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    Home > Medical News > Medical World News > Changes in PD-1 market medical insurance: Junshi and AZ fight against Baekje!

    Changes in PD-1 market medical insurance: Junshi and AZ fight against Baekje!

    • Last Update: 2021-07-22
    • Source: Internet
    • Author: User
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      Medical Network News, March 2 On March 1, the highly anticipated 2020 version of the National Medical Insurance Catalog was officially launched
    Compared with previous years, the 2020 version of the medical insurance catalog has the largest number of drugs transferred, and the benefits are the most extensive, including the world's latest tumor immunotherapy drug PD-1 monoclonal antibody

    Coincidentally, just the day before, Junshi Biotech and AstraZeneca China jointly announced a strategic cooperation.
    Junshi Biotech granted AstraZeneca the right to promote teriplimumab injection in non-core markets in mainland China, as well as subsequent acquisitions.
    The exclusive right to promote nationally approved urothelial cancer indications

    At a special time point, the expressions of "non-core market promotion rights" and "national exclusive promotion rights for urothelial cancer" are very eye-catching

    As we all know, AstraZeneca has a large commercial promotion team, which has been cultivating in core and non-core markets for many years, and will set up a county-level oncology team in 2020, covering Teresa, Iressa, Lipzo, and Infineon ( Imfinzi) and a series of anti-tumor drugs and innovative treatment pipelines

    The industry view believes that the cooperation between AstraZeneca and Junshi Biosciences, on the one hand, the expansion of AstraZeneca Imfinzi's urothelial cancer indications has been frustrated, Junshi Biomedical will reduce the price to respond to the pressure on sales, and the two parties seek a win-win business cooperation; On the other hand, it also reflects the complicated market competition situation of PD-1/L1 subdivision indications.
    Considering that BeiGene tislelizumab was approved for urothelial cancer indication in April last year, and this indication has already entered For medical insurance, Junshi Biotech's intention to cooperate with AstraZeneca is quite targeted


      AZ crashed urothelial carcinoma marketing exerted pressure on the
    tumor is one of AstraZeneca's key business areas, areas around the treatment of lung, breast, ovarian, prostate cancer and other roots for many years, while tumor immunotherapy, gene and drug resistance in tumor drive Multiple platforms such as mechanism, DNA damage repair and antibody-conjugated drugs have achieved a comprehensive layout

    However, just last week, AstraZeneca issued a document on the official website of AstraZeneca.
    Because Imfinzi failed in the stage III clinical indication of "previously treated adults with locally advanced or metastatic urothelial cancer (bladder cancer)", the company decided to withdraw its clinical application.
    Eligibility for listing in the United States


    In fact, as early as 2017, based on the safety and efficacy data of phase I/II clinical trials, the US FDA approved the use of Imfinzi for the treatment of patients with locally advanced or metastatic urothelial cancer; at the same time, the FDA required Imfinzi to be post-marketed.
    , It is necessary to continue to carry out Phase III studies to prove its efficacy and safety

    Unfortunately, in a phase III clinical trial for patients with urothelial cancer called "Danube", Imfinzi, Imfinzi+tremelimumab first-line treatment of unresectable, stage IV (metastatic) urothelial cancer patients, None of them can bring significant overall survival benefits compared with standard treatments

    At present, the competition for urothelial cancer indications in the immunotherapy field is extremely fierce.
    Many domestic and foreign PD-1/L1 drugs have successively won the market qualifications for this indication, including Merck’s Keytruda, Roche’s Atelizumab, BMS' Opdivo, Merck/Pfizer's Bavencio, BeiGene's tislelizumab and other immunotherapy drugs

    Urothelial cancer is the first indication for Imfinzi.
    The subsequent approved indications for non-small cell lung cancer and small cell lung cancer will gradually drive the growth of the drug's sales.
    In 2020, the sales of Imfinzi will exceed 2 billion US dollars.
    Vizumab is evenly matched

    However, clinical studies of urothelial cancer have not been able to bring extra points

    In addition, although AstraZeneca stated that the decision to withdraw the indication will not affect the approval of the indication outside the United States or the approval of other indications of Imfinzi globally, the actual situation is still worrying

    Affected by many factors such as the new crown epidemic, mass
    procurement , and medical insurance negotiations, the performance of multinational pharmaceutical companies in China has clearly differentiated
    Investment and return are often proportional.
    From the perspective of overall revenue in 2020, AstraZeneca leads MNC with a revenue of US$5.
    375 billion in China.
    In the face of such excellent revenue performance, AstraZeneca wants to achieve greater results in 2021.
    Breakthroughs will inevitably require greater efforts to optimize product resources

    Analysts said China had by AstraZeneca Pharmaceuticals green leaves and cooperation in the commercial exploration of the cardiovascular field yielded results, the two sides to further extend cooperation in the field of tumor near future but also to see the multinational industrial
    companies and local enterprises more diversified cooperation Possible
    "Imfinzi has been sold in the field of urothelial cancer for nearly 4 years, and its commercialization capabilities in segmented areas are very prominent.
    It is logical to seek alternative products after the indication is withdrawn

    " The above-mentioned person pointed out that CStone Pharmaceuticals and Pfizer, Cinda and Eli Lilly , BeiGene and Novartis, the cooperation between the leading companies of tumor immunity products has been finalized, and the domestic market competition will continue to intensify after the medical insurance market

    AstraZeneca China stated in an interview that through continuous deepening of cooperation with outstanding local companies, local innovative drugs will benefit Chinese patients with a wider range of indications, wider coverage, and faster access

    "AstraZeneca China, with its current leading position in the oncology field, a professional oncology product market sales team, a strong sales network and rich commercial operation experience, can work with its partners to better improve the patient availability of innovative drugs.
    And, jointly promote the development of China's tumor immunotherapy

    " However, AstraZeneca China is not worry-free in the oncology field.
    The volume purchase of gefitinib and the negotiation of Osimertinib medical insurance have caused the pressure of "price for volume" to increase sharply

    In addition, Hausen’s ametinib is coming fiercely, and products such as Iris' vometinib and Aisen Pharmaceutical's Avitinib will also have an impact on its core and non-core markets in the future

    Just before and after the Spring Festival, news broke out in the industry that the business indicators of the AstraZeneca county oncology team have been significantly increased.
    Especially since March 1, the first-line treatment of osimertinib has entered medical insurance.
    If the commercial team wants to reach the target, it must speed up admission to the hospital.
    And to benefit more patients, the difficulty of market development cannot be ignored


      County competition curtain went up health insurance on the amount of competition for junior hospital
    From the perspective of terminal sales in the oncology field, market competition is divided into several levels: the first level is the core market competition of "top experts", especially a series of national academic leaders and provincial-level big-name experts, which are collectively referred to in the industry as "top experts".
    KOL"; the second level is the “first-line push” competition.
    How many
    medicines can enter the hospital and how many hospitals can prescribe prescriptions.
    This requires the sales team to carry out landing work, especially in non-core market competition.
    The commercialization ability is extremely tested

    In the case that the product does not enter the medical insurance, more resources of the company focus on the top KOL of the core market, but after entering the medical insurance, the local enterprises are placed in front of the huge regional and even the grassroots market

    In previous interviews, the market expected changes in the complicated competition situation in the hospital's channels

    Taking the indication for urothelial cancer involved this time as an example, BeiGene's tislelizumab entered medical insurance, and Junshi Bio-Treprizumab's urothelial cancer indication was approved due to short-term inability to directly Incorporating medical insurance payment, Junshi Bio will inevitably face greater promotion pressure during a period of channel competition

    According to the current situation, teriprizumab is suitable for the new indications for the marketing application of locally advanced or metastatic urothelial cancer that has failed or intolerated systemic treatment in the past.
    It was approved by the National Medical Products Administration in May 2020.
    Accepted and will be included in the priority review procedure in July 2020

    In response to the interview, Junshi Biotech expressed the hope that the application for this indication will usher in good news at the end of the first quarter and the beginning of the second quarter of this year

    "We fully believe that with AstraZeneca's extensive channel network accumulated over the years of deep cultivation in China, especially its ability to promote in the county market, Triplimab will achieve greater success in the Chinese market

    " Junshi Biotech Confidence in AstraZeneca’s county marketing capabilities is not unfounded

    AstraZeneca China explored the establishment of a county-level team in 2015.
    Initially, there were only a hundred people and a full-product operation; in 2019, the county-level team rapidly expanded to thousands of people, and it is located in many relatively mature and potential regions.
    In the market, the front-line representatives of the county-level teams all split the product line, and a considerable proportion of the representatives are responsible for the promotion of anti-tumor drugs

    To measure the importance that pharmaceutical companies attach to the county-level hospital market mainly depends on which level of county-level hospitals are covered, as well as the ratio of personnel and marketing expenses resources invested

    In 2020, AstraZeneca China announced the formation of a county-level oncology team.
    Through external recruitment and internal transfer, the goal is to achieve an average coverage of a full-time oncology representative in each county

    In terms of local companies, facing the post-medical insurance market opportunities of PD-1 products, various companies are also actively deploying: Cinda Biotech's sales force has grown rapidly after Sindilizumab entered the medical insurance; Hengrui
    Pharmaceuticals continues to expand its tumor promotion sales team , To increase the development of the county-level grassroots market; BeiGene began to form a "broad market team" last year to actively deploy and extend the tumor market
    Regarding how AstraZeneca China and Junshi Bio will divide core and non-core markets, as well as the next stage of indication competition and hospital admission pressure in the segmented field, AstraZeneca China did not make a specific response in the interview; 100 "Pharmaceutical Economic News" will continue to pay attention to what kind of market response Jeshenju will make

    The effect of market price cuts after medical insurance has quickly emerged

    With the inclusion of four domestically-produced PD-1s into medical insurance, the two imported PD-1s of Merck’s Keytruda and BMS’s Opdivo immediately updated the charity donation policy.
    According to estimates, the price of imported PD-1 will be reduced after the charity donation policy is changed.
    Over 50%

    Market research believes that domestic PD-1 has a price advantage over MNC.
    In addition to small tumors such as melanoma and lymphoma, there are also indications for large tumors such as second-line liver cancer, first-line non-squamous non-small cell lung cancer, and second-line esophageal squamous cell carcinoma.
    Started to enter medical insurance, which will greatly increase the affordability of patients.
    It is expected that domestic PD-1 will usher in explosive growth this year, and the market share of MNC may suffer a huge impact

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