Paul Thomen

Thursday, 21 February 2013

US, Canada & Australia Prostate Cancer Drug Forecast and Market Analysis to 2022

GlobalData has released its new Country report, “PharmaPoint: Prostate Cancer – US, Canada & Australia Drug Forecast and Market Analysis to 2022″. The recent approvals of second-line metastatic castration-resistant prostate cancer (mCRPC) therapies like J&J’s Zytiga (abiraterone acetate) and Medivation/Astellas’ Xtandi (enzalutamide) will drive strong market growth over the next decade. These safe and orally administered treatments will provide safety and convenience benefits over the current standard of care, chemotherapy with docetaxel, while prolonging the overall survival of patients with mCRPC. The December 12, 2012 FDA approval of Zytiga for the added indication of chemotherapy-naïve mCRPC marks the onset of a new treatment paradigm for the disease, in which chemotherapy is relegated to second-line therapy and beyond. For patients with earlier-stage prostate cancer, androgen deprivation therapy with LHRH agonists and first-generation antiandrogens remains the standard of care for suppressing testosterone levels and temporarily controlling the disease.

US prescribers widely use routine PSA screening to diagnose prostate cancer, as well as a DRE. GlobalData’s primary research shows that the majority of patients treated by urologists and medical oncologists in the US in 2011 were diagnosed or monitored using PSA screening. The diagnosis is confirmed and the cancer is staged following a TRUS-guided multiple-core needle biopsy, and any metastases are diagnosed using a bone scan or Computed Tomography (CT) scan (NCCN, 2012). Most prescribers surveyed intend to decrease their use of routine PSA screening to diagnose prostate cancer in asymptomatic patients in response to the recent USPSTF recommendation against it (see Section 5.2.2). While GlobalData predicts that the use of routine PSA screening will slightly decrease, we still believe that it will be the primary tool used in the diagnosis of prostate cancer over the forecast period, as there are currently no better, cost-effective options available.

In Canada, prostate cancer is diagnosed following an abnormal DRE, elevated PSA levels detected during routine screening, or a patients’ presentation with symptoms that leads to either of these tests. A suspected diagnosis of prostate cancer is confirmed by TRUS-guided multiple core needle biopsies, and bone metastases are detected using a CT scan or bone scan. The uptake of routine PSA screening has been high in Canada, but some Canadian physicians surveyed by GlobalData reported that they plan to decrease their use of routine screening in response to the recent USPSTF recommendation against it (Baade et al., 2009).

In Australia, prostate cancer is diagnosed following a patient’s presentation with symptoms, elevated PSA levels as a result of routine screening, or an abnormal DRE. The diagnosis is confirmed after multiple core needle biopsies or TRUS, and bone metastases are detected by CT or bone scan. Routine PSA screening is more commonly used in Australia compared with the 5EU, but less frequently than in the US (Baade et al., 2009).


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