彭博社丨沙利文：中国在全球PD-1/L1市场的占比将会逐渐攀升

为什么PD-1药物在中国相对便宜？根据沙利文的预测，到2030年，中国在全球PD-1市场的市场份额将逐渐攀升，为什么？帕博利珠单抗没有进医保且价格很高，但在中国依旧还是卖得很好的原因是什么？

 弗若斯特沙利文（Frost & Sullivan，以下简称“沙利文”）大中华区生命科学事业部项目经理王禺接受  彭博社  采访时表示，   中国的PD-1/L1药物价格远低于美国的原因包括：1）人均消费能力本身是低于美国的；2）中国患者人群远大于美国，药企们在考虑定价时也会为了渗透更大比例的患者而选择稍微低一些的定价；3）药品进入中国医保时会需要通过医保谈判进行降价。

 王禺指出，在全球层面，尤其是发达地区，PD-1/L1的渗透已到一个较高水平，剩余的可渗透空间有限；而在中国，癌症人群中仍然有较大的可供PD-1/L1药物渗透的空间，所以中国的PD-1/L1市场占全球的比例会逐渐攀升。

此外，帕博利珠单抗在中国卖得很好的主要的原因还是品牌好，在中国大众潜意识中，“进口产品”会与“更好的品质”相挂钩，且对于中国人来说，给家人花钱治病这件事是义不容辞的，各个家庭往往愿意花更多钱来购买进口药品。

 *点击文末“阅读原文”即可阅读完整版报道

Bloomberg

Q

 Why are PD-1 drugs much cheaper in China than the US and why are there more options in China?

 a) There are a lot of reasons why PD-1/L1 drugs are cheaper in China. Generally speaking, drugs are intrinsically cheaper in China due to lower affordability of the general public. The annual per capita disposable income in China is just over 5 thousand USD compared to over 50 thousand in the US. It is a ten times difference.

 b) Furthermore, the patient pool is absolutely huge in China, for all these PD-1 companies, penetrating a higher percentage of patients but pricing products cheaper is financially more appealing than pricing products more expensive but penetrating a lower percentage of patients.

 c) Lastly, over 95% of Chinese citizens are covered by the national basic medical insurance. The basic insurance reimburses on average 70% of the expenses for drugs in Class B category, which four Chinese PD-1 drugs are in. Meanwhile, the national insurance fund is under heavy burden and controlling the drug price is a must. Therefore, PD-1 drugs that entered the national reimbursement drug list all had surprisingly large price drops during their negotiations with the insurance committee.

 d) For your second question, there is no clear answer to that. Corporations determine their product pipelines based on their own strategic reasons. Keytruda has been a promising product since its clinical trials and has been a hot-selling product since its commercialization in 2014. My guess is that all these Chinese corporations saw that 10 years ago and considered PD-1 a great opportunity.

Q

 Frost & Sullivan estimates the market share of China in the global PD-1 market will rise in the years towards 2030. Why is that the case?

 

 a) For the global market, one thing worth mentioning is that the PD-1 markets in developed regions takes up the major shares of the global PD-1 market. It is known that Keytruda and Opdivo’s key patent will expire in 2028 and a bunch of generic drugs might flood in with a much lower price. At the same time, the penetration of PD-1 drugs in developed regions is already relatively high and the room for further penetration is less broad compared to that in China around 2028. With lower price and relatively stable selling quantity, the market size in terms of revenue is forecasted to start sliding around 2028.

 b) For China, although there are a lot of players in this market, there is still room for further penetration. The price is already low and can be expected to stay steady for many years. Therefore, the market size in terms of revenue is forecasted to continue to rise, leading to a growth in China’s share in the far future.

 c) In summary, the China market share is growing because China PD-1 market has a larger room for further penetration compared to markets in developed countries.

Q

 Keytruda retains about a fifth of the PD-1 market share today in China according to PDB's sample hospital data, despite no insurance coverage and relatively high price in the country, how could they achieve that?

 a) Brand name: the MSD brand name as well as the Keytruda brand is convenient for penetration in hospitals. “Imported Products” are often associated with “better quality” in the awareness of the general public.

 b) Willingness to pay: this is more of my personal view. In terms of culture, the bond within a family is very strong in China. A family can put in everything or even borrow a loan for a sick family member. To be more specific, even though the disposable income is low in China, families in China are often willing to spend a relatively high percentage of their disposable income to pay a premium price for drugs with a better brand name.

*本采访刊登于 彭博社  ，记者为洪锦珊   ，原文标题为：《   China Drug-Price Negotiations Offers Glimpse Into Future for Companies in US   》   。

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