Temporal trends in oncology drug revenue among the world’s major pharmaceutical companies: A 2010-2019 cohort study.
Authors: Meyers Daniel E. , Meyers Benjamin S. , Chisamore Timothy M. , Wright Kristin , Gyawali Bishal , Prasad Vinay , Sullivan Richard , Booth Christopher M. 
Published: June 2021

6505 Background: In the past decade there has been a 70% increase in the number of clinical trials for cancer drugs. During this time, there has also been a substantial increase in the price of cancer drugs. It is unclear how these trends have changed the revenue landscape of major pharmaceutical companies. In this study we characterize temporal trends in cancer drug revenue relative to non-cancer drugs. Methods: This retrospective cohort study used publicly available global sales data from the 10 pharmaceutical companies with the highest annual revenue in 2019; Abbvie (AB), AstraZeneca (AZ), Bristol Myers Squibb (BMS), GlaxoSmithKline (GSK), Johnson & Johnson (JJ), Merck (M), Novartis (N), Pfizer (P), Roche (R) and Sanofi (S). We quantified the contribution of cancer drugs to net revenue for each company from 2010 – 2019 using consolidated annual financial reports (i.e. 10-K or 20-F forms). Cancer drugs were defined as those with an FDA-approved indication for anti-cancer effect or supportive care. All sales data were converted to USD and adjusted for global inflation. Trends in the percentage of company revenues accounted for by cancer drugs were assessed with the Kendall-Mann test. P-values were adjusted for multiple hypothesis testing using the Benjamini-Hochberg method. Results: During 2010-2019, cumulative annual revenue generated from cancer drugs in our cohort of companies (n = 10) increased by 96%, from $52.8 billion to $103.5 billion. The cumulative revenue from non-oncology drugs decreased by 19%, from $342.5 billion to $276.9 billion. The proportion of total revenue generated from cancer drugs grew over time; from 13% in 2010 to 27% in 2019 (p < 0.001). During 2015-2019, annual revenue for the study cohort grew by 12%: from $339.7 billion to $380.4 billion. During this period non-oncology revenues remained stagnant (mean $278.9 billion, range 276.9 – 281.9), while oncology revenues grew by 66%; from $61.4 billion to $103.5 billion. Six companies (AB, AZ, BMS, JJ, N, and P) saw substantial increases in the proportion of revenue attributable to cancer drugs. R had both the highest net revenue ($23.9 billion), and highest proportion of revenue (57%) from cancer drugs in 2010 among the cohort, similar to 2019 ($27.7 billion, 57%; p = 0.37). While not reaching significance over the total study period, M saw increases in oncology revenue from $1.5 billion in 2015 to $12.3 billion in 2019 (4% to 30% of total revenue); driven almost exclusively by sales of Pembrolizumab. Conclusions: Amongst the world’s largest pharmaceutical companies, sales revenue from cancer drugs have increased by 96% over the past decade, while revenues from non-cancer drugs have decreased by 19%. Revenues from cancer drugs accounted for 27% of company revenues in 2019. Further work is needed to understand if this massive increase in sales revenues has translated into proportional improvements in patient and population outcomes.