately, on P&R negotiations.
• A higher proportion of surveyed medical oncologists in the United Kingdom and Germany face restrictions from national reimbursement policies in their prescribing of EGFR and ALK TKIs, compared with physicians in Italy and Spain – who struggle primarily with regional variations in drug access - and France.

Comments from Decision Resources Group Analyst Orestis Mavroudis-Chocholis Ph.D.:

• "Of the eleven emerging therapies we forecast to launch by 2024, three are targeting patient subpopulations harboring novel driver mutations. AstraZeneca's selumetinib in combination with docetaxel is positioned to address the significant unmet need for efficacious therapies for KRAS-mutation-positive patients (25 percent of all Western NSCLC patients), while Novartis's Tafinlar plus Mekinist are targeting the niche BRAF-V600E-mutation-positive patient population (just 2 percent of all NSCLC)."
• "Experts and community oncologists are excited about the prospect of prescribing third-generation EGFR TKIs, such as AstraZeneca's AZD-9291 and Clovis Oncology/Celgene's rociletinib, to their EGFR TKI-treated, EGFR-T790M-mutation-positive patients. However, surveyed oncologists in the EU5 estimate that by 2018, more than one third of EGFR TKI-treated patients will not be tested for EGFR-T790M mutations."