China Medical News

The National Healthcare Security Administration has asked public hospitals and medical staff across the country to use more medicine from centralized procurement while guaranteeing both quality and quantity. According to the circular released by the administration on Dec 19, the move will benefit more people with the achievements made in the country's medical reform.

In October, the trial area for centralized medicine procurement and usage was expanded from 11 cities to the whole country, significantly lowering medicine prices in areas new to the system. The circular calls on provincial-level medical care administrations to timely supervise and guide local medical institutions' usage of drugs covered by the system. It stresses the establishment and improvement of stimulation and assessment mechanisms for the usage of such medicine. The circular also asks medical institutions to be alert of potential shortage or quality issues of the medicine, and inform local medical care administrations if there are any.

In 2018, the centralized medicine procurement system was put on a trial run in 11 cities across China including Beijing and Shanghai, as a result of which the prices of 25 drugs covered by the system dropped by an average of 52%. (Source: Xinhua)

China has added 70 medicines to its national medical insurance catalogue, which will reduce the cost of the drugs by more than 60% on average, the National Healthcare Security Administration (NHSA) has said. In an announcement on Friday, November 29, the NHSA said the price drop comes after “months-long” price negotiations with authorities, and will take effect on January 1.　Of the 70 agreed treatments, 22 are for the treatment of cancer.

“The administration has been actively negotiating with pharmaceutical companies to lower the prices of their products and reduce the financial burden on patients as part of the country's healthcare reform.

“In return, drugmakers will get their products onto the national insurance list, which helps increase sales volume,” the NHSA said.

Xiong Xianjun, head of the administration's medical service department, said some drugmakers had agreed to provide their drugs for the “lowest prices in the world for Chinese patients”. Additionally, he said it was estimated that due to the major price cuts, the out-of-pocket amounts paid by patients will drop by between 80 and 95 percent," he said.

The NHSA said the country’s cancer patients are in urgent need of affordable treatment and are discouraged by prohibitive prices. As a result, some have resorted to purchasing generic, cheap versions from overseas to sustain treatment.

The newly-added cancer drugs include a foreign medication—Jakavi—that treats myelofibrosis, an acute form of bone marrow cancer, developed by Novartis. Deng Yuexin, head of the market access department at Novartis Oncology in China, said the medication, priced at about 8,000 yuan ($1,138) for 60 tablets, will be sold at the world's cheapest price in China. The company said it could not reveal how much of a discount it has granted to the Chinese market due to a confidentiality agreement with Chinese authorities.  "Last year, we failed to reach an agreement with the administration during the price negotiation due to shifts in our global market expansion strategy, which had saddened many of our Chinese patients," she said. "This time, they are bound to be over the moon."

Eight homegrown drugs also made it to the list, including Tyvyt, which targets lymph cancer. It was developed by Suzhou-based Innovent Biologics. He Shiwen, an employee at Innovent, said the price of Tyvyt has been reduced by 64%. "Even before the price cut, Tyvyt was significantly cheaper than its counterparts available on the Chinese market. The medication is now even more affordable for patients," he said. Agreements have also been renewed for another 27 products already on the list, with an average price cut of 26.4 percent, Xianjun said. (Source: Life Sciences IP Review)

More hospitals in China are going to set up National Metabolic Management Centers (MMC) in their exploration of a new model of diabetes treatment, according to a national metabolic disease clinical research center.

An association of metabolic management centers along the Yangtze River Delta was established Wednesday, one day ahead of World Diabetes Day. Over 200 MMCs will be set up in the delta region to provide more convenient and standardized treatment for diabetes patients. So far, a total of 343 hospitals in China have such centers.

The MMC, initiated by Ning Guang, an academician of the Chinese Academy of Engineering and a diabetes specialist, aims to provide one-stop diagnosis and treatment to help lower the occurrence rate of diabetes and its complications.　Patients can also upload data of their blood glucose, blood pressure and heart rate to an intelligent network platform to access online services.

The number of diabetes patients in China has reached 114 million, but the degree of care and treatment standards still fall short. "The MMC is expected to provide more convenient and efficient treatment of diabetes through a high degree of standardization," said Ning.Statistics show that MMCs across the country have provided services for more than 200,000 patients over the last two years. (Source: Xinhua)

The number of diabetes patients in China has reached 114 million but almost two-thirds of those have not yet been diagnosed, leading medical experts warned on Tuesday, in the run-up to World Diabetes Day, which falls on Thursday.

Experts have urged people at risk of the disease, through factors including obesity, a family history of diabetes and elevated blood glucose levels discovered in regular physical examination to seek screening, as an early diagnosis and standard disease management can lead to a better prognosis.　"If someone very often feels tired, untimely thirst, has blurred vision, edema and foamy urine, or undergoes weight loss for no reason, he or she should not ignore them as such situations may be a warning signal for diabetes," said Zhu Dalong, director of the department of endocrinology of the Nanjing Drum Tower Hospital, Affiliated with the Nanjing University Medical School.

In Shanghai on Tuesday it was announced that China's leading diabetes experts and French pharmaceutical company Servier will initiate a project to focus on patients not yet diagnosed, and to urge those who are diagnosed to pay attention to the hidden risk of complications happening to their eyes, feet and kidneys.　"Free screening and clinical activities will be available at more than 100 community health centers, especially those in small and disadvantaged regions throughout the country, to help identify those invisible patients in the project," said Su Qing, director of the department of endocrinology of Xinhua Hospital Affiliated with the Shanghai Jiao Tong University School of Medicine, and one of the project's initiators. "We will also provide disease education onsite at grass-root communities and on the internet."

Experts say that so far, just one in four of diagnosed patients have accepted health education about the disease. Jiang Sunfang, director of general practice at Zhongshan Hospital Affiliated with Fudan University in Shanghai, said that general practitioners at community health centers can help patients to better control their condition in the long term through disease management approaches, including professional advice on physical sports, diet and blood glucose control. (Source: China Daily)

The overall myopia rate among Chinese adolescents reached 53.6% in 2018, according to a news briefing from the Ministry of Education on Wednesday, youth.cn reported. The myopia rates of six-year-old children, primary school students, junior high school students and high school students were 14.5%, 36%, 71.6%, and 81%, respectively.  The myopia rate among children from 15 provinces was above the average rate across the country, and that among children from 24 provinces was beyond 50%.

Wang Dengfeng, director of the Department of Physical, Health and Arts Education, said causes of myopia were complicated. Excessive schoolwork, abuse of electronic products, limited extracurricular physical exercise, especially outdoor exercise poor eye habits and other factors can all lead to myopia among children, he said.

The ministry and nine other departments issued a series of measures to reduce the burden on primary and secondary school students. It has also deepened reform on physical education to ensure sufficient hours in health and physical exercises. Disciplines and majors related to optometrists have been added at 30 universities and 69 higher vocational colleges to provide support in prevention and control of myopia among children.

The ministry included students' visual health as an index to determine students' physical health status, and will conduct selected examinations at schools as a way of supervision. The ministry, with the National Health Commission, set an annual target of reducing myopia rate among children. It hopes provinces and regions can reduce the myopia rate among children by 0.5 or 1% each year. (Source: China Daily)

World-leading pharmaceutical enterprises pledged during a news conference on Tuesday to introduce new anti-cancer products at the second China International Import Expo which will take place from November 5 to 10 in Shanghai.

The area showcasing anti-cancer products and solutions will be a key component of this year's fair, said Shi Huangjun, deputy secretary of the Party committee of the National Exhibition and Convention Center (Shanghai) Co Ltd.

Wu Kun, head of Pfizer China, said that the company will present several innovative drugs at the upcoming trade fair, including a breakthrough therapy for advanced breast cancer. He explained that this is because cancer research is a hot topic in the pharmaceutical industry and has been receiving considerable media attention in recent times. In addition, cancer cases are rising in the country every year.　Wu added that the reform of the national registration policy for new drugs has resulted in the faster approval of new pharmaceutical products over the years, and that the pace of new drugs being introduced into the Chinese market today is comparable to that of European countries and the United States.

Also in attendance at the conference was Liu Jianbin, market director of Elekta China, a medical enterprise specializing in radiotherapy treatment for tumors. Liu said that China, which is now the second largest radiotherapy market in the world, is poised to overtake the US and become the first within three years.

Zhang Likun, vice-president of MSD China, said that the company will display high-quality innovative drugs, vaccines and animal health products and services to help promote the Chinese government's HealthyChina2030project. MSD, also known as Merck&Co in the US, will have a stand that measures almost 800squaremeters at this year's fair, he added. Other major pharmaceutical companies that attended the conference and expressed an intent to participate in the second CIIE were Roche and Johnson & Johnson. (Source: China Daily)

China's average hospital stay in 2018 was 9.3 days, down by 42.6% compared to that in 1992, according to a report issued by the National Health Commission.  The average hospital stay has been dropping for five years in a row in tertiary hospitals, the top tier of China's hospital grades which has the largest number of beds and provides comprehensive medical services.

The drop in hospital stays shows that China's medical service efficiency kept increasing by developing new medical service models, said Guo Yanhong, an official with the commission. The commission has been optimizing the service procedures in hospitals across the country and promoting the services of ambulatory surgery and early rehabilitation. Guo said the amount, quality and capability of China's medical service have also been increasing in recent years. (Source: Xinhua)

The National Health Commission has launched an information system to register the treatment of rare diseases in a bid to promote their diagnosis and treatment. More than 300 hospitals in a collaborative network on rare diseases are required to register the information of all patients with rare diseases from Nov. 1 and finish registering those treated since 2015 by the end of this year.

With the data collected, the diagnosis and treatment service, medical care and access to medicines for rare diseases are expected to be improved, according to Zhang Shuyang, secretary-general of the China Alliance of Rare Diseases. Misdiagnosis and difficulties surrounding drug use are among the main challenges in diagnosing and treating rare diseases. (Source: Xinhua)

China has taken new measures to lower patients' expenditure on treating high blood pressure and diabetes, according to the National Health Commission. Outpatients with the two chronic diseases will be reimbursed for over 50% of their spending on medicine included in the national basic medical insurance catalog, the commission said. Over 300 million people under the country's basic medical insurance programs will benefit from the move, according to the commission.

The move is also aimed at improving the health of senior citizens, as China has over 180 million elderly citizens suffering from chronic diseases, of whom 75 percent have one type or more. Chronic diseases including high blood pressure and diabetes have become the main causes of death in the country. (Source: Xinhua)

China's National Health Commission (NHC) on Wednesday said the inpatient mortality rate has been gradually declining in China. China's inpatient mortality rate has fallen from 1.1% in 2005 to 0.44% in 2018, Guo Yanhong, an official with the NHC, said at a press conference.

The mortality rate of hospitalized patients with acute myocardial infarction decreased from 6.12% in 2014 to 5.02% in 2017, according to Guo. In addition, the mortality rate of patients with gastrointestinal bleeding decreased from 3.59% in 2014 to 1.72% in 2017. Guo said the mortality rate of craniocerebral surgeries, which are difficult and risky, has been decreasing for five years.

The total number of medical and health workers in China surpassed 12.3 million, and the number of medical institutions was close to one million in 2018, said Guo. Compared with 1949, average life expectancy in China rose from 35 years in 1949 to 77 years in 2018, according to data previously released by NHC. (Source: Xinhua)

China has expanded a pilot drug bulk-buying program to almost the entire country in an attempt to negotiate lower prices from drug manufacturers, heaping fresh pressure on multinational pharmaceutical companies and their domestic rivals.

The program rolled out last year saw 11 Chinese cities, including Beijing and Shanghai, band together behind a tender process to bulk-buy 25 types of drugs. This caused the price of some medicines to plunge over 90%, state news agency Xinhua said.

The scheme will be expanded to 25 provinces and regions, who will form a league to look for suppliers for these drugs that will be stocked at public hospitals as well as some military and private medical institutions, according to documents released on Sunday by the drug procurement branch of the Shanghai Healthcare Security Administration.

The drugs on the list include off-patent blockbusters that are made by Western pharmaceutical giants, but which have generic made by local players, such as Eli Lilly’s cancer treatment drug pemetrexed, which is sold under the brand name Alimta, and leukaemia therapy imatinib sold by Novartis as Gleevec. The tenders for the two drugs in last year’s pilot program were won by Chinese drugmakers’ generic products.

Beijing’s nationwide expansion measure could add strains on multinational drugmakers to consider larger price cuts for their off-patent blockbusters, a move that they have tended to refrain from in order to maintain their premium brand image, analysts said.

The documents also cited that as many as three winners of the tender for each drug could obtain as much as 70% share of the government’s purchase volumes, while the sole winner of a tender could win up to a 50% share of purchase volumes.

Under the new expansion plan, only the provinces of Fujian and Hebei are not involved in the program on mainland China.

“The 11 cities [in the previous pilot program] accounted for a relatively low market share in China,” John Yung, head of Asia healthcare research at Citi, told Reuters. “But as for the 70% market in the entire nation, the pressure is different.”

Novartis and Eli Lilly offered to cut prices for Gleevec and pemetrexed by about 30% in some provinces earlier this year, according to releases on local governments’ drug procurement websites.  (Source: Reuters)

A total of 148 drugs have been newly included in a renewed list of drugs covered by China's basic medical insurance. Of the 148 new additions, 47 are western medicines and 101 are traditional Chinese medicines. The renewed list now contains a total of 2643 drugs, including 1322 western medicines and 1321 Chinese patent medicine.

In addition, a total of 150 varieties were transferred off of the list, of which about half were drugs that were revoked by the State Drug Administration, and the rest were mainly drugs with low clinical value, obvious abuse, and better substitution.

This updated national drug reimbursement list is the first comprehensive adjustment after the establishment of the National Medical Insurance Bureau. In the next step, the National Medical Insurance Bureau will work with relevant departments to guide the provinces (autonomous regions and municipalities) to implement the updated drug catalogue. The updated national drug reimbursement list is set to take effect on Jan 1, 2020.

Meanwhile, 128 drugs, which are all exclusive products of high clinical value but have relatively high prices, have been identified following expert reviews as potential additions to the list. The next step will be to confirm the company's intention to negotiate, organize negotiations according to relevant procedures, and incorporate the successful negotiation into the catalogue. (Source: Xinhua)

China has over 180 million elderly citizens suffering from chronic diseases, of whom 75% have more than one, according to the National Health Commission (NHC).

The average life expectancy of Chinese people was 77 years in 2018, but the healthy life expectancy was 68.7 years, meaning people have more than eight years to live with diseases, said Wang Haidong, director of NHC's Department of Ageing and Health.

The State Council has issued a guideline to implement the country's Healthy China initiative, calling on promoting elderly people's health, improving their living quality and realizing healthy aging. It vowed to decline the incidence of disability among elderly people aged between 65 and 74 and slow the growth of dementia morbidity among those aged 65 and above.

By the end of 2018, China had about 249 million elderly people aged 60 and above and 167 million at the age of 65 and above, accounting for 17.9% and 11.9% of the total population, respectively. (Source: Xinhua)

The epidemic of viral hepatitis has been effectively controlled in China thanks to the country's increased prevention and control efforts, according to an official with the National Health Commission (NHC).

The prevalence of hepatitis B surface antigen in children aged between one and four stood at 0.32% in 2014, achieving the World Health Organization's goal of reducing that figure to below 1% ahead of schedule, said Chang Jile, head of the disease control bureau under the NHC. The reported incidence rate of hepatitis A in the country registered a record low of 1.17 per 100,000 people, Chang said in Beijing earlier this week at a conference to mark the World Hepatitis Day which falls on Sunday. In recent years, the country has made continuous efforts in preventing and controlling viral hepatitis and achieved progress in this regard, especially hepatitis B vaccination and the introduction of advanced new medicines for treating hepatitis C.

There are still 86 million people infected with hepatitis B and 10 million infected with hepatitis C in China, Chang said, noting that tasks of fighting viral hepatitis are still arduous. (Source: Xinhua)

Chinese authorities on Friday (June 21) released a list of 34 generic medicines, encouraging pharmaceutical firms to develop and produce them. Anti-AIDS drugs Rilpivirine and Abacavir, and leukemia drug Azathioprine are included in the list issued by the National Health Commission (NHC).

The 34 medicines were proposed by experts from the NHC, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, the National Medical Products Administration and the National Intellectual Property Administration. The patents of these drugs are either expired or will soon be expired with no fresh applications for registration, according to a statement concerning the list, which also includes drugs that are in short supply. The list is the first of its kind in the country and new lists will be published at the end of each year starting 2020.(Source: Xinhua)

Chinese government subsidies to public hospitals have increased by 15.6% annually since 2010, a health official said on June 14. The government allocated 270.5 billion yuan ($39.26 billion) of subsidies directly to public hospitals in 2018, up from 84.9 billion yuan in 2010, said Zhu Hongbiao, a senior official with the National Health Commission, at a press conference.

However, government funds only accounted for about 10% of the total revenue of public hospitals by the end of 2018, Zhu said. Public hospitals in China used to have three main sources of revenue — service charges, additive charges on medicines and direct government subsidies. An ongoing nationwide reform on public hospitals, which was unveiled in 2017, aimed to remove the additive charge on medicine.

"The revenue of public hospitals will depend on service charges," Zhu said. Local health departments have explored various ways to reform the pricing of service charges so as to make it affordable for the public, he said. They were asked to adopt a gradual approach in raising medical service charge, including the fees of diagnosis, surgery, rehabilitation, nursing and traditional Chinese medicine, according to Zhu.

The raised service charge will be included in the reimbursement of medical insurance schemes so as not to increase the cost, he said, adding that authorities will also work to lower the cost of examinations using large medical equipment. The ongoing reform was also expected to improve the salary, welfare and working environment for hospital staff, he said. (Source: Xinhua)

China has taken measures on to address its insufficient number of anesthetists. There were about 55.96 million surgeries operated in Chinese hospitals in 2017, but only 76,000 anesthetists were available. To hit the standard of 2.5 anesthetists per 10,000 operations in developed countries, at least another 270,000 anesthetists are needed.

"Recently, the amount of surgeries has risen by 10% annually, while the number of anesthetists has only increased about 5%," said Mi Weidong, an expert in labor analgesia at the Chinese Medical Doctor Association. With people's increasing need for medical services, a major predicament is that the surging number of surgeries largely outnumbers the increase of anesthetists every year.

China has put more efforts into dealing with the shortage of anesthetists in recent years. A total of 382 training bases for anesthetists have been selected to cultivate more professionals, and over 55 universities and colleges began enrolling undergraduate students majoring in anesthesia. Thanks to the efforts, the number of anesthetists in China has increased by 20% in the last five years.

In 2018, a guideline for strengthening and improving anesthesia medical services was issued. It aims for the total number of anesthetists to reach 90,000 by 2020. (Source: Xinhua)

The health of women and children has climbed in China because of improved services, and gaps between regions have narrowed significantly, according to a report released on May 27.

Maternal mortality - or deaths related to childbirth - in China has moved below the average of some mid - to high-income countries, while life expectancy at birth is higher than the average, according to Qin Geng, director of the department for women and children's health at the National Health Commission.

Rural and urban maternal mortality rates have both fallen substantially since 1990 - dropping by 81.2% to 19.9 per 100,000 in rural areas, and falling 67.2% to 15.5 per 100,000 in urban areas, according to the National Health Commission report. Last year, pregnant women in rural areas were just 1.3 times more likely to die than their peers in urban areas. In 1990, the risk was 2.2 times more likely, the report said.

The discrepancy between areas also decreased. Last year, for example, the maternal mortality rate in western areas of China, which is less developed, was 25.2 per 100,000, 2.3 times that of eastern regions. In 1996, women in western areas were 4.7 times more likely to die, the report said. Gaps in infant mortality and the overall growth of rural and urban areas, as well as between different regions, have also significantly narrowed over the past three decades, the report said.

A major program launched in 2000 that provided subsidies to pregnant women in rural areas to encourage them to give birth at hospitals has helped to increase the percentage of hospital births to 99.8 percent in rural areas last year, up from 51.7 percent in 1996, Qin said. He noted that this has resulted in reduced maternal mortality in rural areas across China. Qin said that, in general, women's and children's health in China has significantly improved over the past seven decades. When the People's Republic of China was founded in 1949, average life expectancy was 35, but increased to 77 years for babies born last year, he said. Female life expectancy reached 79.4 years in 2015.

The mortality rate for babies was as high as 20% before 1949 because of a lack of doctors and medicine, particularly in rural areas, compared with 0.61% last year, he said. Health authorities have been improving the network of care for women and children across China and have launched various health assistance programs focusing on pregnancy in remote and rural areas. Those programs are expected to continue contributing to reducing regional gaps, he said. (Source: China Daily)

Chinese experts have suggested regulating the use of antimicrobial drugs nationwide in response to threat of antibiotic resistance.

The National Health Commission (NHC) issued a circular this March, requiring measures to contain the fast increasing antimicrobial resistance of carbapenems, the most powerful antibiotics. A 2017 report suggests that 20.7% of commonly existing pseudomonas aeruginosa and 56.1% of acinetobacter baumannii, which are likely to cause infections in hospitals, are resistant to carbapenems. Failure to prevent or control antibiotic resistance will lead to difficulties in curing commonplace infections, longer hospital stays and even increased mortality, experts said.

Doctors should prescribe suitable antibiotics of appropriate doses, and hospitals should put guidelines on infection prevention and control into effect, said Yang Xiaoqiang, an expert with the NHC. Liu Xiaolin, deputy general secretary of the Chinese Pharmacists Association, suggested efforts to improve supervision of the clinical use of antimicrobial drugs. (Source: Xinhua)

Over half of Chinese elderly suffer from hypertension, and the prevalence reaches nearly 90% among those aged 80 and above, according to a 2019 guideline on the management of the disease. The document was jointly issued by the Hypertension Branch of the Chinese Geriatrics Society and the National Clinical Research Center of the Geriatric Diseases. Experts suggest a slow and cautious approach in lowering blood pressure for the elderly. May 17 was World Hypertension Day. (Source: Xinhua)

China has issued a provisional plan to enhance the reporting and management of data from hospitals nationwide. Hospitals will be asked to report data on medical quality and security, medical services and hospital revenue, among others, according to the plan issued by the National Health Commission (NHC). Hospitals should also report their proportion of revenue from sales of medicines and the use of anti-bacterial medicines and basic medicines.

The plan also asked hospitals to report data related to prescriptions, such as the number of prescriptions on anti-bacterial medicines, narcotic drugs and psychotropic drugs. Reporting of data on the use of hospital beds is also required. The collected data could play a big role in the future formulation of medical policies and the bidding and procurement of medicines, the NHC said. (Source: Xinhua)

Multiple infectious diseases that can be prevented by vaccination, such as measles, have registered their lowest recorded incidence in China, according to data released by the Chinese Center for Disease Control and Prevention (China CDC).

Since the hepatitis B vaccine for the newborn became popular in China, the carrier rate among children aged under five has dropped from 9.7% in 1992 to 0.3% in 2014, and the number of infected children has shrunk by close to 30 million, the China CDC said at an event about prophylactic vaccination for children earlier this week.

The vaccinated population under the national immunization program is on the rise. According to the China CDC in 2017, China had 157,100 vaccination units nationwide, covering all urban and rural areas. There were around 420,000 vaccinators across the country and more than 400 million doses of vaccines within the program were used each year.

Gao Fu, director of the China CDC, said China's health authorities have been strengthening the sound and standard management on prophylactic vaccination and improving its security and effectiveness, hoping the public will keep confidence in China's vaccine. China has maintained an above 90% vaccination rate of vaccines under its immunization program. (Source: Xinhua)

The five-year survival rate for Chinese breast cancer patients has reached 83.2%, up 7.3% over the past decade, according to the 2019 annual meeting on breast cancer held by the Chinese Society of Clinical Oncology (CSCO).　New cases of breast cancer account for 16.5% of new cases of malignant tumors in women in China, making it the most commonly occurring cancer in women, according to the meeting.

An updated guideline on the diagnosis and treatment of breast cancer was released at the meeting. "The new guideline has incorporated content about drugs independently developed by China and updated content about all breast cancer subtypes of all stages," CSCO secretary general Jiang Zefei said at the meeting.

According to the meeting, multiple hospitals have built a big data platform collecting clinical data on breast cancer, which will facilitate doctors to optimize clinical decisions. (Source: Xinhua)

China will include more anti-cancer drugs on its new list of medicines eligible for medical insurance reimbursement to be released this year. Apart from cancer drugs, medicines for rare diseases, chronic illness, children and first-aid treatment are among the options for a lengthened reimbursement list, the National Healthcare Security Administration (NHSA) said in a document aimed at reducing the burden on patients.

The candidates for inclusion should be drugs that have been launched in markets with the approval of the National Medical Products Administration before Dec. 31, 2018, said the document. It also banned some medicines from the list, including those containing endangered wild animals and plants, contraceptives, and pharmaceuticals for slimming, cosmetology and smoking cessation. The existing medicines for reimbursement that have been banned from production, sales and use by national drug regulators should also be excluded from the list, said the document.

It is the first comprehensive adjustment of the list after the establishment of the NHSA in 2018, with the current version released in 2017, containing a total of 2,588 medicines. (Source: Xinhua)

Less than a year after securing its first Chinese approval, in previously treated metastatic melanoma patients, Merck & Co.’s Keytruda has leapt ahead of Bristol-Myers Squibb’s Opdivo and nabbed a green light in newly diagnosed non-small cell lung cancer.

The new approval is for the combination of Keytruda, Eli Lilly’s Alimta and platinum chemo as first-line treatment of patients with NSCLC without EGFR or ALK mutations. And it’s based on the foreign Keynote-189 study, which showed the regimen could cut the risk of death by half.

With that, Keytruda has become the first PD-1/L1 to expand its Chinese label, and has outrun Opdivo—which was approved last June in previously treated NSCLC as the country’s first immuno-oncology agent—into the first-line setting. (Source: FiercePharma)

China's recent policy to increase patients' access to cancer medicines has helped more people receive quality treatment, said the Beijing-based newspaper Health News Wednesday.  In October 2018, 17 cancer drugs widely used in tumor treatment were added in the China's national basic healthcare system and saw an average price slash of 56.7%, after a three-month negotiation between the government and domestic and foreign pharmaceutical companies.

When explaining how patients gain from the new policy, Li Lin, an oncology doctor at Beijing Hospital, told the newspaper that a patient with lung cancer under targeted therapies used to pay more than 50,000 yuan (about 7,460 U.S. dollars) every month for the medicines. "Now, the total cost is down to about 15,000 yuan since the hospital buys from the supplier at a government-negotiated price. Covered by the insurance scheme, the patient only needs to pay about 3,000 to 4,600 yuan after reimbursement," Li said.

The country saw a soaring hospital use of the drugs during the last few months. By the end of last year, hospitals and pharmacies purchased 1.84 million doses of cancer medicines at the lower prices reached by the government with suppliers, according to the National Healthcare Security Administration.

They paid 562 million yuan for the medicines, 918 million yuan less than if the medicines were sold at the price set before the government-suppliers negotiations, and a total of 44,600 patients were reimbursed 256 million yuan from the medical insurance fund for the drugs.  "The supply of these cancer drugs is sufficient," said Zhang Yi, director of the thoracic surgery department in the Beijing-based Xuanwu Hospital affiliated to Capital Medical University.  Although the policy only took effect four months ago and many hospitals have yet to list them in their routine medicine reserve, the hospitals opened temporary fast-track channels to purchase them from suppliers. (Source: Xinhua)

The first guidebook for the diagnosis and treatment of rare diseases in China was released on Feb 27.

The guide includes definitions of 121 rare diseases included in the catalogue released by the National Health Commission, their causes, and procedures for diagnosis and treatment, according to Peking Union Medical College Hospital, a major drafter of the guide.

Zhang Zongjiu, chief for medical administration and supervision at the National Health Commission, said release of the guide will greatly improve diagnosis and treatment of rare diseases and benefit patients. Experts also borrowed related international guides in drafting it, he said.

"Although incidences of rare diseases are very low, cases of rare diseases in China are not rare due to China's big population," he said. "In general, medical institutions in China lack enough skills to effectively diagnose and treat rare diseases, and the guide can be of great significance to conducting training among medical staff and improving their skills for diagnosis and treatment," Zhang said. (Source: China Daily)

China's Ministry of Finance announced Friday VAT reductions for rare-disease drugs to lower the cost for patients with rare diseases and encourage development of the pharmaceutical industry.

Starting March 1, 2019, the VAT rate for the import of rare-disease drugs will be reduced to 3%, the ministry said in an online statement. VAT for the production and sale, wholesale and retail of rare-disease drugs will also be reduced to 3% from March 1.

A total of 21 rare-disease drugs and four active pharmaceutical ingredients will become first to enjoy the polices, according to the ministry. Currently, China has more than 20 million people with rare diseases, who have very few options in terms of treatment. (Source: Xinhua)

Thanks to a key research program, nine Class I new drugs have been approved in 2018, an official of the National Health Commission said Friday. Class I new drugs refer to those which have never been marketed in China or overseas.

Yang Qing, head of the health science, technology and education division of the commission, revealed the information at the launching ceremony of Tyvyt, a newly approved domestic cancer drug.

A special key program on developing new drugs was launched in 2008, which has supported over 1,900 projects and produced 38 Class I new drugs.

The central government has invested nearly 20 billion yuan (about 3 billion U.S. dollars) in the program, attracting another 200 billion yuan of investment from local governments and enterprises. (Source: Xinhua)

China's National Medical Products Administration (NMPA) approved 18 new cancer medicines in 2018, up 157% on 2017, said an NMPA official Tuesday. Cancer medicines accounted for 37.5% of the total new medicines approved in 2018, "a notable increase over previous years," said Wang Ping, chief of the division of medicine registration under the NMPA, at a press conference. "It takes 12 months on average for a new anti-cancer medicine to be approved by the NMPA, down from 24 months before 2018," Wang said.

Last year the Chinese government adopted a series of measures to speed up the approval of imported and domestically-developed cancer medicines. According to Wang, the government exempted imported medicines from quarantine at border ports so they could reach hospitals and pharmacies as quickly as possible. The approving procedure for imported medicines to enter the Chinese market, as well as that for domestic pharmaceutical firms to conduct clinical tests, were also simplified.

The NMPA and National Health Commission (NHC) listed 48 types of imported medicines that were much needed in China, including those for rare and deadly diseases. The review period of imported medicines for rare diseases is three months, while for the rest it is six months. "The country has tried to develop a favorable policy environment for innovation in medicines so that the latest medical research findings could benefit Chinese patients as soon as possible," Wang said.

This year the NMPA will work with the NHC to develop the second list of much needed imported medicines that are qualified for fast-track review, he said. The NMPA will also try to speed up the review procedure for imported and domestic cancer medicines and tighten up monitoring of adverse reactions, he added. (Source: Xinhua)

Most commonly used cancer drugs have been included in China’s basic medical insurance program, and the government is continuing negotiations on the price of expensive drugs with the aim of including them, the country’s top medical security authority said.

China has included 34 drugs that treat major cancers in the national basic medical insurance program after successful price negotiations with pharmaceutical companies in the past three years, the National Healthcare Security Administration said recently. The prices of most of the drugs have been cut by more than half, and patients will spend even less after reimbursement from the medical insurance fund, the administration said.

The pace of progress has been accelerating. Two cancer drugs were approved for inclusion in the medical insurance program after their prices were cut by more than 50 percent in 2016, while 15 were approved in 2017 and 17 were included in October. The administration also has recognized significant demand from patients with other serious diseases. It is considering engaging in price negotiations on drugs used to treat those patients this year, the administration said. “The number of patients with some other serious diseases such as heart disease and hepatitis B is also high, and they’ve also appealed for more affordable drugs,” it said. The administration said it will continue to try to include new cancer drugs in the program after they are proven effective.

There are an estimated 3.8 million new cancer cases in China every year, with cancer becoming a leading cause of death, with the incidence of some cancers, such as lung and breast cancer, rising rapidly, the Cancer Hospital at the Chinese Academy of Medical Sciences said in a report last year.

The National Medical Products Administration, China’s top drug regulator, said in January that it has accelerated inspection and approval procedures for new drugs developed overseas that are urgently needed by Chinese patients. A number of them, including cancer drugs, will be available on the domestic market this year.

In many European countries and the United States, price negotiations are routine between commercial insurance companies and pharmaceutical companies. But in China, such negotiations have been held between the government and pharmaceutical companies only in the past few years. (Source: China Daily)

China has adopted a fast-track approach in its drug evaluation and approval system, allowing more new domestic drugs, innovative drugs and imported drugs to hit the market in 2018. Last year, the Center for Drug Evaluation of State Drug Administration proposed to approve 59 imported branded drugs and 11 new domestic drugs, including two traditional Chinese medicines, according to an SDA statement. Nine of the 11 domestic drugs were first approved across the world.

Most of the newly approved were anti-cancer, antiviral and orphan drugs (drugs for the treatment of rare diseases). Among the approved ones, 18 were antineoplastic while many were for tumor indications, which will bring about more therapy alternatives for chemotherapy, the SDA said. The speedy approval of some specific medicines has enabled Chinese patients to receive better treatment. For instance, China in May approved Epclusa for the treatment of adults with chronic Hepatitis C virus infections, the latest treatment for the disease. China also created a special channel for clinical drug-trials, which previously took two to three years after application but is only 60 days currently, if no queries or negative feedback are returned to the applicants.

The SDA Center for Drug Evaluation has communicated more with drug enterprises in new drug research and development. As of Dec 10, the center had received and handled a total of more than 1,500 communication applications, the statement said.

Meanwhile, the SDA has accelerated the process to introduce clinically needed new drugs from overseas, with 10 types accessible at home now and more expected this year, it said.

China will continue deepening the reform of drug evaluation and approval, and will make more efforts such as simplifying the requirements for importing overseas drugs and encouraging the research and development of innovative drugs, it added. (Source: Xinhua)

Lately, every day seems to bring new talk about "innovative" payment models for expensive drugs in the U.S. and Europe. Now, China's getting enthused, too.  Pfizer has launched the country’s first pay-for-performance program in oncology with its blockbuster breast cancer drug Ibrance, China Daily reported. Under the new program, called Bo’ai Xin’an, Pfizer promises reimbursement of up to 33.5% of Ibrance costs if an enrolled patient’s disease progresses within four months.

The U.S. pharma set up the project in collaboration with one of China’s largest commercial insurers, People’s Insurance Company of China (PICC) and MediTrust Health, a Shanghai-based firm that offers healthcare financing services. It’s a small, if groundbreaking, program. It will accept no more than 500 patients, and only those who haven't received hormone therapy are eligible. Patients must also join the program within 28 days of starting Ibrance, Biocentury reported. China runs a national healthcare scheme, and private insurance plans have only interested a few.

China is now the second-largest pharmaceutical market overall and will probably grow more important as drug reforms continue. Its medicine spending will reach up to $170 billion by 2023, from 2018’s $137 billion, according to an IQVIA report released Tuesday. But as access to medicines in general and new medicines in particular expands, the Chinese government is starting to feel the pressure from increased spending. Beijing has begun to crack down on drug prices, especially in the essential drug category, trying to make way for innovative drugs as a new, more streamlined review process ushers those new products to market faster.

And that's one reason why multinational pharma companies like Pfizer are turning more focus toward new drugs in the country. For example, in a new bulk purchase scheme China’s piloting, off-patent drugmakers offered steep discounts to win big tenders from major Chinese cities. As a result, foreign pharmas’ original drugs, Pfizer’s Lipitor included, were mostly defeated by local firms’ cheap copycats. (Source: FiercePharma)

China's population growth rate has reached the lowest level in decades, according to data released by the National Bureau of Statistics on Jan 21. A total of 15.23 million babies were born last year on the Chinese mainland, a drop by about 2 million from that of 2017, according to data released by the NBS.

The population growth rate dropped from 532 to 381 per 100,000 population from 2017 to 2018, NBS figures show. The rate is the lowest since 1961.  It also marks the second year consecutive decrease since the country relaxed its family planning policy and fully implemented the universal second-child policy.

China adopted the universal second-child policy at the beginning of 2016, allowing all couples to have two children, to counter problems such as ageing and dwindling workforce. After the number of birth reached 17.86 million that year, the highest since 2000, the number of birth fell to 17.23 million in 2017.

Latest NBS figures also show that the total population on the Chinese mainland reached 1.395 billion, an increase of 5.3 million year-on-year. The number of people at 60 years old or above exceeded 249 million, accounting for 17.9% of the total population, according to the bureau. (Source: China Daily)

China's top drug authority said it has been accelerating approval of new drugs researched and developed overseas, and a number of such new drugs will be available for patient use on the Chinese mainland this year.  The National Medical Products Administration released a list at the end of last year of 48 overseas new drugs, including 12 cancer drugs, for priority approval, and eight have been available in the domestic market, the administration said, China Central Television reported on Jan 14.  All these drugs are already available in overseas markets, and they are urgently needed by domestic patients, it said.

China has been simplifying inspection and approval procedures of overseas new drugs so they can be available in China more quickly. The administration would recognize data of clinical trials conducted outside China in the approval of new drugs, as long as their applicants believe the drugs will not cause different safety risks and effects to peoples of different races, according to a guideline released by the administration last year.

Previously, such data was not recognized by the administration, so lengthy clinical trials had to be conducted in China again before drugs could be approved, even though they had been available for use overseas for years. This was a cause for delay in the availability of many new drugs in the Chinese market. (Source: China Daily)

The latest 17 cancer drugs included in China's national basic medical insurance program in October are now available in more than half of all major hospitals in China, the top health authority said on Jan 10.

The National Health Commission instructed major hospitals across China in late October to buy the drugs as quickly as possible so patients will not have to wait, Song Shuli, spokeswoman of the National Health Commission, said at a news conference.

As of early January, 1,257 tertiary hospitals and 129 cancer hospitals in all 31 provinces, autonomous regions and municipalities on the Chinese mainland had bought at least one type of the drugs, with more than 600,000 boxes of drugs being used by patients, she said. "Availability of the cheaper drugs has greatly eased the financial burdens of some cancer patients," Song said. "We will continue to encourage hospitals to buy these drugs to improve cancer patients' access to them." The number of tertiary hospitals on the Chinese mainland was 2,460 as of the end of September, according to the commission.

The 17 cancer drugs, many of them imported, treat major cancers such as lung, rectal and kidney cancers, and are in high demand by patients in China. They were included in the national basic medical insurance program in October after price negotiations organized by the National Healthcare Security Administration, which resulted in prices falling by 57% on average. Patients would spend even less on the drugs after reimbursement from the medical insurance fund.

Many patented drugs, including cancer drugs, were sold at higher prices on the Chinese mainland than in most other countries for various reasons, such as higher circulation costs and lack of research and innovation ability among domestic producers, which caused a public outcry for a reduction of prices. Moreover, many of the cancer drugs were not available at the hospitals before, as they were not included in the basic medical insurance program. Li Guohui, director of the Pharmacy Office of the Cancer Hospital of the Chinese Academy of Medical Sciences, said "Now many cancer patients can have access to drugs that they could not find or afford before, and they have more choices of drugs". (Source: China Daily)

China's homegrown drug sintilimab designed for treating relapsed or refractory classic Hodgkin lymphoma has won international recognition, with its clinical trial research published as the cover paper in the January issue of The Lancet Haematology.

Hodgkin lymphoma is a rare malignant lymphoma that occurs mostly in young people between the ages of 20 and 40. Although the cure rate of early treatment is high, patients have a 20% chance of recurrence after their first treatment. Patients with relapsed or refractory classic Hodgkin lymphoma lack effective treatment in China.

Sintilimab, an anti-PD-1 drug, is a type of checkpoint inhibitor, an emerging anti-cancer therapeutic modality that boosts the immune system to help the body target and kill tumors.

Professor Shi Yuankai from the Cancer Hospital, Chinese Academy of Medical Sciences, led the clinical research, which enrolled 96 patients with relapsed or refractory classic Hodgkin's lymphoma from 18 hospitals in China. Results showed that Sintilimab has favorable activity and acceptable toxicity in Chinese patients with relapsed or refractory classical Hodgkin lymphoma, with 80.4% of the patients showing an objective response.

Stephen M Ansell from the Division of Hematology at the Mayo Clinic commented that Sintilimab is a "highly effective treatment which potentially improves the outcomes of patients with classical Hodgkin lymphoma worldwide."

Sintilimab was approved for market authorization by China's National Medical Products Administration in December 2018. "The approval will bring more treatment options for cancer patients in China," Shi said. (Source: Xinhua)

China will publish a list of generic drugs before the end of June and encourage pharmaceutical companies to research and produce them.　The list will be updated at the end of every year starting from 2020, according to a work plan jointly issued by 12 government departments including the National Health Commission.

Key generic technologies of major chemical and biological medicines on the list will be incorporated into national plans for research and development, said the plan.　The plan also promised to prioritize the approval of generic drugs on the list and ensure they have the same quality and effect as their branded counterparts.　 (Source: Xinhua)