When it comes to diseases and disorders that need the immediate attention of drug developers, there's a good chance you'll find cancer at or very near the top of the list.

Within the United States, cancer is the second leading cause of death, behind only heart disease. The scary thing is that according to the World Health Organization, the incidence rate of cancer is expected to rise over the next two decades from an estimated 14 million diagnoses per year now to 22 million diagnoses. This means consumers need choices now to help what could be a rising tide of cancer diagnoses in the future.

capsule and cancer cell

Image source: Getty Images.

Big pharma turns its focus to cancer
To this end, the good news is that pharmaceutical companies are listening loud and clear. Oncology drug development is a cornerstone to the success of quite a few pharmaceutical companies, not only because it'll keep them profitable, but because it'll save lives and fund additional research into curing new types of cancers and other diseases.

According to the IMS Institute for Health Informatics, consumers and health-benefits providers spent $91 billion globally on cancer drugs in 2013, and this figure is expected to grow to well in excess of $100 billion in coming years.

Breast cancer cell. Source: National Cancer Institute, Wikimedia Commons.

Furthermore, based on data from GlobalData, aggregated by PMLiVE, the top 25 global pharmaceutical companies accounted for $88.9 billion in global oncology sales in 2013 (this includes generic drug sales as well). But, what's really interesting when you dig into the data is that three companies comprised about half of all cancer drug sales in 2013.

Who's not among the top 10 cancer drug developers in the world by sales? Some surprisingly big names, such as AbbVie, Biogen Idec, GlaxoSmithKline, Sanofi, and Pfizer. Of course, Pfizer's luck could change with the possible approval of palbociclib.

But, even more high-profile names are left out of the top three. Bristol-Myers Squibb, Merck, AstraZeneca, Eli Lilly, Johnson & Johnson, and Celgene make up spots nine through four. Combined, these six companies were responsible for $24.4 billion in cancer drug sales in 2013. Yet, the No. 1 company on the list sold more oncology drugs than these six companies combined!

Three companies responsible for half of all global cancer drug sales
Here's a breakdown of the three companies that controlled roughly half of all cancer drug sales in 2013.

No. 3: Novartis (NYSE:NVS): $8.6 billion in total oncology drug sales
Novartis' appearance on this list probably shouldn't be a huge surprise as it's been a cancer drug powerhouse for quite some time. In 2013, it counted on chronic myeloid leukemia drug Gleevec (known as Glivec overseas) for nearly $4.7 billion in global sales, but also relied on Sandostatin (for acromegaly) and Afinitor (breast cancer) for $1.6 billion and $1.3 billion in global sales.

What sets Novartis apart is its deep pipeline of phase 2 and 3 cancer drugs as well as its announced deal with GlaxoSmithKline to boost its cancer drug portfolio and pipeline. Novartis will be sending its vaccines business to GlaxoSmithKline and setting up a joint-venture for its consumer health products segment in exchange for Glaxo's oncology program. The deal nets Glaxo some much-needed cash (just shy of $8 billion when the swap is complete), but more importantly, it establishes Novartis as a dominant cancer drug player. Glaxo's melanoma drugs mekinist and tafinlar will be a perfect complement to its growing portfolio of products designed to improve patients' quality of life.

Novartis' pipeline also currently has more than a dozen experimental oncology drugs in mid- or late-stage studies, meaning multiple new catalysts and life-improving cancer drugs could be right around the corner.

No. 2: Amgen (NASDAQ:AMGN): $11.9 billion in total oncology drug sales
Surprised by Amgen's ranking? Don't be, as the company has a long history of supportive cancer care therapies. Neulasta (known as Neupogen overseas), is a roughly $6 billion per year drug designed to stimulate white blood cell growth for patients currently undergoing chemotherapy. Aranesp is responsible for another $2 billion in annual sales and helps treat anemia in patients undergoing chemotherapy and in kidney failure. And of course, we can't forget multiple myeloma drug Kyprolis, which was acquired when Amgen purchased Onyx Pharmaceuticals for a cool $10.4 billion.

Looking ahead, Amgen has a healthy lineup of new cancer drug hopefuls. Its immunotherapy product talimogene laherparepvec, or T-Vec, would appear to me to have a better than 50-50 shot at approval in the U.S. and abroad as a treatment for metastatic melanoma. T-Vec could also demonstrate plenty of other applications as a combo therapy beyond just skin cancer.

Amgen is also trying to push Kyprolis into a second-line indication for multiple myeloma. The drug currently is approved for third-line or above, and mixed data between its ASPIRE and FOCUS studies doesn't indicate which way U.S. and EU regulators will rule, either. Either way, expect Amgen to remain a key oncology player for the time being.

No. 1: Roche (OTC:RHHBY): $25.4 billion in total oncology drug sales
Sitting atop the list of annual cancer drug sales is Swiss-based Roche, which generated more than one quarter of all oncology drug sales in 2013 by itself! But, should we really be surprised with Roche currently possessing a clinical pipeline that's more than 100 trials deep, of which around 60 of those studies are for cancer indications? I'm not shocked one bit!  

In 2013, four of Roche's top-five selling pharmaceutical products were geared at fighting cancer and improving lives. These include MabThera/Rituxan for non-Hodgkin's lymphoma ($8.1 billion), Avastin, which can be used for colorectal, breast, kidney, lung, and a host of other cancer types ($7.3 billion), Herceptin, a commonly-used therapy to treat HER2-positive breast cancer ($7.1 billion), and Xeloda for colorectal, colon, or breast cancer ($1.8 billion). Note that my own currency-translated figures may add up to a bit more than PMLiVE report's data, which tried to remove currency fluctuations from their calculations.

Roche has made it its focus to develop new and innovative cancer drugs, as well as expand the possible label indications for its existing drugs. For example, Perjeta is an extremely intriguing new cancer compound for HER2-positive breast cancer patients. When combined with Herceptin and docetaxel in the CLEOPATRA trial for advanced HER2-positive breast cancer patients, it led to a median overall survival of 56.5 months. This was nearly a 16-month improvement relative to the group that didn't receive Perjeta, and it's the longest reported period of median overall survival in any advanced cancer study -- ever!

Long story short, Roche is an absolute powerhouse when it comes to cancer drug innovation, and that could be good news for investors, and great news for those unfortunate enough to be afflicted by cancer.

This article represents the opinion of the writer, who may disagree with the “official” recommendation position of a Motley Fool premium advisory service. We’re motley! Questioning an investing thesis -- even one of our own -- helps us all think critically about investing and make decisions that help us become smarter, happier, and richer.