China di­a­betes triples cre­at­ing $ 3.2 bil­lion drug mar­ket

The Pak Banker - - Front Page -


Doc­tor Li Guang­wei sees China’s strug­gle with 90 mil­lion di­a­betes suf­fer­ers daily. Among the stand­ing-room-only crowd wait­ing out­side his clinic door are pa­tients with slurred speech, mis­matched clothes and ag­gres­sion.

These are the ones with low blood­sugar, a con­di­tion that can make peo­ple ap­pear drunk and is of­ten caused by too much of the hor­mone in­sulin, said Li, head of Fuwai Hospi­tal’s di­a­betes unit. More than half of China’s di­a­bet­ics have in­ad­e­quate blood- glu­cose con­trol, a 2011 study of 140,000 pa­tients showed.

Preva­lence of Type 2 di­a­betes, a dis­ease linked to in­ac­tiv­ity and ex­cess calo­ries, has more than tripled in China over the past decade, fu­el­ing 20 per­cent-a-year growth in drug sales and strain­ing health ser­vices. It’s also stok­ing need for newer, costlier med­i­ca­tions from Merck & Co. (MRK), Novo Nordisk A/S (NOVOB) and Sanofi that help avoid blood-su­gar spikes and com­pli­ca­tions such as heart at­tack and stroke.

“If we can choose drugs with lit­tle or no risk to more ef­fec­tively treat pa­tients, we can stop us­ing older drugs that raise in­sulin lev­els and can cause hy­po­glycemia,” said Li, us­ing the med­i­cal term for low-blood su­gar that some­times causes his pa­tients to be­come deliri­ous and to pick fights. “It im­pairs brain func­tion and there’s no way to stop it un­til we get the blood su­gar back to nor­mal.”

The main­stay di­a­betes treat­ment world­wide is met­formin, avail­able free in China through the gov­ern­ment’s na­tional health in­sur­ance pro­gram. Doc­tors want to aug­ment the 50-year-old pill with newer medicines, such as Janu­via from Merck, which helps to sta­bi­lize blood-su­gar, ac­cord­ing to an April 2012 pa­per in the jour­nal Di­a­betes & Me­tab­o­lism. Vic­toza, sold by Novo Nordisk, of­fers “min­i­mum risk of hy­po­glycemia,” ac­cord­ing to com­pany- spon­sored re­search in the Lancet in 2010.

As few as two in five di­a­bet­ics in China have their blood- su­gar un­der con­trol, said Ji Li­nong, pres­i­dent of the Chi­nese Di­a­betes So­ci­ety, po­ten­tially dam­ag­ing the heart, blood ves­sels, kid­neys, eyes and feet. That com­pares with the U.S., where blood-su­gar is con­trolled in 70 per­cent, ac­cord­ing to Manish Pant, di­rec­tor of pol­icy and pro­grams at the In­ter­na­tional Di­a­betes Fed­er­a­tion in Brussels.

A key dif­fer­ence is that an av­er­age of $194 a year is spent treat­ing each di­a­betes pa­tient in China, ver­sus more than $5,000 in de­vel­oped coun­tries such as the U.S., the IDF said. Even as China’s health-spend­ing is fore­cast to al­most triple to $1 tril­lion over the next eight years, surg­ing rates of di­a­betes mean China is strug­gling to de­tect cases and pro­vide ba­sic care, ac­cord­ing to Pant.

China has al­most four times as many peo­ple with di­a­betes than the U.S., where there are 23.7 mil­lion suf­fer­ers, ac­cord­ing to the IDF. By 2030, 40 mil­lion more will have the con­di­tion in China, where di­a­betes causes 173.4 bil­lion yuan ($28 bil­lion) a year in med­i­cal costs, the di­a­betes group es­ti­mates.

“China, un­for­tu­nately, has be­come the world’s cap­i­tal for di­a­betes,” said Michael Rosen­blatt, Merck’s chief med­i­cal of­fi­cer, in an Oct. 25 in­ter­view in Shang­hai. “The gov­ern­ment is start­ing to pay more at­ten­tion as this is the be­gin­ning of a huge prob­lem, both health and eco­nomic.”

China’s di­a­betes drugs mar­ket will ex­pand 20 per­cent an­nu­ally to reach 20 bil­lion yuan ($3.2 bil­lion) by 2016, spurred by guide­lines that set higher treat­ment stan­dards, said Yan Shangjun, a Shang­hai-based con­sul­tant with IMS Health Inc. China’s phar­ma­ceuti- cals mar­ket over­all will in­crease 15-to-18 per­cent a year to reach as much as $165 bil­lion over the same pe­riod, the re­search com­pany said in July.

Merck’s Janu­via was ap­proved for use in China in 2009 and costs 9.6 yuan ($1.50) per 100-mil­ligram tablet, typ­i­cally taken daily. Merck has ap­plied to have the medicine added to China’s Na­tional Drug Re­im­burse­ment List, the White­house Sta­tion, New Jersey-based drug­maker said in an e-mail.

It takes as long as five years for a new prod­uct to be added to the re­im­burse­ment list, McKin­sey & Co. said in an Au­gust re­port. Ad­di­tion makes it avail­able to the masses and can bol­ster sales.

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