Cancer drugs are fundamental in precision medicine. The cost of cancer drugs has increased over the last 10-20 years. This study investigates the spending and access to cancer drugs in Europe 2005-14 and the impact of prices and indicators of clinical value for variations in access.
Sales data from IMS Health standardized to population, incidence and/or mortality of specific cancers for comparisons between countries. Listed prices are used (no discounts). Determinants of variations in access are investigated with statistical methods.
Cancer drugs sales in Europe were € 7.4 billion in 2005 and € 19.5 billion in 2014. Eight countries (Austria, Belgium, France, Germany, Italy, Netherlands, Spain, UK) accounted for > 80% of sales in both 2005 and 2014. France used most in 2005 but was passed by Germany in 2014; 25% of cancer drug sales in the EU-28. Two of the top 5 drugs in 2005 were not in the top 10 in 2014 (docetaxel and oxaliplatin) and one (paclitaxel) was last on the list. Trastuzumab had doubled as No1 selling drug, and several new agents are listed, e.g. bevacizumab and lenalidomide. Among the top 5 drugs in 2014, 3 have recently lost exclusivity or will in the near future (trastuzumab, rituximab and imatinib). Cancer drugs' share of direct costs for cancer care has doubled and was 21% in 2014. The newest drugs make up only 8% of total sales, varying between 4% and 11% per year in different countries, with the higher share in richer countries. Countries in Eastern and Southern Europe with low GDP/capita have a usage that is 1/3 of countries in Western Europe, and this has not changed between 2005 and 2014.
Access to cancer drugs varies in Europe and relates to the countries' economic status. There are also significant variations in access between countries of similar economic power, indicating opportunities for improvement through policies aimed at evidence based and cost-effective precision cancer medicine.
Legal entity responsible for the study
Swedish Institute for Health Economics
Novartis, Roche, BMS, Jansen, MSD
All authors have declared no conflicts of interest.