OBJECTIVES: This study aimed to examine launches of new cancer drugs around the globe over the past 3 decades and country characteristics associated with launch and launch delay.

METHODS: We identified new cancer drug launches in 1990-2022 from a pharmaceutical intelligence database of all commercially developed drugs. We first examined the trends in the annual number of new cancer drug launches in a country by its income level. We then estimated the associations between the number of new cancer drug launches in a country and the country’s health expenditure per capita, cancer incidence, number of physicians per population, population size, and Gini index in a linear regression. In a Cox regression with shared frailty, we estimated the associations between launch delay of a drug in a country with the above-mentioned country characteristics.

RESULTS: A total of 515 cancer drugs were launched for the first time globally between 1990 and 2022. The average number of launches in a country in a year increased from 0.5 in 1990 to 8.7 in 2022 among high-income countries, from 0.1 to 1.5 among upper-middle-income countries, from 0.02 to 0.3 among lower-middle-income countries, and from 0 to 0.07 among low-income countries. Higher health expenditure per capita (adjusted difference [AD]: 4.59; P=0.001), larger population (AD: 0.06; P=0.003), higher cancer incidence (AD: 0.06; P<0.001), and fewer physicians per population (AD: -3.17; P=0.004) were associated with more launches in a country. Higher health expenditure (hazard ratio [HR]: 1.14; P<0.001), larger population (HR: 1.003; P<0.001), higher Gini index (HR: 1.03; P=0.007), higher cancer incidence (HR: 1.007; P<0.001), and fewer physicians (HR: 0.81; P=0.015) were associated with shorter launch delay in a country.

CONCLUSIONS: This research reveals significant disparity in the launch and launch delay of new cancer drugs across countries. This disparity may have contributed to the disparity in cancer outcomes around the globe.