Global Oncology R&D Surges While Cancer Care Disruptions Ease, Says IQVIA Institute for Human Data Science

Global research and development in oncology continues to surge with historically high levels of trial starts in 2021, up 56% from 2016. Also, a record 30 novel active substances launched globally last year, according to a new report from the IQVIA Institute for Human Data Science on Global Oncology Trends 2022. While disruptions in cancer care are easing, more new patients were presenting to community oncologists with metastatic disease in several tumors during 2020 and 2021 due to delays in diagnosis and screenings.

"Global oncology is a bifurcated tale of two very different worlds," said Murray Aitken, executive director of the IQVIA Institute. "On the one hand, we are witnessing a remarkable surge in R&D and innovation, potentially leading to new therapies for unresolved cancers. On the other hand, the global oncology community and patients continue to struggle with the impact from delays in screenings, diagnoses and cancer care. Even with the bright outlook for R&D and innovation, it will take a while for the oncology community to work its way through these challenges."

A few key highlights of the report include:

• Innovation: A record 30 oncology novel active substances were initially launched globally in 2021, in addition to 104 in the past five years and a total of 159 since 2012. In the U.S., there were 83 unique new cancer medicines launched in the past five years, with many approved for more than one indication. Oncology drugs increasingly received accelerated approvals and orphan or breakthrough designations, and a small but increasing number are proceeding from patent filing to product launch in less than five years.

• Research and development: Oncology trial starts reached historically high levels in 2021, up 56% from 2016 and mostly focused on rare cancer indications. Most cancer research focuses on metastatic or advanced cancers, but early cancer trials and vaccines have more than doubled in 10 years. Composite success rates in oncology have been trending down since 2015, reaching 5.2% in 2021, while rare tumors averaged 15.6%. Compared to other therapy areas, oncology trials have significantly less administrative "downtime" between phases, which accelerates successful drugs' time to market. Emerging biopharma companies were responsible for 68% of the oncology pipeline in 2021, up from 45% a decade ago.

• The impact of COVID-19 on cancer care: Oncologists report that caseloads are 20?29% below pre-COVID-19 levels and more new patients presented to community oncologists with metastatic disease in several tumors during 2020 and 2021. Even as disruption to cancer care eases, delays in surgeries and chemotherapy and fewer diagnoses continue to be a concern for oncologists. Screenings for common cancers were down 1?16% in the U.S. through the end of 2021. More than 30 million screenings for four common tumors have been disrupted since the onset of the pandemic, risking delayed or missed diagnoses for more than 58,000 patients.

• Bringing scientific advances to cancer care: Global numbers of treated patients have increased at an average of 4% over the past five years and are expected to accelerate in the next five years after disruptions from the pandemic ease. Despite this growth, the pace of bringing novel cancer therapies to patients is uneven across countries, with differences in biomarker testing rates, adoption of novel therapies and infrastructure capacity to deliver some of the most advanced therapies. Use of checkpoint inhibitors is two to three times higher in some major developed countries than others and is much higher than in lower-income countries. Next-generation biotherapeutics, including cell and gene therapies, are an area of intense research, and while the number of CAR T centers is growing, locations are generally not convenient to all patients and not all centers have all approved products available.

• Spending on oncology medicines: Cancer medicine spending rose to $185 billion globally in 2021 and is expected to reach more than $300 billion by 2026, driven by continued innovation. Growth in major markets is driven by new products and brand volume and is offset by losses of exclusivity, including biosimilar impact. The U.S. remains the largest market globally, followed by major European countries. China's oncology spending now exceeds the rest of pharmerging countries and is driven by expanded access to new therapies and offset by lower prices. Globally, seven of the top 10 tumors will see double-digit spending growth from expected novel therapies. Together, PD1/PDL1 inhibitors are used across most solid tumors and represent 45% of spending for lung cancer in 2021. The robust pipeline of next-generation biotherapeutics in oncology includes significant potential as well as a wide range of uncertainty both clinically and commercially.

The full version of the report, including a detailed description of the methodology, is available at www.IQVIAInstitute.org. The study was produced independently as a public service, without industry or government funding.

About the IQVIA Institute for Human Data Science

The IQVIA Institute for Human Data Science contributes to the advancement of human health globally through timely research, insightful analysis and scientific expertise applied to granular non-identified patient-level data.

Fulfilling an essential need within healthcare, the Institute delivers objective, relevant insights and research that accelerate understanding and innovation critical to sound decision making and improved human outcomes. With access to IQVIA's institutional knowledge, advanced analytics, technology and unparalleled data, the Institute works in tandem with a broad set of healthcare stakeholders to drive a research agenda focused on Human Data Science, including government agencies, academic institutions, the life sciences industry, and payers. More information about the IQVIA Institute can be found at www.IQVIAInstitute.org.

About IQVIA

IQVIA (NYSE:IQV) is a leading global provider of advanced analytics, technology solutions, and clinical research services to the life sciences industry. IQVIA creates intelligent connections across all aspects of healthcare through its analytics, transformative technology, big data resources and extensive domain expertise. IQVIA Connected Intelligencetm delivers powerful insights with speed and agility ? enabling customers to accelerate the clinical development and commercialization of innovative medical treatments that improve healthcare outcomes for patients. With approximately 79,000 employees, IQVIA conducts operations in more than 100 countries.

IQVIA is a global leader in protecting individual patient privacy. The company uses a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. IQVIA's insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors and scientific advances, in an effort to advance their path toward cures. To learn more, visit www.iqvia.com.