Sales of breast cancer treatments are set to increase by an average of 5.8% a year in nine major markets, increasing from a value of $9.8 billion in 2013 to $18.2 billion by 2023, according to new forecasts from IMS Health.

The highest-growing segment of the market is the HER2-positive subtype, where sales are set to show a compound annual growth rate (CAGR) of 7.6% over the period, rising from $5.6 billion to $12.5 billion, while the triple negative segment will increase at a CAGR of 4.6%, from $470 million o $760 million, it says.

Worldwide, breast cancer is the most commonly-diagnosed type of cancer in women. In 2012, there were 1.6 million new cases and 500,000 deaths were reported, making it also the leading cause of cancer death.

In the nine countries covered by the IMS study – US, France, Germany, Italy, Spain, UK, Japan, China and Brazil – 1.2 million patients received drug treatment in 2013, and this number is set to increase, by a CAGR of 1.4%, to 1.4 million patients in 2023. In the five European Union (EU) nations covered by the study – France, Germany, Italy, Spain and the UK – numbers of drug-treated patients will rise from 448,000 in 2013 to 495,000 by 2023, at a CAGR of 0.9%, says IMS. 

The market size for the five EU countries is set to increase from $3.3 billion in 2013 to $5.1 billion by 2023 (3.9% CAGR). The highest growth will be seen for the HER2 segment, rising from $1.9 billion to $3.2 billion (4.7% CAGR), while the triple-negative segment will grow at a CAGR of 4.3%, from $180 million to $280 million.

In 2014, the breast cancer market stands at a crossroads, says IMS. Over the past 40 years, treatment has been revolutionised by two drugs – tamoxifen for hormone-positive breast cancer and Roche’s Herceptin (trastuzumab) for the HER2-positive subtype. Herceptin still leads the market, but its dominance will end soon, with biosimilars and new-generation agents now on the horizon.

In 2013, the products of three manufacturers – Roche, Novartis and AstraZeneca - accounted for more than 70% of the total nine-country market. Also, the 10 top-selling products represented 73% of sales both in the nine markets surveyed overall and also in the five EU nations.

The top sellers across the nine markets, in order of 2013 revenues, are: Roche’s Herceptin; Novartis’ Afinitor (everolimus); AstraZeneca’s Faslodex (fulvestrant); Roche’s Avastin (bevacizumab); Novartis’ Femara (letrozole); Roche’s Perjeta (pertuzumab); Celgene’s Abraxane (nab-paclitaxel); Eisai’s Halaven (eribulin); GlaxoSmithKline’s Tyverb/Tykerb (lapatinib); and Roche’s Kadcyla (ado-trastuzumab emtansine).