But there’s also good news. Really, really good news: there are far more medications—and genuinely innovative medications—for treating cancer patients. In the past five years, 70 new oncology drugs have been approved for treatment of 20 different tumor types, according to IMS. These include the groundbreaking class of immunotherapy drugs that are extending the lives of patients with some of the deadliest forms of cancer, including advanced melanoma and the squamous form of non-small cell lung cancer.

“There’s been a tremendous boost in the number and nature of treatment options,” says Murray Aitken, Director of the IMS Institute. “We still have a long way to go, but we shouldn’t understate the significance of this current surge of innovation.”

There are certainly more new medications to come: the industry’s pipeline of oncology drugs has expanded by more than 60% in the past decade, with more than 500 companies now working in the field. In 2015, there were 586 cancer compounds in late-stage clinical development. And the ten largest sellers of oncology drugs have 130 candidates in their late-stage pipelines.

These new medicines are also making it to market more quickly. In 2015, the median time from patent filing to FDA approval was 9.5 years in the U.S., down from 10.25 in 2013. A few recent drugs have sped through the process in just 4 years, thanks in part to the FDA’s Breakthrough Therapy designation, which expedites approval for groundbreaking treatments.

Aitken notes that, while incredibly positive, this surge in new medications, has introduced some new complexity and strain in treating patients. “Clearly the rising cost of these drugs to health systems puts pressure on budgets,” he notes. “The infrastructure to handle the diagnostic cost, and the administering of treatments, all of that is under some stress.”

Indeed, these new medications, which are expensive and being consumed both more widely and for longer periods of time, are the main driver for the climbing expense of cancer care. Globally, oncology treatment cost 11.5% more in 2015 than they did last year, at $107 billion. IMS expects that figure to top $150 billion by 2020.

These costs are increasingly concentrated in the U.S., which in 2015 accounted for 46% of the global oncology bill, up from 39% in 2011. The trend reflects the availability and accessibility of new medications, which remains limited in much of the world. More new oncology drugs are available and reimbursed in the U.S. than any other market.

A few other trends highlighted by the IMS report:

• Hospitals are particularly expensive. Administration of the same cancer drug typically costs twice as much in a hospital as it does it a physician’s office.
• Cancer treatment at the pharmacy. An increasing number of oncology drugs are available as oral, rather than injectable, medications.
• The rise of the rebate. While patients are shouldering more of the cost of their cancer treatment, drug manufacturers are also increasingly offering discounts to help offset those costs. A quarter of cancer drug prescriptions filled by patients with commercial insurance, were partly covered by a coupon, up from 5% in 2011.