Are Cancer Vaccines Worth the Cash?

Wednesday 17 April 2013, Amsterdam

Over a million new cases of cancer are diagnosed globally per year, and the disease burden is expected to rise as elderly populations grow across many countries and unhealthy lifestyles remain commonplace. However, cancer vaccines, the latest treatment option, may be restricted to the developed counties due to their high price, states a new report.

The new report explains that there is currently a high degree of uncertainty surrounding the pricing and reimbursement of cancer vaccines. Only prostate cancer vaccine Provenge is currently approved, and solely by the FDA.

The estimated annual cost of treatment with therapeutic cancer vaccines in the US is often in excess of US$50,000, reflective of the high costs associated with the manufacturing and logistics of vaccines, particularly in personalized vaccines. Medicare and major insurance companies have confirmed they will cover the cost of the on-label use of Provenge, and so it can be predicted that they will also cover all or some of the costs of other cancer vaccines approved in the future.

However, the cost-to-clinical-benefit is expected to be the major barrier in Europe, with authorities such as the National Institute for Health and Clinical Excellence demanding that a product proves its cost-effectiveness before it can be prescribed in large volumes, which is subsequently driving down the costs that companies charge for their vaccines.

Cancer vaccines are expensive to manufacture as they are derived from cellular material, and require tightly controlled and regulated processes to avoid contamination. Smaller companies have traditionally led the way in the development of cancer vaccines, but they often have limited resources with which to fund clinical trials and product development, particularly if the vaccine is intended to be used in combination with other therapies. With uncertainty surrounding the success rate of cancer vaccines and a high level of clinical trial failure, small companies may struggle to secure necessary funding, subsequently halting or canceling the development of a potential breakthrough vaccine.

It is likely that the cost of different cancer vaccines will vary substantially, based on the target population and type of vaccine, with ‘off-the-shelf’ vaccines anticipated to cost less than personalized vaccines, as standardizing and optimizing manufacturing processes could be utilized. The pipeline for therapeutic cancer vaccines currently boasts 265 vaccines in active development, targeting more than 16 major indications. However, over one third of cancer vaccines currently under development target the most commonly diagnosed cancers, as these large markets will drive pharmaceutical companies’ revenues, even if a vaccine demonstrates low market penetration. This focus on common cancers will likely drive the anticipated growth in the global vaccine market.

The therapeutic cancer vaccines market is anticipated to grow rapidly throughout the forecast period from an estimated US$590m in 2013 to approximately US$7.59 billion by 2019, driven primarily by the approval of up to 12 vaccines across seven indications. The US market is predicted to account for 96% of the total global therapeutic cancer vaccines market in 2013, decreasing slightly to 94% in 2019 with the approval of numerous vaccines in the EU and Japan, but remaining overwhelmingly dominant throughout the forecast period and into the foreseeable future.