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EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
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Oncology Link Insight Series #1
Regimens set to overtake monotherapies in total immuno-oncology (IO) sales
Aug 01, 2022
ASCO’s Annual Meeting has once again shown how important combinations of novel therapies with established regimens are for expanding into earlier lines or other indications, especially as a drug’s market matures and it chases harder to reach patient pools. Immuno-oncology (IO) drugs have shown rapid growth through repeated success following this strategy, as they chase multiple indications.
A long-standing question from payers has been whether the rise of IO drugs in combination, will lead to spiralling costs as innovative drugs are grouped together into expensive regimens.
To tackle this question, we can use IQVIA’s Oncology Link, Regimen Link and Forecast Link modules to provide the means to break down the sales of the constituent oncology drugs within a regimen (see charts that follow where IOs are defined as CTLA4 and PD-1/PDL-1 inhibitors).
By 2026, IOs in combination will take over two-thirds of the combined market, compared to just under a third in 2021, where monotherapies comprised the largest segment. The primary driver of this growth is through label expansion due to a desire to reach a greater number of patients experiencing lower treatment response to monotherapies.
The global value of these regimens will reach $51bn at list price by 2026 with the majority (64%) coming from IOs combined with cytotoxic or targeted therapies. Interestingly, while much concern has been expressed on the potential cost of IO+IO combinations (i.e. currently CTLA4 with PD-1/PD-L1), they are only forecast around $5bn (11% of the 2026 market).
The rest of sales from these regimens are from “pull-through” drugs, i.e. cytotoxic and targeted drugs that are in the same regimen as IOs. Many of these are small molecules giving the generics sector a chance to pursue increased growth on the back of IO expansion.
The value-shift from monotherapies to combinations signals a progression towards maturity in IO. This is due to a change in strategy as players seek growth through the capture of existing market share as their ability to expand into white-space diminishes. As the above charts show, it will become increasingly important to monitor the growth of regimens, both to track spend and to understand competitive dynamics when multiple drugs from the same company are used in exclusive combinations.
To learn more about the market challenges and opportunities, don’t miss seeing the webinar online here.
Need to build and assess brand strategy for different indications?
For pipeline and in-line products by monitoring market share KPIs at disease level, IQVIA Oncology Link provides one-click access to syndicated disease splits for 25 indications based on best-in-class local IQVIA data assets, updated quarterly. Fill in the form here for a complementary trial and find out how IQVIA Oncology Link can help you.
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