Expanding Market Access for Cancer Therapies in China

"Cancer is a complex disease, and, with increasing incidence and mortality, it is a major public health concern in China," according to a new paper published by The Economist Intelligence Unit (EIU). "The Chinese government’s 13th Five-Year Healthcare Plan for 2016-20 has prompted The Economist Intelligence Unit to re-evaluate the local cancer care market, which is evolving rapidly amid bold medical reforms." The EIU's paper, Cancer in China: Expanding market access for cancer therapies, explores "the market landscape in China and market-access initiatives of companies offering cancer treatments, to help pharmaceutical companies to understand how to better facilitate early and expanded access to this market."

The paper explains: "The availability of new and innovative cancer therapies in China lags behind that in other countries. Of 49 new cancer treatments that entered the market between 2010 and 2014, only six are available in China, compared with 41 in the US." Moreover, "Targeted therapies—a relatively new form of treatment that can be an effective approach for patients who do not respond to more traditional types of treatment such as chemotherapy and radiotherapy—also have a lower penetration rate in the local market than in the US. This lag can be attributed to the lengthy regulatory process in China. The product approval process for the introduction of new, innovative cancer drugs to China's market can take three to five years longer than in other countries."

Encouragingly, "Expanded access programs are now being put in place to reduce the complexity of bringing innovative drugs to patients in China. A drug may be granted priority review and approval under the China Food and Drug Administration's Green Channel program, which aims to reduce the time for a drug to enter the market if it meets defined clinical-value criteria—for example, innovative agents that demonstrate clear treatment advantages."

The paper also looks at how various stakeholders in China interact with prevailing cancer drug prices, and the impact of recent medical reforms on cancer-drug prices and pricing arrangements. "Even when cancer drugs are available in China, prices can be prohibitive for many patients, a substantial number of whom pay out of pocket for treatment. In terms of local affordability of cancer-drug prices, China emerges as one of the countries with the least affordable prices in the world."

Authors of the paper note: "Cancer-care affordability in China is a significant challenge that demands immediate attention. Pharmaceutical companies have explored a number of different avenues to increase patient access. One approach is by partnering with private insurance companies to offer insurance policies that provide cancer-care coverage."

Interestingly, "The private health-insurance industry in China is underdeveloped" with "an estimated 6% of the Chinese population has a health-insurance policy that covers the costs of cancer treatment. Private insurance policies can help to fill gaps in current social insurance schemes, such as limited coverage for Chinese residents who seek care outside their home cities, given that a large proportion of the country's cancer-care capabilities are centralized in the cities of Beijing, Shanghai and Guangzhou. 

The paper concludes with the following questions aimed to help China implement successful growth strategies to the country's challenges in expanding market access for cancer therapies:

• Impact analysis: What is the impact of regulatory and reimbursement changes on the cancer market and your business?
• Pricing strategy: How to find the right price points to gain access to a wider market? What alternative pricing arrangements can be explored through bundling of therapies, indication-based pricing, etc, to achieve a win-win solution on prices for all stakeholders?
• Development of payment and financing models to expand access: How to find the right partners— for example, private insurers or charities—to reach patient groups that have fallen through the cracks of wider reimbursement policies?
• City- and provincial-level insights to inform volume growth strategies: The ability to access a bigger market requires companies to understand the varying policies and factors that influence the adoption of treatments in different cities and provinces:
• What do companies need to understand about Provincial Reimbursement Drug Lists?
• How do tendering and listing work in hospitals across China?
• How do oncologists in different cities and provinces prescribe cancer treatments?
• What do patient pathways to diagnosis and treatment look like?
• Go-to-market strategy: Finding the right price points and innovative ways of offering your products and services to target different customers is important for making a wider range of products and services available to cancer patients in China.
• Who are the key stakeholders and influencers for a successful product launch?
• What models of engagement should companies develop to engage key stakeholders and policymakers?
• What is the value story that you can develop for China?
• How can pharmaceutical companies pave the way for value-based approaches in China in ways that will help healthcare providers to manage costs and deliver improved care with limited resources?

What strategies should be utilized to expand market access for cancer therapies in China?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.