Non-Hodgkin's Lymphoma Market Projected to Exceed $5 Billion by 2018

New treatments drive growth forecast.

Moderate growth is predicted for B-cell non-Hodgkin’s Lymphoma (NHL) treatment across 6 major markets, with an increase from $4.59 billion to $5.41 billion projected by 2018, according to a new report from research firm GlobalData.

The company predicts the global treatment paradigm in the relapsed/refractory setting to shift away from chemoimmunotherapy regimens due to the launch of targeted B-cell receptor inhibitors, ibrutinib (Imbruvica) and idelalisib (Zydelig).

“The US Food and Drug Administration gave the green light to Imbruvica for use in Rituxan-refractory mantle cell lymphoma (MCL) patients in November 2013. Meanwhile, Zydelig recently received approval for the treatment of relapsed/refractory follicular lymphoma patients who have received at least two prior therapies,” said Brooke Baker, PhD, GlobalData oncology and hematology senior analyst in a press release. “Imbruvica has set the bar for pricing in the NHL market with an annual cost of therapy (ACOT) calculated at approximately $133,000. On the other hand, Zydelig will be priced very competitively, at an average ACOT of around $87,000, in anticipation of its future combination with Roche’s Rituxan.”

Idelalisib is forecast to garner the highest overall revenue in NHL treatment across all indications, with projected sales up to $888 million by 2018, primarily as a result of a smaller patient population for ibrutinib.

The company notes that disease management for the largest B-cell NHL indications presently include multiple rounds of Rituxan-based chemotherapy. While this treatment can generate durable remissions to induction therapy, patients who relapse after the primary treatment have poor prognosis and high unmet needs, the report stated.

While the pipeline for B-cell NHL is currently limited, GlobalData said there are several game changing treatments recently approved or looming on the horizon. Promising pipeline agents predicted to have a significant impact on the treatment of relapsed/refractory patients are Pharmacyclics’/Janssen’s Imbruvica (approved for relapsed/refractory MCL patients in November 2013), Gilead’s Zydelig (approved for relapsed/refractory FL patients in July 2014), and Roche’s Gazyva, which will launch in 2015.

Additionally, GlobalData predicts that the market in France, Italy, Germany, Spain, and the United Kingdom to decrease from $1.66 billion to $1.53 billion by 2018. This anticipated shift is due to pricing limitations and competition from the generic bendamustine and the biosimilar rituximab, which are set to begin in 2014 and 2018, respectively.

“From 2017, we anticipate that Zydelig will also be utilized in combination with Rituxan, and the potential to combine with the gold-standard backbone therapy will further drive the drug’s uptake in this setting,” Dr. Baker said. “However, both Zydelig and Imbruvica’s opportunities for premium pricing will be limited in cost-conscious European countries, and this will limit revenue growth in these markets despite the strong uptake among patients.”