The Impact of New Treatment Approvals in Oncology on Relative Survival Rates for EU Patients

The Cancer Treatment Landscape in the EU 1995-2014

Between 1995 and 2014, the EMA approved 59 non-generic, non-biosimilar medicines to treat high incidence cancer types: lung, breast, colon, prostate, melanoma, lymphoma, and ovarian. During this period, cancer treatments resulted in meaningful gains in the relative survival rate. For those cancers where data was available starting in 1995, the highest increase in survival rate was in prostate cancer (14.9%), followed by colon (10.5%), breast (6.2%), lung (5.1%), and ovarian (4.8%). For lymphoma and melanoma, data was available beginning in 2000. Lymphoma patients experienced a relative survival rate gain of 6.9% over 14 years, while melanoma only saw a 2.4% gain.

Gains in relative survival were moderated by the average level of survival. For example, melanoma’s average survival rate was already high, with 87.3% survival in 2000-2004 vs. 89.8% survival in 2010-2014. Colon cancer, by contrast, had a 52.8% survival rate in 1995-1999 which increased to 63.3% in 2000-2014.

Improvements also occurred in primary endpoints that are key in defining how patients respond to treatment, including progression-free survival and disease-free survival. These and other endpoints have been linked to and demonstrated to be good surrogates for overall survival.

The improvements in relative survival rates were driven by the research and innovation that reached the market during this timeframe, including small molecules such as kinase inhibitors and cancer immunotherapy.

The 59 cancer treatments identified that the EMA approved from 1995 to 2014 were not evenly distributed across cancer types. For example, during this period the EMA approved 12 new drugs for lung cancer, but only four for melanoma. This disparity in innovation seems to be driven by the difference in epidemiology, as well as other factors. For example, in the case of a highly complex disease like melanoma, much of the innovation has not demonstrated survival improvement for patients.

Connecting New Product Approvals with Relative Survival Rates

Our experts conducted an analysis to understand the relationship between the number of new cancer treatment approvals and the five-year relative survival for EU patients. They used global surveillance data for Europe from the Concord 2 and Concord 3 global surveillance studies. The list of approved branded, authorized, non-generic, non-biosimilar medicines from the EMA came from an online list of European public assessment reports. The selected countries included in the study were EU members for the entire period from 1995 to 2014.

The relative survival across all countries was calculated by averaging the individual country survival rates together with an adjustment for population size. For example, Germany’s population of 80 million counted more towards the average than Iceland’s population of 350,000.

The average survival rate across the EU was then regressed by the number of approved drugs at a given period.

Impact of Approved Treatments on Survival

The analysis suggested a significant relationship between the number of approved drugs and the relative survival rate for two cancers: lung (p = .0280) and colon (p = .0231). For the other cancers, the link between the approved drugs and relative survival was not statistically significant. This disparity may be due to the fact that the majority of the approved drugs targeted cancers with high epidemiology numbers which has propelled innovation. 20% of the 59 new medicines were for lung cancer.

The meaningful findings for lung and colon cancer warrant further analysis on how the breadth and diversity of approved cancer treatments positively impact patient survival.

Learn More About the Impact of New Treatment Approvals in Oncology

Cumulative effort over the past two decades in developing treatments for solid tumors has impacted millions of lives. Specifically, our poster shows that a coordinated effort and investment from pharma companies in specific pathologies with high incidence (such as lung and colon cancer) has improved patient survival.

Our analysis suggests that pharma companies can shift the treatment landscape and address the unmet needs of patients with less prevalent or more difficult to treat oncology pathologies, such as melanoma, by applying the same effort and investment that has been applied to the more prevalent cancer types.

To learn more, make sure you download the poster “Treatment Approvals in Oncology and Relationship With Improvement in 5-Year Relative Survival for Cancer Patients Europe” presented at ISPOR Europe 2023.

References

• Global Surveillance of Cancer Survival 1995–2009 … – the lancet. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62038-9/fulltext (Accessed: 30 October 2023).
• Global surveillance of trends in Cancer survival: Analysis of … Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879496/ (Accessed: 30 October 2023).
• HRABOVSZKI G. Download medicine data – European Medicines Agency. European Medicines Agency. Published October 19, 2018. https://www.ema.europa.eu/en/medicines/download-medicine-data