26 billion yuan in the lung cancer market: targeted drugs are competing, with an average annual growth of 122% for icotinib

In May this year, the first batch of national drug price negotiation results were released, and the price negotiation procedures for non-small cell lung cancer targeted drugs exetane (Zhejiang Beida Kemena), gefitinib (Iresa) and anti hepatitis B drugs tenofovir dipivoxil were completed According to reports, the next step is to select 18 drugs for price negotiation, which are still hot drugs in the tumor market In the field of tumor treatment, with the new drugs coming into the market, targeted drugs and immunotherapy bring more hope to patients In the era of precision medicine, chemotherapy is still the cornerstone of cancer treatment, standardized treatment can improve the survival benefits of patients Overview: TiNi is the pillar variety According to the data disclosed in the 2015 annual report of China cancer registration, in recent years, the incidence of cancer in China has continued to rise In terms of the whole country, lung cancer ranks first in the incidence of malignant tumors, followed by gastric cancer, colorectal cancer, liver cancer and esophageal cancer The top 10 malignant tumors accounted for 76.39% of the total, which has been widely concerned Under the rigid demand, it is a general trend to promote the localization of anti-tumor drug market Lung cancer is usually divided into NSCLC and SCLC in clinic NSCLC accounts for the majority of lung cancer, while NSCLC is subdivided into adenocarcinoma, squamous cell carcinoma and large cell carcinoma The treatment of lung cancer includes surgical treatment, radiotherapy, chemotherapy and immunotherapy Early diagnosis of lung cancer means that a considerable number of patients can be cured and improve the survival rate Comprehensive and differential treatment can achieve better therapeutic effect At present, the first-line chemotherapy for NSCLC is carboplatin or cisplatin combined with Taxus or gemcitabine Since the advent of small molecule targeted drugs, gefitinib, erlotinib, exetane and pemetrexed as the second-line treatment scheme can benefit the elderly patients with lung cancer At present, TiNi drugs are the mainstay of lung cancer drugs New drugs for lung cancer are changing with each passing day According to the latest data, from 1997 to March 2016, the US FDA approved a total of 128 anti-tumor drugs From the perspective of classification, chemotherapy and antibody drugs are the main drugs in the front In 2015, China spent $107 billion on cancer treatment, up 11.5% year on year According to the market data of anti-tumor drugs in 2015, monoclonal antibody drugs accounted for 36.92%, conventional chemotherapy drugs accounted for 27.84%, and small molecule targeted drugs accounted for 22.94% As of June 2016, the U.S FDA approved a total of 72 targeted drugs, 11 of the 24 small molecule targeted TiNi drugs were used to treat lung cancer, accounting for 46% of the total There are 6 small molecule targeted TiNi drugs for lung cancer in China (see Figure 1) At present, the small molecule targeted Tinian drugs that have not been introduced to treat lung cancer in China are gilotif, zykadia, tagrisso, alecensa, xalkori and so on, which have been approved by FDA since 2013 In recent years, the drug market of Chinese anti-tumor drug hospitals has shown a rapid growth trend According to the data of mienei.com, in 2015, the market of chemotherapy drugs for lung cancer in public hospitals in key cities in China reached 6.509 billion yuan, an increase of 5.61% over the previous year It is conservatively estimated that the market of lung cancer treatment in China has reached 26 billion yuan There are 34 commonly used chemotherapy drugs in domestic sample hospitals, among which taxol, docetaxel, pemetrexed, tegio, gemcitabine, ubenimex, gefitinib, exetinib, solafeni and erlotinib are the top ten The amount of top 10 drugs for lung cancer accounted for 78.75% of the market of lung cancer chemotherapy With the arrival of the era of precision medicine, anti-tumor drug treatment shows new market characteristics of personalized treatment, differential treatment, targeted treatment, immunotherapy and combination therapy With the awesome policy of the state and the improvement of medical insurance year by year, the small molecule targeted drugs have gradually entered the field of vision According to the data of MI Nei net HDM system, in 2015, the amount of small molecule targeted drugs for lung cancer in public hospitals in key cities in China reached 816 million yuan, an increase of 12.02% over the previous year, while the growth rate in 2014 was as high as 47.76% The top 5 drugs are gefitinib, exetinib, sorafenib, erlotinib and apatinib according to the amount of medication According to industry estimates, the domestic market has exceeded 5 billion yuan At present, the drug varieties of lung cancer treatment in domestic sample hospitals are basically in line with international standards Pemetrexed, erlotinib, exetinib, gefitinib, sorafenib, bevacizumab, recombinant human tumor necrosis factor (tianenfu), recombinant human vascular endothelial inhibitory factor (endu) have been used in clinical practice At present, under the influence of many factors, such as medical insurance and medical expenditure, there are still some differences in the main types of lung cancer treatment market at home and abroad In general, in the international anti-tumor market, monoclonal antibody and TiNi molecular targeted drugs are the main drugs; in China, cytotoxic drugs such as paclitaxel, docetaxel, gemcitabine, epirubicin, carboplatin and ifosfamide have been the key treatment options In the past 10 years, lung cancer treatment has made great strides The discovery of lung cancer driving genes has brought about this progress For the treatment of lung cancer, targeted drugs need to be combined with chemotherapy drugs At present, there is a preliminary consensus on chemotherapy for non-small cell lung cancer in clinical practice Using cisplatin plus docetaxel, paclitaxel, gemcitabine, vinorelbine, one or more of them, and choosing different combinations can achieve the purpose of improving the efficacy and reducing the toxicity Variety gefitinib: "leader" to reduce price for sales gefitinib is a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor After the drug enters the body, it can improve the antitumor activity of conventional chemotherapy, radiotherapy and hormone therapy, improve the symptoms of metastatic non-small cell lung cancer, and thus improve the survival period of patients Gefitinib was developed by AstraZeneca in the United Kingdom In May 2003, FDA approved it to be listed in the United States Its trade name is IRESSA It has become the third-line drug for patients with advanced non-small cell lung cancer whose chemotherapy of platinum and paclitaxel series compound preparations is ineffective Currently, in the United States, Japan, Australia and China, gefitinib is the main drug approved for the treatment of advanced lung cancer or metastatic non-small cell lung cancer Yiruisha's curative effect on lung cancer in foreign countries has been controversial In Europe and America, yiruisha was once frustrated and the market performance fluctuated As a result, the global sales performance of eresa in its 15 years of listing is only one third of that of Roche erlotini In February 2005, gefitinib of AstraZeneca entered the Chinese market under the trade name of "Iresa" Gefitinib showed a certain activity to EGFR mutation in patients with different races of lung cancer, and its efficacy exceeded the common first-line chemotherapy Studies have shown that Iressa has a significant life prolonging effect on Oriental or non-smokers In the complex situation of academic promotion and high drug price, its sales performance is hovering According to the data of MI Nei net HDM system, in 2015, the amount of gefitinib used in public hospitals in key cities in China was 253 million yuan, down 7.11% year on year After the first batch of drug price negotiation by the national health and Family Planning Commission, if we can enter the new medical insurance catalogue, we can achieve the effect of taking the quantity at a reduced price Exetane: the acceleration is rapid, with an average annual growth of 122% With the listing of a new generation of domestic Tinian drugs, the market share of small molecule targeted drugs is increasing year by year According to the market statistics of domestic sample hospitals in 2015, domestic Tinian drugs market accounts for 20% of the total Tinian market, and domestic small molecule targeted drugs have become a new highlight in the market The first small molecule targeted anti-tumor drug with completely independent intellectual property right in China is exetane from Zhejiang Beida Pharmaceutical Co., Ltd., which was approved at the beginning of the 12th Five Year Plan for advanced non-small cell lung cancer, under the trade name of Kemena Exetane has Chinese, American and international patents, similar to gefitinib and erlotinib in chemical structure, molecular mechanism of action, efficacy, etc., but with better safety, so it has won the high praise of international clinical oncologists, and gradually broke the monopoly market situation of imported drugs According to the data of MI Nei net HDM system, in 2015, the amount of exetinib used in public hospitals in key cities in China was 189 million yuan, an increase of 33.95% over the previous year; in 2015, the market size of exetinib in China was 896 million yuan According to the data of the listing prospectus of Beida Pharmaceutical Co., Ltd., the sales revenue of exetane has reached 2.058 billion yuan in three years, and it has maintained a high growth rate for four consecutive years, with an average annual growth rate of 122% It is predicted that the drug will become the leader of small molecule targeted drug market for lung cancer in 2016