China has included 17 life-saving cancer drugs in its national public insurance after negotiations drastically cut their prices, in response to their cost fuelling the smuggling of cheap drugs from abroad in an echo of the popular Chinese film Dying to Survive.
All of the drugs – 12 for treating solid tumours and the others for blood tumours – are considered clinically necessary, effective and urgently needed for patients suffering from non-small-cell lung carcinoma, renal cell carcinoma, colorectal cancer, melanoma, lymphoma and other types of cancer, according to a statement by the State Medical Security Administration.
Most of the drugs are produced by international pharmaceutical giants such as Novartis, Pfizer and Merck and are far from patent expiration. The prices have been brought down 56.7 per cent on average, with imported drugs 36 per cent lower than in neighbouring markets, the administration said.
“We have more power in price negotiations and achieve the target of more quantity for lower price,” Hu Jingling, head of the administration, said in an interview with China Central Television.
The administration was set up in March and oversees insurance for both rural and urban residents, instead of two agencies previously.
“Covering these cancer drugs in public medical insurance will make them affordable for more patients and improve their treatment,” Hu said.
The price of Erbitux, manufactured by Merck, was brought down from more than 4,200 yuan (US$607) to 1,295 yuan (US$187), the lowest globally, Yuan Zezhi, a senior executive from Merck, told CCTV.
“It’s quite remarkable to drop the price of foreign patented drugs to such an extent,” said Shi Lichen, director of Dingchen Pharmaceutical Management Consulting. “This will benefit local residents.”
More than 10,000 people were diagnosed with cancer in China each day in 2014, according to the latest statistics from the National Cancer Centre. The highest incidence is lung cancer, followed by gastric cancer, colorectal cancer and breast cancer, and more likely in people aged 60 to 64.
A large population of smokers, unhealthy diets and longer life expectancy have contributed to cancer rates in China.
Although China established a public medical insurance system for almost every resident, the coverage has been limited and included very few patented anti-cancer drugs, which in turn was beyond affordability for many.
Some tried to smuggle in drugs from abroad, considered counterfeit by drug regulator since they are not approved in China, or buy cheaper but effective generic drugs from India.
The popularity this year of the film Dying to Survive, which depicted a man who was jailed for smuggling in generic drugs from India for myelocytic leukaemia patients who could not afford a patented drug, touched a chord with many.
Shi said that those who could not afford the drugs even after they are covered by national public insurance, which covers up to 80 per cent of the price, would still use smuggled generic medicine and that a global purchase of generic drugs by national health authorities would make cancer treatment more affordable.
Striving to make the life-saving medicine more accessible, Beijing began the price negotiations in 2016 with only three drugs successfully included in the first round. More pharmaceutical companies were invited in the second round last year to introduce competition and eventually 36 more drugs were covered in the national health insurance scheme.
Ten of the 17 drugs are new drugs that hit the market after 2017.
“These cancer drugs are all new drugs that started sales only in recent years,” Hu said. “The strategic purchase of these high-quality innovative drugs will play a role in promoting pharmaceutical companies to increase investment in research and develop more and better innovative drugs.”
China is also preparing to provide more affordable foreign drugs in other ways. Beijing removed tariffs on all imported cancer drugs starting on May 1, after Premier Li Keqiang toured Roche Shanghai and said he hoped companies could sell drugs at lower prices and profit from increased sales.
The State Drug Administration announced in July that foreign drugs could use their clinical trial dates overseas for approval on the mainland, greatly reducing the application period. Previously, foreign drugs already approved abroad were required to be trialled again in China.