Spending on Cancer Drugs Expected to Nearly Double in the Next Five Years Worldwide

Global spending on oncology drugs will nearly double over the next five years, far exceeding the growth in spending on drugs for other conditions that are expensive when it comes to pharmaceutical expenditures, according to IQVIA’s Global Use of Medicines report.

The projected 95% rise in spending on cancer drugs from $193 billion in 2022 to $377 billion in 2027 will be partly the result of 100 new cancer drugs coming on the market, according to IQVIA’s analysts. The introduction of biosimilars to Avastin (bevacizumab), Herceptin (trastuzumab) and Rituxan (rituximab) in recent years moderated spending on oncology drugs somewhat. But the IQVIA report, which was published last week, says it won’t be until 2027 that next major cancer drug, Ibrance (palbociclib) faces new biosimilar competition.

It is a different story for drugs for immunological conditions such as psoriasis, atopic dermatitis and severe asthma. IQVIA projects global spending will increase from $143 billion in 2022 to $177 billion in 2027, which works out to a 24% increase. New drugs have fueled growth in spending in recent years, but IQVIA’s analysists say that more half of the drugs for immunological conditions (also known as autoimmune diseases) will face generic or biosimilar competition in developed markets, such as the U.S., in the next five years.

Global spending on diabetes drugs is expected to grow at roughly the same rate as spending on drugs for immunological conditions and will reach $168 billion in 2027, according IQVIA’s analysis. But the report stresses the rebates and discounts on diabetes drugs, especially in the U.S. By 2027, rebate and discounts will make the net price of diabetes 75% less than what the report calls an “invoice” price.

Spending on drugs for obesity has soared as diabetes drugs such as semaglutide have been repurposed and rebranded into drugs, such as Wegovy that produce substantial weight loss. The heavy marketing of Wegovy has generated controversy. But the IQVIA report projects a wide band of possible spending on obesity drugs that will hinge, the report says, on guidelines and coverage policies set by payers. If guidelines are not expanded and payers restrict coverage, global spending may only increase from $10 billion in 2022 to $17 billion in 2027, a large relative increase, but a fraction of the $377 billion that might be spent on oncology drugs. But the $17 billion is the low-end estimate by IQVIA. Obesity spending would be as high $100 billion in 2027, a tenfold increase from the 2022 expenditures, and their middle-ground estimate is $48 billion.