overview of oncology market

OVERVIEW OF INDIAN ONCOLOGY MARKET

Presented By:Vikas Sopan GoreDepartment of Pharmaceutical Management NIPER Mohali

Flow of Presentation

Introduction to Cancer Global Scenario Indian Scenario SWOT Analysis Market Drivers Market Challenges Conclusion

Cancer is a group of diseases involving abnormal cell growth with the potential to spread to other parts of the body.

Normally, human cells grow and divide to form new cells as the body needs them. When cells grow, old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumours.

Many cancers forms solid tumours, which are masses of tissue. Cancers of the blood, such as leukaemia's, generally do not form solid tumors.

Introduction Global Scenario Drivers Challenges Conclusion Indian

Scenario SWOT

Types of Tumors:

Benign tumors do not spread to nearby tissues. Benign tumors can sometimes be quite large. When removed, they usually don’t grow back. Most benign tumors found in the body, benign brain tumors can be life threatening.

Cancerous tumors are malignant, which means they can spread to nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.


Scenario SWOT

BenignMalignant

The cancer drugs market is segmented by the therapeutic modalities, cancer types and geography.

MARKET BY THERAPEUTIC MODALITIES Chemotherapy Targeted Therapy Immunotherapy (Biologic Therapy) Hormonal Therapy Monoclonal And Polyclonal Antibodies Stem Cell Transplantation Surgery


Scenario SWOT

Breast cancer Bladder Cancer Colorectal Cancer Oesophageal Cancer Kidney Cancer Lung Cancer Leukaemia Lymphoma Ovary Cancer

Pancreatic Cancer Prostate Cancer Skin Cancer Uterine Cancer

MARKET BY CANCER TYPES


Scenario SWOT

MARKET BY GEOGRAPHY North America

• United States• Canada• Mexico

Europe • Germany• France• United Kingdom• Others


Scenario SWOT

Asia-Pacific• India• China• Japan• Australia• New Zealand• Others

Source: https://www.alliedmarketresearch.com/oncology-cancer-drugs-market


Scenario SWOT

Worldwide in 2012 (the latest year for which information is available)— 14.1 million new cancer cases were diagnosed. 8.2 million people died from cancer. 32.6 million people were five-year cancer survivors

By 2025, 19.3 million new cancer cases are expected to be diagnosed each year.

New Cases

Deaths

0 2 4 6 8 10 12 14 16

8

5.3

6.1

2.9

No Of Cancer Cases And Death Worldwide In 2012

Less developed region More developed region


Scenario SWOT

13

12

10

876

4

40

Most Common Cancers Worldwide in 2012

Lung Cancer(1.8 mn people) Breast (Cancer 1.7 mn people)Colorectal Cancer (1.4mn people) Prostate Cancer (1.1mn people)Stomach Cancer (952000 people) Liver Cancer(782000people)Cervical Cancer(528000people) Other

19

9

9

965

4

39

Most Common Cause of Cancer Death Worldwide in 2012

Lung cancer (1.6mn people) Liver cancer(745000 people)Stomach cancer(723000 people) Colorectal cancer(694000 people)Breast cancer(522000 people) Oesophagus cancer(400000 people)Pancreas cancer(33000people) Other

Source: http://www.statista.com/statistics


Scenario SWOT

The global oncology drugs market is expected to reach at $111.9 billion by 2020. Patent expiration of key cancer drugs such as Herceptin, Erbitux, Rituxan and

Avastin, is expected to boost the growth of cancer bio-similars market by 2020. Geographically, North America, dominates the market followed by Europe. North America accounted for about ~38% share in the overall oncology drugs

market in 2013. Asia-Pacific market would grow at the promising CAGR of 8.7% during the forecast

period. The global cancer market was worth $56.7billion in 2009, growing at 16.8 percent

and is forecast to reach a value of $76.9 bn by 2012 (2009-12).


Scenario SWOT


Scenario SWOT

Roche Celgene Bristol-Myers Squibb

Novartis Pfizer Johnson & Johnson

Astra Zeneca Astellas Pharma

Merck & Co Eli Lily0

5000

10000

15000

20000

25000

3000028467

1419712614

11314

83296812 6725

5332 5167 4964

25828

7407

3833

8729

30464158

29971459

2986 2875

Top 10 Global pharma Companies by Oncology in 2014-2020 (in million U S dollar)

20202014

Source: http://www.statista.com/statistics


Scenario SWOT

Top 10 Best selling Cancer drugs Globally in 2013

Drug Brand Name Sales(in Bn)

Manufacturer

Indication

Rituximab Rituxan/MabThera $7.78 Roche Non-Hodgkin's lymphoma, chronic lymphocytic leukaemia

Bevacizumab Avastin $6.75 Roche colorectal, lung, kidney, and glioblastoma

Trastuzumab Herceptin $6.56 Roche breast, oesophageal, and gastricImatinib Gleevec $4.69 Novartis variety of leukaemia's and

gastrointestinal stromal tumors

Pegfilgrastim Neulasta $4.39 Amgen febrile neutropenia


Scenario SWOT

Top 10 Best selling Cancer drugs Globally in 2013

Drug Brand Name Sales(in Bn)

Manufacturer

Indication

Lenalidomide Revlimid $4.28 Celgene LungPemetrexed Alimta $2.70 Eli Lilly colorectal, lung, kidney, and

glioblastomaBortezomib Velcade $2.61 Johnson &

Johnsonmultiple myeloma, mantle cell lymphoma

Cetuximab Erbitux $1.87 ImClone andMerck

colorectal, head and neck

Abiraterone Zytiga $1.70 Johnson &Johnson

prostate

Source: Medscape Medical News > Oncology, June 12, 2014


Scenario SWOT

India has around 1.8 million people suffering from cancer, with patients of breast, cervical and oral cancers topping the list.

Every 13th new cancer patient in the world is an Indian. Official data show there are only about 1,000 trained oncologists in the country and

the ratio of oncologists to cancer patients is about 1:2,000. During year 2012 about 683,000 deaths due to cancer were registered. India has 27 dedicated cancer hospitals and an additional 300 general or multi-

specialty ones providing care to cancer patients. Research reports suggest for those aged between 25 and 69 years, cancer is the fourth leading cause of death in India (after cardiovascular diseases, respiratory diseases and tuberculosis).


Scenario SWOT

Concentration of cancer patients is more in the north-eastern states, Uttar Pradesh, Bihar and West Bengal.

The Missing Curer: 1.8 million: People living with cancer in India (within five years of diagnosis) 683,000: Deaths due to cancer in 2012 Over 1 million: Number of new cases getting added every year 1,000: Total number of trained oncologists in the country (doctor-patient ratio of

1:2,000) 27: Dedicated cancer hospitals in India.

Source:http://www.businessstandard.com/article/currentaffairs/ India May 24, 2014


Scenario SWOT

More than 70% of fatal cancers occur in productive ages of 30–69 years. Rates of cancer deaths were generally similar between rural and urban areas and

about twice as high in the least versus the most educated. A large proportion of cancer deaths in middle age (30–69 years) arise from tobacco-

related cancers, particularly in the northeastern states of India Lip ,Oral cavity & Pharynx Cancer in Men & Cervical Cancer in woman is the most

common cancer responsible for the death in Indians, based on the study conducted & funded by Bill & Melinda Gates foundation & US National Institute of Health.

Source: Max Neeman , Contract Research Organization, Cancer Scenario in India


Scenario SWOT

With rising cancer cases in the country, the oncology market in India is growing at 20 per cent annually and is expected to touch Rs 3,831 crore by 2017 and previously it is Rs 2000 crore in 2013.

Among this chemotherapy recorded the highest market value of approximately Rs 700 crore in 2013

Oral cavity & lung cancers in men & cervix & breast cancer in females together account for 50% of cancer related deaths in India.

“On an average a patient spends anywhere from Rs 2-10 lacs on cancer treatment,” says Pradeep K Jaisingh, Managing Director and CEO, International Oncology Services Private Ltd (IOSPL)


Scenario SWOT

Currently, a stage 2 patient spends an additional Rs 1.5 lakh for IMRT. If it's stage 3, they might have to spend an additional Rs 70, 000 for chemotherapy. Indian version of drugs like Herceptin costs Rs 57, 500 per vial, while Rituximab costs Rs.50, 000 per cycle.

Though the government has rolled out insurance schemes like Rashtriya Swasthya Bima Yojana, Rajiv Arogya Sri scheme, it often cover only a very small part of the expense incurred by the patient.

Only about 15 percent of the country's population is covered by some form of health insurance. Average policy amount of health plans sold was about Rs1.9 lakh and average bill of a cancer patient is nearly Rs10 lakh.

The cost of Radiation therapy is between Rs 30,000 and Rs 70,000.


Scenario SWOT

Apollo Cancer Hospital, Chennai

P.D Hinduja National Hospital, MumbaiKidwai Memorial institute of Oncology, Bangalore

Tata Memorial Hospital, Mumbai

RCC Thiruvanantpuram,Kerala


Scenario SWOT

Top 5 Cancer Care Hospitals in India

Market Players Key international players include Roche which captures 24% share with its

blockbuster drug Herceptin, breast cancer drug. Other key international players include GSK, Astrazeneca, Sanofi-Aventis.

Key domestic players include Cipla, later Dr.Reddys and Natco pharma which captured a market share of 10% and 5% respectively. Other key players include Biocon and Piramal healthcare.

Source: https://wikibizpedia.com/Cancer_Treatment_Industry_In_India


Scenario SWOT

Reform in tax structure

PPP(public private partnership) projects

Cancer control program

Reduction in drug prices

Government Initiatives


Scenario SWOT

Recognition of new Regional Cancer Centres (RCCs) by providing a onetime grant of Rs.5 crore

Strengthening of existing RCCs by providing a one-time grant of Rs.3 crore. Development of Oncology Wing by providing enhanced grant of Rs.3 crore to the

Government institutions (Medical Colleges as well as government hospitals). District Cancer Control Programme by providing the grant-in-aid of Rs.90 lacs

spread over a period of 5 years. Decentralised NGO Scheme by providing a grant of Rs.8000 per camp to the NGOs

for cancer.

There are 5 schemes under the Revised Programme:


Scenario SWOT

CASE 1 Swiss drugmaker Novartis glivec has not been granted patent in India

Glivec enjoys patent protection in over 40 other countries. The drug is available in India for Rs 1 lakh for a one month therapy; patients typically may need it for five or six years if not more.

A generic version of glivec, sold by Hyderabad's Natco Pharma and branded veenat, launched before Indian law changed in 2005, sells for around Rs 7,500 for a one month therapy.

CASE 2 Compulsory Licensing of Bayer’s Patented Cancer Drug (Nexavar) Sorafenib Granted to Natco Pharma in India

Bayer's Nexavar cancer drug costs around $5,500 a month in India, making it "not available to the public at a reasonably affordable price", the patent office ruled. About 40 percent of Indians live below the poverty line, government data shows.

Natco ready to sell it at 8800 Rs per 120 capsule of a month therapy.


Scenario SWOT

SWOTOPPTUNITY*Increasing disease burden*Government initiatives *Compulsory licensing for generic players

STRENGHT*Approved for a broad range of major and niche tumor types which has resulted in blockbuster sales*Newer therapy and new indications*High growth rate

WEAKNESS*40 drugs under NLEM*Lack of medical diagnostic infrastructure*Lack of awareness

THREAT*Compulsory licensing*Cost/benefit analysis of therapy*Multidrug resistance


Scenario SWOT

• Increasing number of cancer cases• Cancer prevalence• Development of alternative cancer therapies• Early diagnosis• Increase in FDI• Academic collaborations and partnerships• Blockbuster presence• Duration of treatment• Changes in the treatment scenario

Source: /biostrategyanalytics.wordpress.com


Scenario SWOT

Increased competition

Cost containment

Barriers to entry

Patent Cliff


Scenario SWOT

Key challenges faced by cancer market are shortage of specialized surgical & medical oncologists where there are only 1600 oncologists including Medical, Surgical & Radiation oncologists which in turn creates shortage of Surgical & medical oncologists.

There are only 30 Regional Care Canters (RCCs) & only 5-6 RCCs employ skilled & trained medical oncologists. Infrastructure facilities remain poor in India to handle high incidence of cancer.

Equipment used in cancer treatment is costly where particulary in India is imported from other countries and makes it available only to the rich as it involves huge costs.

The cost of setting up an oncology unit is often considered as the major reason for the spiraling cost of cancer care. A linear accelerator costs from Rs 6 to Rs 19 crores, based on the range of work that it can do. Further, the import duty makes it more expensive. If you look at the surgical part of it, a cyber -knife costs around Rs 20- 23 crore.


Scenario SWOT

A large group of patients remain untapped and do not receive the medical treatment thus making the expandability of the market difficult. If this scenario prevails then neither the patient nor the manufacturer can benefit.

Cancer market captures a lion's share in therapeutic segment of India. The market is predicted to rise in the coming years of 2017 but due to certain forces like low affordability & unorganised healthcare services the growth can't be at the rate predicted.


Scenario SWOT

I Wish Cancer Would get Cancer and Die!

overview of oncology market

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