DEVELOPMENT AND INNOVATION IN CANCER MEDICINE - Innovation in the Biopharmaceutical Industry - page 58

Drug (brand
name)

Generic name Manufacturer Yearly cost of

treating a
patient

Herceptin traztuzumab Roche £60K

Mabthera rituximab Roche £40K

Glivec imatinib Novartis £50K

Erbitux cetuximab BMS £60K

Avastin bevacizumab Genentech £70K

Tarceva erlotinib Roche £65K

Iressa gefitinib AZ £40K

Fig. 5. Marketed targeted therapies showing their high cost.

explosion of new therapies in cancer care will continue, and pricing of these drugs
will remain high. The cost of cancer drugs in 2005 is estimated to be $24bn globally.
Of that amount, $15bn is spent in the United States. If effective drugs emerge from
the research and development pipeline, the cancer drug market could reach $300bn
globally by 2025, with this cost spreading more widely around the world (Fig. 5).
Paralleling the explosion in therapies and the increase in costs, a number of
confounding factors will make markets smaller (Locock et al. , 2003). Technology
will reveal which patients will not respond to therapy. Hence, blockbuster drugs
will be made obsolete. Doctors will know the precise stage in the disease process
where treatment is necessary. As cancer becomes a chronic disease, people will have
more co-morbidities, bringing associated drug-drug interactions and increasing care
requirements.
How do we balance this equation? The pharmaceutical companies will not nec-
essarily want to do the studies to fragment their market. Research that leads to
rational rationing will need to be driven by health care payers. There is a risk that
pharmaceutical companies could stop developing cancer drugs and begin to focus
instead on therapeutic areas that have less individual variation and therefore more
scope for profit. Furthermore, development costs are rising. Ten years ago, the aver-
age cost of developing a new cancer drug was around $400m. Today it is around
$1bn. At this rate of growth, the cost of developing a new drug could soon reach
$2bn, an amount that would be unsustainable in a shrinking market. With all this in
mind, the process of drug development must be made faster.
Instead of simplifying research, changes in legislation concerning privacy and
prior consent make research more difficult. The EU Clinical Trials Directive will
make it impossible to have quick hypothesis-testing trials. Other challenges exist
as well, such as obtaining consent for new uses of existing human tissue — fol-
lowing political anxiety when consent for removing and storing tissues had not
been obtained in the early years of the 21st century. However, surveys have shown