GlobalData expects the chronic lymphocytic leukaemia (CLL) market in the US, France, Germany, Italy, Spain, the UK, and Canada (7MM) to experience modest expansion from $7.7bn in 2017 to $9.3bn in 2027, with a compound annual growth rate (CAGR) of 1.9%.

The modest growth in the 7MM will be driven primarily by the ageing population, which will increase CLL incident cases and thus increase the treatable patient population. Other contributing factors that will act as barriers to growth are the lack of agents in the late-stage pipeline with novel mechanisms of action and the erosion of Roche’s sales of Rituxan/MabThera (rituximab) by biosimilars. Most sales in the 7MM in 2027 will come from small molecule inhibitors (55.1%), followed by antibodies (38.7%) and chemotherapies (6.3%), with limited changes in these proportions compared to 2017 sales.

Targeted drugs such as AbbVie/Johnson & Johnson’s BTK inhibitor Imbruvica (ibrutinib) have already saturated the CLL market at premium prices, leaving little room for growth. With a CAGR of 29.4% by 2027 across the 7MM, AbbVie/Roche’s BCL-2 blocker Venclexta (venetoclax) is anticipated to experience the largest increase in sales among the small molecule inhibitors that are either already marketed or in late-stage development. This will predominantly be driven by Venclexta’s label expansion during the forecast period into frontline CLL therapy in combination with Roche’s Gazyva (obinutuzumab) or with Imbruvica.

In contrast, GlobalData expects reduced sales in the 7MM of Gilead’s Zydelig (idelalisib) and Imbruvica, with downward CAGRs by 2027 of 25% and 9.6%, respectively. Zydelig sales will mainly be replaced by Venclexta, while Imbruvica sales will be diminished by the arrival of ibrutinib generics following patent expiry in 2026. Nonetheless, given Imbruvica’s current position as a well-established standard of care, it will remain a significant player in the future CLL treatment landscape even as Venclexta begins to share its success.

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By GlobalData