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Commercial Perspectives: Hepatitis B and C - The Chinese Way?Published by: Datamonitor Published: Aug. 26, 2004 - 102 Pages Table of ContentsTABLE OF CONTENTS CHAPTER 1 EXECUTIVE SUMMARY 3 Scope of the analysis 3 Datamonitor insight into the Chinese Hepatitis B & C market 3 Despite possessing a fifth of the global population, a largely undeveloped economy restricts Chinese healthcare expenditure to 1% of global medical expenses and spending per capita ($49 per head) almost 10 times less than that recorded in the US (WHO figures). Pharmaceutical expenditure accounts for a large proportion of healthcare spending (approx 70% in 2002) of which Western companies such as GSK play an increasing role. 4 Parenteral viral infections such as HIV/AIDS, hepatitis B and hepatitis C greatly affect regional populations in China, especially Yunnan and Guangdong provinces where use of unsafe syringes (ranging from 30-100%) and maternal-to child transmission are key epidemiological drivers. China is estimated to account for one third of chronic HBV and one fourth of chronic HCV infections worldwide with 20m sufferers of viral liver disease in total. 250-280,000 HBV related deaths occur annually, claiming more lives than HIV/AIDS. 5 Official estimates suggest that China’s yearly medical expenses for liver disease infections are more than $12 billion providing a significant cost-benefit argument for effective Western treatments and HBV vaccination, which compete against non-pharmaceutical treatment options. Key China HBV antiviral products are GSK’s Heptodin (lamivudine), Hepsera (adefovir dipivoxil) and Sciclone’s Zadaxin (thymosin alfa 1) the latter being launched first in 1996. 6 According to IMS Health the total Chinese HBV and HCV combined market was worth over $70m in 2003 and is growing rapidly (CAGR 1999-2003, 36%). This growth is largely due to increased uptake of branded antivirals such as Heptodin and Zadaxin, which have reduced market share of unmodified interferons (Schering-Plough’s Intron A). Generic molecules make-up around 52% of market share in 2003 despite the absence of locally produced lamivudine. Datamonitor estimates that IMS sales data covers between 56-67% of current HBV and HCV 2003 market value, which could be as high as $112m. If China can reach average Western rates of diagnosis and treatment the annual market for an HBV antiviral could be approx $660m, or five times the current market value. 7 Key metrics 9 CHAPTER 2 CHINA: AN OVERVIEW 18 Country profile 18 Economy 18 Shift from a centralized to a market economy 18 Benefits from World Trade Organization (WTO) membership 20 Society 22 Healthcare in China 23 The current scenario 23 Symptoms of an ailing healthcare system 25 Discrimination against the poor 26 Reforms on the horizon? 26 Economic potential of the Chinese healthcare market 28 International presence 31 CHAPTER 3 HBV & HCV IN CHINA 33 Infectious diseases in China 33 Viral hepatitis: a brief introduction 34 Disease definition and epidemiology 35 HBV disease definition 35 Transmission and disease manifestation 36 Disease life-cycle and progression 37 Coinfections with other pathogens 39 HCV disease definition 39 Transmission and disease manifestation 39 Disease life-cycle and progression 40 HBV & HCV epidemiology 41 Case study: pharmaceutical management of HIV/AIDS in China 47 Background: parallels between HIV/AIDS and chronic hepatitis 47 Roles for the international corporate sector 49 Governmental intervention 50 CHAPTER 4 HEPATITIS TREATMENT OPTIONS 53 Treatment goals 53 HBV disease management 53 Criteria for initiation of treatment 53 HBV drug therapy 54 Immune modulators 56 Nucleoside analogues 57 Combination therapy 60 HBV drugs in the pipeline 60 HCV disease management 61 Criteria for initiation of treatment 61 HCV drug therapy 61 Monotherapy: interferons and pegylated interferons 62 Combination therapy 63 Genotype dependence on response rate 64 HCV drugs in the pipeline 64 Threats to the Chinese pharmaceutical market 65 Traditional Chinese Medicine (TCM) 66 Counterfeit drugs 66 Case study: Pfizer takes action against counterfeit medicines 67 Prevention 67 HBV vaccination 68 Hepatitis management in China 70 CHAPTER 5 THE CHINESE HBV & HCV MARKET 71 HBV & HCV pharmaceutical sales 71 Western presence in the Chinese pharmaceutical market 73 Market share by drug class 74 Market share by individual drug 76 Generic competition 79 Case study: Sciclone’s success story Zadaxin 82 The current and prospective Zadaxin market 83 Sciclone’s growth strategy 85 Case study: GSK’s lamivudine causes conflict of interest 87 Limitations of the Midas Medical Data, IMS Health 89 IMS sales data versus real sales 90 Estimation of annual Chinese HBV antiviral commercial potential 91 APPENDIX A 93 Bibliography 93 Journal articles 93 Conference presentations 94 Press releases 95 Organizations and websites 97 Miscellaneous 98 APPENDIX B 100 About Datamonitor 100 About Datamonitor Healthcare 100 Datamonitor Healthcare’s research and analysis methodologies 101 Disclaimer 102 AbstractIntroductionAlong with China's growing economy, the need for improved healthcare infrastructure and modern pharmaceuticals has attracted many Western manufacturers. One immediate opportunity is the region's high proportion of global chronic Hepatitis B and C. Antivirals such as lamivudine and adefovir compete not only against Zadaxin and interferons, but also established traditional remedies. Scope Up to date overview on Chinese healthcare indicators, current market scenario and outlook for Western manufacturers Discussion of impact of infectious diseases on China with focus on parenteral viruses: Hepatitis B and C, HIV/AIDS Discussion of Hepatitis B and C epidemiology in China along with disease management strategies including availability of Western treatments Discussion of China market dynamics including class, product and company share. Appraisal of IMS data coupled with epi based HBV market evaluation Highlights Despite possessing a fifth of the global population, a largely undeveloped economy restricts Chinese healthcare expenditure to 1% of global medical expenses and spending per capita ($49 per head) almost 10 times less than that recorded in the US (WHO figures). China is estimated to account for one third of chronic HBV and one fourth of chronic HCV infections worldwide with 20m sufferers of viral liver disease in total. 250-280 thousand HBV related deaths occur annually, claiming more lives than HIV/AIDS. According to IMS Health the total Chinese HBV and HCV combined market was worth over $70m in 2003 and is growing rapidly (CAGR 1999-2003, 36%). Datamonitor estimates that IMS sales data covers between 56-67% of current HBV and HCV 2003 market value, which could be as high as $112m. Reasons to Purchase Gain an up to date view on infectious diseases in China including current epidemiology, treatments and outlook Understand current penetration strategies of Western manufacturers as they gain foothold in this significant market Benchmark the commercial potential of markets for HBV and HCV treatments with internal estimates Get Full Details About This Report >> |
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