Consumption and expenditure on monoclonal antibodies and Fc-fusion protein biologic medicines in Asia-Pacific regions.

Abstract

Aim/Objective: Monoclonal antibody (mAb) and Fc-fusion protein (FcP) are highly effective therapeutic biologics. However, high costs can impede their affordability and accessibility. We aimed to analyze the consumption and expenditure trends in 15 Asia-Pacific regions (APAC) and three benchmark countries (UK, Canada, and USA). Methods: We analysed 448 biologics products from IQVIA-MIDAS database between 2010 and 2020, 89% of which were indicated for cancer or autoimmune diseases. We classified them according to their targets of action: tumor necrosis factor (TNF, N=121), interleukin (IL, N=42), lymphocyte (N=91), programme death/ligand receptor (PD, N=15), endothelial growth factor (EGF, N=107) and tumor cell or selective immunosuppressants (N=21). For each year, we used standard units sold (SU per 1000 population) and manufacture level price (2017 US dollars) to evaluate the consumption (accessibility) and expenditure (affordability). Consumption and expenditure increase over time were estimated using compound annual growth rate (CAGR). Results: In 2020, TNF accounted for the major market share in the three benchmark countries (41-57%) while EGF was predominantly used in APAC (15-60%). Between 2010 and 2020, there was increasing consumption trend for all regions’ product classes with the greatest CAGR observed for PD (102%), followed by IL (68%). The average increasing rate of biologic medicines expenditure in lower-middle-income regions (21%) was greater than upper-middle (14%), high-income regions (13%) and benchmark countries (12%). Despite this, consumption of biologics was lower in lower-middle-income regions (0.47 SU per 1000 population) than in upper-middle-income regions (2.86), high-income regions (52.92) and benchmark countries (113.09). Consumption was significantly correlated with 2017 GDP per capita (Spearman’s coefficient = 0.8; p< 0.001). Conclusion: The uptake and healthcare spending on mAb and FcP biologics significantly increased in the last 11 years, however the accessibility and affordability of these medicines remain unequal and largely associated with the country income.