Maria Shepherd, President and Founder, Medi-Vantage09.10.21
No patient ever wants to hear a cancer diagnosis, because the treatment may be worse than the cure. Cancer is the first or second leading cause of death for patients under 70 years old in 112 of 183 countries across the globe, according to estimates from the World Health Organization in 2019.1 Cancer mortality and incidence by type is reported to be growing worldwide (Table 1)2 due to population growth and aging as well as changes in the prevalence and distribution of the main risk factors for cancer. Many risk factors are associated with socioeconomic development, such as tobacco use, alcohol consumption, obesity, and/or occupational and environmental exposure.3 The development of cancer as a leading cause of death is, in part, caused by decreases seen in the mortality rates of coronary heart disease and stroke in many countries.1
Table 1: Estimated number of new cancer cases and deaths from cancer in 2021 (by type) in the United States.2
Why This Is Important
There are so many medical devices critical to the treatment of cancer. According to the World Health Organization, capital equipment (e.g., scopes, electrocardiography, infusion pumps, MRI, etc.) are vital tools in cancer management. So are laboratory diagnostics and pathology equipment, surgical equipment, PPE, shielding and radiation protection, imaging devices, medical furniture (like beds and IV poles), and of course, single-use medical devices. Medications such as chemotherapy and biosimilars, for those who can afford them, are also needed in the fight against cancer.
The Impact of COVID on Cancer
Experts are still estimating the extent of the COVID-19 pandemic’s impact around the world. Most agree, however, delays in diagnosis and treatment, patient fears of contracting COVID at a treatment facility, difficulties in gaining access to healthcare facilities due to closures or gatekeepers, and/or delayed or reduced access to screening programs are expected to cause a short-term decrease in reported cancer incidence. Further, it is predicted this period will be followed by an increase in late-stage diagnoses and cancer mortality in some areas of the world.
COVID notwithstanding, data are available for 2020. There were an approximated 19.3 million new diagnoses of cancer and almost 10 million cancer deaths across the globe in 2020. For men and women combined, approximately 50 percent of all cancer cases and 58.3 percent of cancer deaths were assessed to have occurred in Asia in 2020. This aligns with population estimates—an estimated 59.5 percent of the global population resides in that region. Europe reported 22.8 percent of total cancer cases and 19.6 percent of cancer deaths. These numbers do not align with population estimates in Europe—9.7 percent of the global population. In North America, the incidence is 20.9 percent with 14.2 percent of deaths worldwide (Table 2). Sadly, the percentage of cancer deaths in Asia (58.3 percent, as noted above) and Africa (7.2 percent) are greater than the incidence (49.3 percent and 5.7 percent, respectively), likely caused by the different types of cancer experienced there and higher case fatality rates in many of these underserved regions. For both sexes combined, the top 10 cancers account for >60 percent of the newly diagnosed cancer cases and >70 percent of cancer deaths.4
Table 2: Global deaths from cancer by region in 2020.4
What Will Cancer Look Like in 2040?
Globally, a projected 28.4 million new cancer cases are forecasted for 2040, a 47 percent increase from the 19.3 million cases in 2020, assuming the national rates estimated in 2020 remain constant. This projection is based on the growth and aging of the population, and may be further worsened by the rising prevalence of risk factors in many areas of the world. Many countries are experiencing a marked increase in the prevalence of known cancer risk factors that prevail in high-income western countries (e.g., smoking, poor diet, obesity, and physical inactivity).5 Data shows a shift is occurring in the incidence of poverty and infection-related cancers (e.g., liver, cervix, and stomach) with cancers consistently seen in developed countries (e.g., breast, colorectum, lung, and prostate). If there are increases in the incidence of these “developed world” cancers, it is expected mortality rates will also increase, as has been observed for breast and colorectal cancer.6
A Strategic Opportunity
According to McKinsey, the oncology therapeutics market sold $143 billion in pharmaceuticals in 2019—around 20 percent of global pharmaceutical sales.7 Analyst consensus forecasts suggest a strong 12 percent CAGR with global oncology medication sales forecast projected to reach $250 billion by 2024. Country economies play a big role in determining which patients get the gold standard of care. For example, a recent European study shows differences in non-Hodgkin lymphoma five-year survival rates.8 In Northern Europe, survival rates were 63 percent while just reaching 50 percent in Eastern Europe. There is also an outcomes gap in 10-year survival statistics for breast cancer—76 percent in Northern Europe compared to 65 percent in Eastern Europe. On the other side of the planet, in China, outcomes have considerably improved for cancer statistics. The five-year survival rate for all cancers combined was approximately 40 percent for Chinese patients who were diagnosed in 2013—a significant increase from the 30 percent of Chinese patients diagnosed in 2003.9
Adjust Strategies
A very small number of highly successful products signifies a top-heavy share of the oncology market. The blockbusters are the first place to look for opportunities in medical devices. The blockbusters are Keytruda, Revlimid, OPDIVO, Avastin, Rituzxan, Herceptin, and Imbruvica. The top seven drugs are indicated for patients with metastatic melanoma, multiple myeloma, metastatic non-small cell lung cancer, metastatic carcinoma of the colon or rectum, non-Hodgkin's lymphoma, adjuvant or metastatic breast cancer, and metastatic gastric cancer and chronic lymphocytic leukemia, respectively.10 There are 28 other indications for blockbusters between $1 billion and $5 billion, another place to look for opportunity.
The Medi-Vantage Perspective
A large segment of our research is outside the U.S. to examine market opportunities for specific products. There are barriers and opportunities outside of the U.S. that need to be examined before dipping a toe in an OUS market. In addition to new regulatory requirements in the EU and the U.S. (think Breakthrough Devices and new CMS reimbursement changes), medical device and diagnostics companies are facing greater demands from many other stakeholders. Value-based data is critical to satisfy questions from price-sensitive public healthcare systems who need to fully understand the long-term benefits of a medical device on patient care and the impact on country medical budget financial management.
References
Maria Shepherd has more than 20 years of leadership experience in medical device/life-science marketing in small startups and top-tier companies. After her industry career, including her role as vice president of marketing for Oridion Medical, where she boosted the company valuation prior to its acquisition by Medtronic, director of marketing for Philips Medical, and senior management roles at Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing and business strategy and innovation research for the medical device industry. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd has taught marketing and product development courses, speaks regularly at medtech conferences, and can be reached at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.
Table 1: Estimated number of new cancer cases and deaths from cancer in 2021 (by type) in the United States.2
Why This Is Important
There are so many medical devices critical to the treatment of cancer. According to the World Health Organization, capital equipment (e.g., scopes, electrocardiography, infusion pumps, MRI, etc.) are vital tools in cancer management. So are laboratory diagnostics and pathology equipment, surgical equipment, PPE, shielding and radiation protection, imaging devices, medical furniture (like beds and IV poles), and of course, single-use medical devices. Medications such as chemotherapy and biosimilars, for those who can afford them, are also needed in the fight against cancer.
The Impact of COVID on Cancer
Experts are still estimating the extent of the COVID-19 pandemic’s impact around the world. Most agree, however, delays in diagnosis and treatment, patient fears of contracting COVID at a treatment facility, difficulties in gaining access to healthcare facilities due to closures or gatekeepers, and/or delayed or reduced access to screening programs are expected to cause a short-term decrease in reported cancer incidence. Further, it is predicted this period will be followed by an increase in late-stage diagnoses and cancer mortality in some areas of the world.
COVID notwithstanding, data are available for 2020. There were an approximated 19.3 million new diagnoses of cancer and almost 10 million cancer deaths across the globe in 2020. For men and women combined, approximately 50 percent of all cancer cases and 58.3 percent of cancer deaths were assessed to have occurred in Asia in 2020. This aligns with population estimates—an estimated 59.5 percent of the global population resides in that region. Europe reported 22.8 percent of total cancer cases and 19.6 percent of cancer deaths. These numbers do not align with population estimates in Europe—9.7 percent of the global population. In North America, the incidence is 20.9 percent with 14.2 percent of deaths worldwide (Table 2). Sadly, the percentage of cancer deaths in Asia (58.3 percent, as noted above) and Africa (7.2 percent) are greater than the incidence (49.3 percent and 5.7 percent, respectively), likely caused by the different types of cancer experienced there and higher case fatality rates in many of these underserved regions. For both sexes combined, the top 10 cancers account for >60 percent of the newly diagnosed cancer cases and >70 percent of cancer deaths.4
Table 2: Global deaths from cancer by region in 2020.4
What Will Cancer Look Like in 2040?
Globally, a projected 28.4 million new cancer cases are forecasted for 2040, a 47 percent increase from the 19.3 million cases in 2020, assuming the national rates estimated in 2020 remain constant. This projection is based on the growth and aging of the population, and may be further worsened by the rising prevalence of risk factors in many areas of the world. Many countries are experiencing a marked increase in the prevalence of known cancer risk factors that prevail in high-income western countries (e.g., smoking, poor diet, obesity, and physical inactivity).5 Data shows a shift is occurring in the incidence of poverty and infection-related cancers (e.g., liver, cervix, and stomach) with cancers consistently seen in developed countries (e.g., breast, colorectum, lung, and prostate). If there are increases in the incidence of these “developed world” cancers, it is expected mortality rates will also increase, as has been observed for breast and colorectal cancer.6
A Strategic Opportunity
According to McKinsey, the oncology therapeutics market sold $143 billion in pharmaceuticals in 2019—around 20 percent of global pharmaceutical sales.7 Analyst consensus forecasts suggest a strong 12 percent CAGR with global oncology medication sales forecast projected to reach $250 billion by 2024. Country economies play a big role in determining which patients get the gold standard of care. For example, a recent European study shows differences in non-Hodgkin lymphoma five-year survival rates.8 In Northern Europe, survival rates were 63 percent while just reaching 50 percent in Eastern Europe. There is also an outcomes gap in 10-year survival statistics for breast cancer—76 percent in Northern Europe compared to 65 percent in Eastern Europe. On the other side of the planet, in China, outcomes have considerably improved for cancer statistics. The five-year survival rate for all cancers combined was approximately 40 percent for Chinese patients who were diagnosed in 2013—a significant increase from the 30 percent of Chinese patients diagnosed in 2003.9
Adjust Strategies
A very small number of highly successful products signifies a top-heavy share of the oncology market. The blockbusters are the first place to look for opportunities in medical devices. The blockbusters are Keytruda, Revlimid, OPDIVO, Avastin, Rituzxan, Herceptin, and Imbruvica. The top seven drugs are indicated for patients with metastatic melanoma, multiple myeloma, metastatic non-small cell lung cancer, metastatic carcinoma of the colon or rectum, non-Hodgkin's lymphoma, adjuvant or metastatic breast cancer, and metastatic gastric cancer and chronic lymphocytic leukemia, respectively.10 There are 28 other indications for blockbusters between $1 billion and $5 billion, another place to look for opportunity.
The Medi-Vantage Perspective
A large segment of our research is outside the U.S. to examine market opportunities for specific products. There are barriers and opportunities outside of the U.S. that need to be examined before dipping a toe in an OUS market. In addition to new regulatory requirements in the EU and the U.S. (think Breakthrough Devices and new CMS reimbursement changes), medical device and diagnostics companies are facing greater demands from many other stakeholders. Value-based data is critical to satisfy questions from price-sensitive public healthcare systems who need to fully understand the long-term benefits of a medical device on patient care and the impact on country medical budget financial management.
References
- bit.ly/mpo210901
- bit.ly/mpo210902
- bit.ly/mpo210903
- bit.ly/mpo210904
- Bray F. Transitions in human development and the global cancer burden. In: Stewart BW, Wild CP, eds. World Cancer Report 2014. WHO Press; 2014:42-55
- bit.ly/mpo210906
- bit.ly/mpo210907
- Is Europe doing better in cancer care since the 90th?: The latest findings from the EUROCARE-5 study, European Cancer Congress, Vienna, Austria, September 25–29, 2015, eurocare.it. Accessed July 30, 2021
- “New BEGINNINGS.” Alternative Medicine, no. 24, InnoVision Health Media, Inc., Sept. 2015, p. 44.
- bit.ly/mpo210910
Maria Shepherd has more than 20 years of leadership experience in medical device/life-science marketing in small startups and top-tier companies. After her industry career, including her role as vice president of marketing for Oridion Medical, where she boosted the company valuation prior to its acquisition by Medtronic, director of marketing for Philips Medical, and senior management roles at Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing and business strategy and innovation research for the medical device industry. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd has taught marketing and product development courses, speaks regularly at medtech conferences, and can be reached at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.
