The price of domestic PD-1 is 6000? Can we "wrinkle a pool of spring water"?
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Last Update: 2018-12-20
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Source: Internet
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Author: User
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On December 17, the domestic PD-1 market broke the dual male pattern of OK drugs and entered the new competitors: the first domestic PD-1 drug, treprizumab injection, was approved for marketing The first indication of this PD-1 drug developed by Junshi biology for the treatment of unresectable or metastatic melanoma after previous systemic treatment failure is the same as that of the first one approved by mosadong K in China In response to the most concerned pricing issue in the industry, Junshi said, "the price is under negotiation and will be very competitive." It is reported that the retail price may be around 6000 yuan If so, drug K will be shocked! The retail price of K medicine is 100mg / 17918 yuan Low income patients use the "3 + 3" mode to pay for nine courses of treatment, covering the whole year The actual annual treatment costs are 320000 yuan / 160000 yuan, only 27% of that in the United States, but the price of Jun Shi will be more "people-friendly" Who decides the price strategy? According to independent sources, Hengrui's carrelizumab has been listed recently If we move forward, all four companies in the first tier of PD-1 in China have submitted listing applications In addition to Junshi, the indications applied for by Cinda, Hengrui and Baiji in Shenzhou are all classic Hodgkin's lymphoma Although there is no overlap with the indications approved by OK medicine in China, the competition between the candidates has formed In addition, melanoma is only a small indication of drug K, and there are fewer patients in China They have submitted an application for lung cancer indication, and OK medicine will soon run on the same screen It is not difficult to predict the picture of domestic PD-1 track, "regardless of things, without you and me, the players are holding their breath." As PD-1 goes public, price is the focus From the perspective of pricing strategy of OK drugs, PD-1 high price strategy is the end They choose to enter the Chinese market at the lowest price in the world Considering the drug donation policy, the actual price is lower If Junshi's pricing is confirmed at a later press conference, it will inevitably have a profound impact on domestic PD-1 products If it is lower than it or no profit, then there will be no market if it is higher than it Isn't that the "old Ganma" extreme pricing strategy? The first is k pharmaceutical According to the latest financial report of Shanghai pharmaceutical, its general agent of local commerce, the distribution revenue of OK pharmaceutical in China is 190 million yuan and 150 million yuan respectively Guo Jun, chairman of CSCO melanoma special committee and professor of Peking University Cancer Hospital, said at the 2018 CSCO tumor immunotherapy annual meeting, "melanoma is the first disease in China to be treated with immunosuppressive checkpoint inhibitors, and also the only tumor that can present four-year follow-up results of PD-1." He pointed out that, unlike the western population, acromegaly and mucosarcoma are the main subtypes in China, and Asian patients have limited benefits from the international breakthrough, so it is particularly important to find a treatment plan that conforms to the characteristics of Asia in the future From this point of view, in addition to the fact that Junshi is pushing the price of K drugs, it is also expected that in clinical practice, who is more suitable for the treatment plan of Asian characteristics will have to contend Although melanoma is a small cancer, if it is such a naked price war, in addition to the shock of drug K, the next PD-1 will be on the market In terms of the progress of domestic application and approval, sindelimab just completed the review on December 13 and entered the stage of administrative approval; Hengrui's carrelizumab will also be on the market soon, and Baiji Shenzhou will be a little later However, the advantages of Baiji Shenzhou are overseas, and the time of application and approval for listing in the United States may be earlier than the other three Judging from the clinical data alone, it's hard to distinguish between high and low Will the price of PD-1 be reduced to "cabbage price", a big question mark and how to start? However, pricing can not only compare figures, which involves investigating patients' ability to pay, analyzing the trend of medical insurance, competitive product strategy, channels and other factors The ultimate price test is the ability of enterprises to commercialize, that is, the value war OK medicine clinical data PK although Junshi has provoked the battle of PD-1 race track in the field of melanoma in China, lung cancer is the real main battlefield from the perspective of indications of domestic acceptance of PD-1 declaration After all, lung cancer is the first malignant tumor in China The incidence rate of non-small cell lung cancer (NSCLC) accounts for 80% to 85% of the total lung cancer About 70% of NSCLC patients are in the late stage or metastasis which is not suitable for surgical resection at the time of diagnosis This track is more crowded In China, only Squibb's drug o has been approved for the market for second-line treatment of NSCLC But look behind you, drug o is "cool", drug K is in the process of approval; domestic PD-1 such as Xinda, Hengrui and Baiji Shenzhou are also actively promoted However, five immunotherapy PD-1 / PD-L1 inhibitors approved by the US FDA can be used to treat NSCLC, especially the advanced NSCLC Roche's drug t, Merck / Pfizer's drug B and AstraZeneca's drug I have all declared the indications of lung cancer in China, and they are all working hard Zhang Zhang, Professor of the cancer prevention and treatment center of CUHK, said, "at the 2018 ASCO conference, the research progress of lung squamous cell carcinoma is a hot topic, among which the most remarkable is the keynote-407 research This study is aimed at patients with squamous cell carcinoma of the lung Chemotherapy alone and chemotherapy combined with PD-1 immunotherapy are given The study shows that the treatment can significantly prolong the total survival period and progression free survival period of patients with squamous cell carcinoma of the lung, suggesting that chemotherapy combined with PD-1 immunotherapy may become a new way of first-line treatment of squamous cell carcinoma of the lung " At this year's ASCO and CSCO conferences, immunotherapy for lung cancer is the most popular field The latest phase III clinical trial of K drug shows that K drug can significantly improve the survival of patients compared with chemotherapy However, this objective clinical effect is only effective in patients with high expression level of PD-L1 In patients with low PD-L1 expression, PD-1 inhibitors alone did not lead to significant survival No matter how the expression of PD-L1 is, the combination of chemotherapy and other immunotherapy can improve the disease-free survival period of patients Compared with chemotherapy alone, combined chemotherapy can effectively improve the efficacy of PD-L1 negative patients with higher TMB, and even enable one third of patients with advanced NSCLC to achieve disease free progress within one year The combination of ipilimumab can reduce the risk of disease progression by half The beauty is that even then, patients with PD-L1 negativity and lower TMB levels will not benefit At the 2018 ASCO conference, t drug also released phase III clinical data: its combination chemotherapy can significantly improve the progression free survival of patients with squamous NSCLC, and even double the one-year progression free survival rate Most importantly, no matter how the PD-L1 expression of patients can achieve the effect; in addition, AstraZeneca recently also published the results of mystic phase III clinical mid-term analysis conducted by combination of drug I and tremelimumab Unfortunately, the combined results did not improve PFS The first level end point of the experiment is OS, and the data will not come out until next year Judging from the latest clinical progress, OK drugs are most likely to take the lead in face-to-face competition in the field of lung cancer In the field of lung cancer, for drug o, drug K is a threat It is said that the policy of "buy 5, send 7" is more powerful than the policy of "K drug", but the policy of drug donation or medical insurance has not yet been announced to the public, and K drug has first announced the charity drug donation program, and has entered the Shenzhen city level medical insurance catalog As a matter of fact, the same kind of products have been competitive, and the OK drugs that have been on the market for many years abroad have been demonstrated for many years At present, the global PD-1 market has exceeded 10 billion US dollars, and the domestic market is just in its infancy Although the huge clinical demand can accommodate more excellent PD-1 products to be expanded, taking lung cancer as an example, OK medicine is bound to rise again At present, the official retail price of drug o is 100mg / 9260 yuan and 40mg / 4591 yuan The first indication approved in China is the second-line treatment driven gene negative non-small cell lung cancer, which is also the core PD-1 product of Squibb in China Once the first-line treatment indication of drug K for lung cancer is approved, it will increase competition Due to earlier access to the tumor market, drug o has always been better than drug K in the clinical approval process, and won the second-line NSCLC in 2015, leading drug K for half a year, but the turning point occurred after drug o in the large-scale three-phase clinical trial scheme checkmate-026 results and the standard chemotherapy scheme has no obvious advantages K drug was selected as NSCLC patients with strong positive PD-L1, and keynote-024 was the first to take the first-line drug of NSCLC with the three phase clinical trial "In the absence of differentiation of PD-L1 expression, k-drug combination chemotherapy has significant clinical advantages in progression free survival, overall survival or remission rate," said Zhang For example, keynote-047 immune research broke the deadlock in the treatment of lung squamous cell carcinoma " For the last indication of NSCLC: squamous cell carcinoma, the clinical manifestation of K medicine is eye-catching At present, drug K has completed the full coverage of NSCLC first-line population Although good results have been achieved in NSCLC clinical trials of drug O and PD-L1 mAb of Roche and AstraZeneca this year, drug K will be the first to choose drug o in the field of domestic lung cancer According to the second quarter report of this year issued by Squibb and MSD, the sales volume of OK drugs is US $1.627 billion and US $1.667 billion, respectively K drugs have a weak advantage in reversing If its lung cancer indications are approved in China, the pressure of O drugs will increase Experts said, "in the era of immunotherapy 2.0, we need to think about expanding indications and optimizing patient screening At present, there are four types of first-line treatment for lung cancer: first, targeted treatment should be preferred if there is gene mutation; second, immunotherapy PD-1 can be used if PDL-1 is highly expressed; third, chemotherapy (pemetrexed, cisplatin) or chemotherapy (paclitaxel, carboplatin, bevacizumab) should be used for non squamous cell carcinoma patients; fourth, dual drug chemotherapy can be used for squamous cell carcinoma patients "
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