There are several trends emerging to create an ideal oncology market for biopharma companies in China. Below, we’ve highlighted some of the key attributes of the market.
The Overall China Oncology Landscape
- China has the largest number of cancer patients globally: 4 million newly diagnosed cancer cases (2018) more than double U.S.
- The oncology drug market was value at $6.5B in 2018; expected to essentially double to $12.6B by 2026
- 50 percent of the global gastric cancer, hepatocellular carcinoma, and esophageal cancer patients China’s cancer mortality rate is 40% higher than that of the U.S.
- Only 10% clinical trial volume vs US
The statistics above already demonstrate that China is already the 2nd largest oncology pharmaceutical market (by revenue), well on the path to being the biggest in the world in the near future. Key drivers of this growth include improved diagnosis and access to care, which have already had a major impact on clinical outcomes. For example, the 5-year survival rate for lymphoma increased from 44% in 2005 to 60% in 2014, although it is still well below 90% in the United States.
The Chinese Oncology Patient Treatment Journey isn’t very predictable
To understand the Chinese Oncology Market better, it may be important to understand the patient journey. For example, in Beijing and Shanghai, 70% and 45% of the respective lung cancer patient populations are nonresidents. Because of that, the percentage of follow-up visits for migrants is significantly lower (roughly half) vs local residents. The resulting impact compliance from treatment plans further impacts future treatment decisions, when modifications would have been appropriate sooner. In addition, Traditional Chinese Medicine (TCM) is often used in conjunction with Western Medicine (as high as 90% patients are utilizing TCM). Whether this adds benefits or not to patients, and to which patients, is an intriguing question, and an important opportunity for global learning from Chinese patient populations.
Cancer Initiatives: Precision Medicine Initiative and the Healthy China 2030 initiative
Two key Chinese government initiatives, both launched in 2016, have been key milestones in advancing the oncology treatment landscape and growth opportunities for advanced oncology therapeutics.
The Precision Medicine Initiative was announced created as part of a plan to pump ~$9 billion for research of human genetics and biology (40x the size of a similar initiative in the United States). Today, Shenzhen’s Beijing Genomics Institute (BGI) is already the world’s largest sequencer and repository of genetic material in cancer and beyond.
Complementing the precision medicine investments, Healthy China 2030 covers five focus areas to ensure improved health: public health services, environment management, the medical industry, and food and drug safety. Goals for this include increasing Chinese citizens’ average life expectancy from 77.3 to 79 years by 2030. Infant mortality decreased from to 9.5 deaths per 1000 live births in 2020 and 6.0 deaths per 1000 live births in 2030.
In combination, the major Chinese government initiatives are already accelerating the advancement of precision medicine and oncology care in China and there is no reason to expect this pace to not continue.
China Pharma Pipeline
While global pharmaceutical companies have been steadily increasing their presence in China over the past 15 years, Chinese pharmaceutical researchers are also accelerating their output in terms of approvals, NCEs/new biologics, and clinical research.
- 12 out of 44 of the new cancer drugs approved in China in between 2018 and August 2020 were discovered in China
- As of January 2020, there were 821 anticancer drug candidates in development in China, including 359 first-in-class agents, with remainder being “me, too” candidates.
Although the majority of the approved drugs discovered in China were “me, too” (e.g., PD(L)-1 inhibitors), there has been a recent trend for first-in class agents, as evidenced by the 2020 pipeline. According to a recent IQVIA report, drugs from China-headquartered companies now own 18% of the early-stage pipeline, up from 3% a decade ago. Summary:
The high incidence of cancer in China, government lead initiatives, increased diagnosis and e.g., overall improvements in patient care, continued growth of investments from global pharma, and the rapid emergence of Chinese biotech innovation and technology are driving the Chinese oncology market to being the world’s largest.
- Opportunities and Patient Insights into the China Oncology Market, LEK 2021
- Managing China’s Growing Oncology Burden, McKinsey August 2020
- Global Oncology Trends 2021, IQVIA
- Trends in Oncology Drug Innovation in China, Nature Reviews Drug Discovery, 2020