Myeloma Outlook 2024: Revolution in Treatment to Drive Global Market to $33 Billion in 2030
Multiple myeloma is the third-largest blood cancer by patient numbers globally, after lymphoma and leukemia, including afflicting 9.7 individuals per 100,000 each year in the US. Incidence is on a rising trend, with variable rates across regions. The rate is higher in richer countries, but this is likely driven by better diagnostics and capacity, further boosted by the availability of multiple drugs.
Innovation in treatment has been intense, with patients living over 10 years vs. 3.5 years in the late 1990s. This has driven up drug sales, with a further 40% jump expected by 2030 vs. 2023, based on our scenario analysis. Almost half the market in 2030 will be accounted for by J&J-Genmab’s Darzalex, followed by CAR-Ts, mostly divided between J&J’s Carvykti and Gilead-Arcellx’ anito-cel, while data from AstraZeneca are awaited. Several bispecific antibody hopefuls will rival J&J’s Tecvayli and Talvay. The market for small molecule drugs is being hit by generic entry.
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Key Research Topics
Bristol Myers Loses Myeloma Crown: Bristol Myers became the largest player in myeloma by sales, driven by Revlimid (lenalidomide) but it faces generic competition. Our scenario analysis suggests erosion of its US sales will be almost complete by 2026. Iberdomide and mezigdomide have potential to offer better efficacy or safety but won’t recoup lost sales.
J&J-Genmab’s Darzalex Dominance: Darzalex’s use in newly diagnosed patients can continue increasing. Another driver is Darzalex’s use as maintenance after induction, bringing it to $14.7 billion sales in 2030, based on our scenario analysis. This is 12% below consensus as we assume the US IRA may force a price cut for the newer Darzalex Faspro in 2029.
CAR-T Race Heats up: Engineered T-cells (CAR-Ts), made for each individual patient to target tumor cells, have shown extremely high efficacy in blood cancers, though with some serious side effects. J&J’s Carvykti leads Bristol’s Abecma due to its better efficacy. But our analysis suggests that from 2027, Carvykti will face stiff competition from Gilead-Arcellx’s anito-cel in earlier lines, with potentially similar revenue of just over $3 billion in 2030.
Bispecifics Add More Breakthroughs: Bispecific antibodies are off-the-shelf drugs that redirect T-cells to kill tumors. J&J’s Tecvayli sales are ramping up, aided by its efficacy and limited access to CAR-Ts. Our scenario analysis assumes Pfizer’s Elrexfio and Regeneron’s linvoseltamab will challenge Tecvayli, but that Tecvayli will remain the biggest seller in 2030.