Business Insight

Business Insight

India oncology market set to grow: Datamonitor

Jumana Barnagarwala, Head – Healthcare Consulting, Datamonitor, India highligts a few findngs of a new report on the global and local commercial environment for oncology drugs

Even as the global pharmaceutical market had to contend with an annual growth rate of 4.4 percent in 2008, the oncology segment ranked number one in value terms, netting sales of $48 billion and growing at 11 percent. In fact two out of the top 15 pharma brands globally are oncologics – Mabthera (Rituxomab; ranked 11 with $4.3 billion sales and growing at 12.9 percent in 2008) and Avastin (Bevacizumab; ranked 15 with $4.0 billion sales and growing at 37 percent in 2008). It is this high value and growth in cancer therapies market that is attracting pharma companies and encouraging further investments into the research and development of newer anticancer therapies. Despite continuous efforts and great deal of innovation, the unmet needs in this segment remain high and this continues to drive R&D effort as well as governmental intervention in key markets.

Molecular targeted therapies are the largest class of oncology drugs both in terms of value and growth (sales of $17.5 billion and CAGR of over 30 percent between 2005 and 2008, in seven major pharma markets) and this category of oncologics has been the primary driver of the oncology market globally. This growth is largely because molecular targeted therapies are high priced and do not as yet have any generic competition in the major pharmaceutical markets across the world. Table 1 below provides the definition of the molecular targeted therapies market along with constituent brands.

Recent trends in global oncology market

While the molecular targeted therapies are galloping ahead, several drugs belonging to the older therapies, namely antihormonals and cytotoxic therapy, are now facing patent expiry and thus are likely to see severe generic competition and consequently lower price levels.

The generic oncology market (includes antihormonals, cytotoxics, immunostimulating agents, targeted therapies and supportive care products) which was worth $1.3 billion in 2004 in the seven major pharma markets is likely to expand to $10.9 billion in value by 2014 (CAGR of 23.5 percent from 2004 to 2014). (Source: Datamonitor, “Commercial Insight: Generic Cancer Market – New Legislation and a Wave of Patent Expiries to Transform the Market” (DMHC2115))

In addition to generic forces, there is greater pharmacoeconomic pressure within several key pharma markets like the US and the UK for lower pricing of innovative cancer therapies. UK’s National Institute for Clinical Effectiveness (NICE) has long been criticized by clinicians for placing cost-effectiveness above the need for innovative drugs in cancer patients. NICE had earlier rejected the use of Revlimid in multiple myeloma patients since the agency did not find it cost-effective and as such had problems with the study design that helped Revlimid obtain approvals in the US and UK. However, NICE has reversed its decision since Celgene has agreed to cover the cost of treatment after first two years (first two years’ treatment costs will be borne by the NHS).

Despite these pressures, research and development efforts in the oncology segment continue to remain at an all time high and research-based companies are now finding innovative ways to collaborate in their R&D efforts in order to develop truly differentiated therapies that will have greater commercial potential in the highly competitive oncology markets of the future. For instance: the recently announced research collaboration between the hitherto arch rivals, Merck and AstraZeneca. This partnership will study the combination of MK-2206 (Merck) and AZD6244 (AstraZeneca) in the hope to improve survival rates since both drugs target different molecular pathways and together could produce higher efficacy rates.

This trend of pharma majors collaborating in their R&D efforts is likely to continue and will remain particularly significant in the oncology therapy area where there are more than 800 molecules in development. (Source: Analyst opinion: Merck and AstraZeneca: rivals join forces in oncology CommentWire; Published 4 June 2009)

ATC Class Description Examples
L1D0 Antineoplastic antibiotics Mylotarg
L1X3 Antineoplastic monoclonal antibodies Avastin, Herceptin, Rituxan, Erbitux
L1X4 Antineoplastic protein kinase inhibitors Gleevec, Tarceva, Sutent
L1X9 All other antineoplastics Velcade
L4A0 Immunosuppressive agents Revlimid, Thalomid
Source: Datamonitor report: Commercial Insight: Molecular Targeted Cancer Therapies; Reference Code: DMHC2535; Publication Date: 08/2009

Indian oncology market and trends

The Indian oncology market is estimated to be about INR 7,000 to 8,000 mn – this definition of the market includes all the cancer chemotherapy drugs as well as supportive drugs such as erythropoetins, colony stimulating factors, and interferons.

It has been indicated that the oncology market in India has been growing at a CAGR of more than 30 percent in the last three years. The three leading classes of drugs in the Indian oncology market are Antimetabolites, Protein Kinase Inhibitors and Aromatase Inhibitors (not considering erythropoetins).

While the Indian oncology market remains largely generic, the increasing incidence of various types of cancers in India is fueling the interest of domestic and global pharmaceutical companies in the Indian market. Not only are Indian majors like Dr. Reddy’s Laboratories (DRL), Natco, Intas Biopharmaceuticals, Biocon, Glenmark, Fresenius Kabi (erstwhile Dabur) etc. looking at a share of the Indian oncology market, they are gearing up to enhance their R&D efforts targeting the regulated markets in the world. For instance: in November 2007 Nicholas Piramal (now Piramal Healthcare) signed a drug development deal with Merck & Co. to help develop two anticancer drugs from targets selected and provided by Merck.

However, in the absence of reliable and latest information regarding the diagnosed incidences of various types of cancers and the prescription and consumption of various types of cancer drugs, the estimation of this market’s size is fairly arbitrary and that could lead marketers to misread the potential of various segments within this market.

Keeping this in mind, Datamonitor India aims to develop an in-depth report titled, ‘Market Insight: Oncology in India’. This report aims to provide market information and insights into the oncology market in India focusing on seven major types of cancers (five solid and two hematological). The five solid cancers covered in the report include: lung, breast, stomach and esophagus, cervix and head and neck; and the two hematological cancers covered include: Non-Hodgkin’s Lymphoma and Leukemia.

The report essentially serves four major objectives:

  • To assess the current diagnosed incidences of the seven types of cancers across India and to forecast the diagnosed incidences of these cancers over the next five years
  • To provide detailed disease algorithms for the seven types of cancers, describing the various stages of patient presentations, the various therapeutic approaches adopted at each stage and the likely outcomes at each stage of each of the indications
  • To provide qualitative and quantitative analyses of the prescription habits (with respect to chemotherapeutic and supportive drugs) of leading oncologists in India for the treatment of the seven types of cancers under study and
  • To estimate and forecast the market for chemotherapeutic and supportive cancer drugs (only erythropoetins and G-CSFs) within hospitals across the country

This report would be useful for both pharma as well as biotech companies that are interested in the Indian oncology market because not only does the report provide insights into the way oncology is practiced in India, it also has sections that detail the regulatory and IP environment of India along with a detailed analysis of the top 10 oncology players in the Indian market (detailed profiles of companies like Biocon, Fresenius, DRL, Natco, Intas, Sun, Piramal Wockhardt, Cadila Healthcare and IPCA are provided).

(For more information on Datamonitor’s report, ‘Market Insight: Oncology in India’ please contact Jumana Barnagarwala at jbarnagarwala@datamonitor.com)