How far are we from "HPV vaccine freedom"?

Because of a piece of news, Zhang Jie, who lives in Chongqing's Yubei District, was defrauded of 8,000 yuan

On August 30, the State Food and Drug Administration announced that Merck's nine-valent HPV vaccine (full name: nine-valent human papillomavirus vaccine) is extended from the original 16 to 26 years old to 9 to 45 years old

This is the first time since the nine-valent HPV vaccine was listed in China that the "age dead line"

Her judgment is correct, for several consecutive days, in the various number snatching reservation purchase groups that are already "difficult to find", people like a tide flock to it, and the "information service fee" has also risen, and the price increase has soared from hundreds to thousands

It is said that "men's Moutai and women's HPV vaccine", the significance of HPV vaccine for women is far better than that of Moutai

She has not "landed" for two years, and has tried all known feasible ways: lottery appointments, platform number grabbing, calling community hospitals one by one for consultation, and joining various consultation groups

This time, she was really panicked, and finally made up her mind to pin her last hopes on

In this way, she has fallen into the "HPV vaccine anxiety" and fell into the scam of the black intermediary agency "snatching the nine-valent HPV vaccine", and the scalper disappeared without a trace

Coming out of the police station, Zhang Jie has been in a trance, and I asked her if she plans to continue to find a high-priced vaccine? After all, objectively speaking, the two-price and four-valent price are the most

She said that once she accepted the "planting grass", this thing was engraved in her mind like a "thought stamp": the boyfriend can not be changed, single for a lifetime is not afraid, but the nine-valent vaccine must be beaten

"There's nothing better than the best, and people always want the best, right?"

Why is "one seedling" so difficult to find?

The HPV vaccine, also known as the cervical cancer vaccine, is currently the only vaccine

The public is most familiar with the star Mei Yanfang, who unfortunately died of this "incurable disease" in 2003, and many people regret for her, if she can get the HPV vaccine, she can completely avoid her untimely death

When we talk about HPV vaccines, we always add a prefix: bivalent, quadrivalent, or nine-valent

Nine-valent HPV vaccine, currently in the domestic dose of about 1300 yuan, three injections can be regarded as a successful "landing"

According to incomplete statistics from the International Agency for Research on Cancer (IARC), there are about 600,000 confirmed cases of cervical cancer worldwide every year, of which China is the highest incidence and ranks second in the world, larger than the European Union and the United States combined, second only to India

For most people, the HPV vaccine is a relatively unfamiliar concept

In 2016, Merck's nine-valent vaccine was officially launched in Hong Kong, China, and going to Hong Kong for vaccination gradually became a trend, beginning to be popular in a small area of modern girls in first-tier cities, but it was only sought after as a trendy healthy lifestyle, and was not labeled
as more complicated.

In 2017, the MERCK quadrivalent HPV vaccine, which had been applied for in 2006, finally officially passed the approval to enter the inland after spending 11 years, making up for the gap
in the domestic quadrivalent vaccine.

On April 11, 2018, when a high-level official came to Shanghai Huashan Hospital to inspect, by chance, he learned of the reality that "the supply of bivalent seedlings can be basically guaranteed, and the four-valent vaccine needs to be booked in advance, while the nine-valent vaccine has not yet been listed in the mainland", and decisively made instructions: let the willing people use the HPV vaccine
nearby as soon as possible.

On April 28, the listing approval of merck's nine-valent vaccine was hung on the official website of the Food and Drug Administration, and it took only eight days from the submission of documents to the approval of approval, setting a "rocket speed"
for Chinese drugs to pass the examination.

▲Source: Tokawa Research Institute (data as of the end of 2018)

The approval of the nine-priced seedling at the speed of light has allowed domestic consumers who need to travel to Hong Kong and other places three times to complete the three-shot treatment course, and the large number of demand accumulated in more than ten years has been completely detonated
.

The market from scratch, extremely low penetration, and broad market space make HPV vaccine one
of the most promising popular vaccine varieties in the industry.

But the vaccine is not engaged in small commodity wholesale, the goods can not be said to pull on the pull, "Chinese-style approval speed" makes this veteran multinational pharmaceutical company mixed, vaccine capacity expansion is usually to year or even decade: where do I go to get so much production capacity out at a time?

The nine-valent HPV vaccine can only be produced by one merck company in the United States, but merck's nine-valent HPV vaccine production capacity is far from meeting the global market demand
.

Considering the balance of supply and demand on a global scale, Merck, which was caught off guard at the beginning, can also transfer goods in a small range of East Asia, and it is obvious that the cup of water cannot save such a big fire, so it can only choose "limited" supply
.

The nine-valent HPV vaccine is not only lacking in China, but also in the global market
.

Domestic supply can only be small and fixed, so in terms of distribution, it can only rely on "grab"
.

Some regions have opened a "lottery appointment system" similar to the license plate for the nine-valent HPV vaccine, and set a "threshold" (16-26 years old) after the winning rate is still only single digits, comparable to playing new stocks
.

Cancer prevention, expensive prices, scarce supplies, age restrictions and other characteristics make the nine-valent vaccine an invisible luxury
.

Backed by the popularity of social media and the circle of friends, many women have a chance to seize the prevention, and in the spirit of "be nice to themselves", everyone hopes to be able to get a better high-priced vaccine
when they are vaccinated.

The nine-valent vaccine has the widest scope of protection, but the "winning rate" of vaccination appointments is extremely low, which has become a heart disease
that makes girls angry and anxious.

Nine-valent vaccines in the mainland have been in short supply from the beginning, and this imbalance between supply and demand has continued to this day and has a growing trend
.

Who is hyping up the HPV vaccine

Vaccines are divided into first-class vaccines and second-class vaccines, the former is provided free of charge by the government, citizens are seeded in accordance with regulations, uniformly purchased by the government on the provincial platform, and directly distributed by production enterprises to the terminal CDC, such as hepatitis B vaccine, live attenuated polio vaccine and other 0-6 years old children are vaccinated
.

The second type of vaccine is paid and voluntarily adopted by citizens, and self-priced, such as rabies vaccine and HPV vaccine
.

"Independent pricing" means that there are middlemen agents, according to relevant policies, foreign companies are not allowed to directly sell vaccine products in China, Zhifei Bio has become the exclusive domestic agent of Merck's nine-valent HPV vaccine, responsible for the promotion, sales and distribution
of terminals.

Merck exclusive production, Zhifei Biological exclusive agent, two "exclusive" to win the entire HPV industry chain profits
.

Merck China's total revenue reached US$4.
262 billion in 2021, up 60% year-on-year; The domestic Zhifei Biological, relying only on the agent MERCK's HPV vaccine, will "lie" and earn more than 20 billion yuan
in 2021.

According to the latest data from the National Bureau of Statistics, the age-appropriate population (16-26 years old) of the nine-valent HPV vaccine is about 120 million
.
Among the nine-valent vaccine batches issued by Zhifei Bio, it was 3.
324 million in 2019 and 5.
066 million in
2020.

By comparison, the number of people who were able to get the vaccine was less than 1.
5 percent
of the total.
This also means that the nine-valent HPV vaccine can only rely on "grab"
at present.

The few remaining fractions of profits are divided
up by domestic intermediaries, medical institutions, content platforms and other organizations in the marketing chain.

Intermediaries are responsible for "snatching", medical institutions are divided into public and private, responsible for sales and injection, and social platforms such as Xiaohongshu, Weibo, and Zhihu are responsible for "planting grass"
.

It is worth noting that there will be a large number of black intermediaries in the intermediary, fraud is not uncommon, private hospitals have so-called "smuggled goods" from Japan, South Korea, Europe and the United States with "human flesh baggage" to bring the vaccine to the country, true and false is also difficult to distinguish
.

Nine-valence substitution robbery is the most common "way to play", which includes both "real scalpers" who make differences through technical means and those who eat the anxiety of the group and wear scalpers
.

On social platforms, searching for "nine-valent vaccine", in addition to obtaining relevant knowledge popularization, experienced users will always find a hidden "proxy robbery", which has also become a channel
for the "scalper" party to profit.

Much criticized is the "planting grass" link
.
The routine of "planting grass" is to rely on selling health anxiety, and then create scarcity to strengthen anxiety, and carry out repeated bombing and speculation
.

Search for "nine-valent HPV vaccine" on the Little Red Book and you'll find more than 320,000 notes
.
Successful reservation of nine prices is the same as the success of the graduate school, which is called "landing"
by bloggers.

"The boy who gave you the nine-valent can get married", such a sentence came to the fore, and the nine-valent HPV vaccine became the standard in various love stories
.

In addition to binding identities to love keepsakes, the nine-valent HPV vaccine also hits the health anxieties
of many young women.

One is because cervical cancer is currently the only gynecological malignancy with a clear etiology, and the other is that it is directly related to the persistent infection of the HPV virus, and the sum of the two becomes a sentence that can more arouse anxiety and empathy:

"Sisters, if you don't get the HPV vaccine, the risk of cervical cancer will be very high, and you can only get the nine-valent vaccine
.
"

The intimidating marketing of equating HPV infection with cervical cancer, coupled with the anxiety of "one seedling is hard to find", has further successfully awakened the sisters' fear
of cancer.

Young girls are trapped in it and can't extricate themselves, some even think that the boyfriend or husband does not help her make an appointment, that is, does not love her performance, there will be classmates crying to complain to girlfriends, boyfriends "there are more than ten thousand in the card, is not to buy me nine prices.
"

Under the long-term publicity of social media, in the minds of countless people, "HPV vaccine" is the default and "nine-valent vaccine" is equated
.

The entire industrial chain is interlocked and the division of labor is clear, each performing its own duties, each benefiting, successfully pushing the nine-valent HPV vaccine to the "ceiling" of hpvide vaccine, objectively speaking, in fact, the bivalent and quadrivalent have basically met the needs, and regular screening is king
.

In an era of consumerism, vaccines became fashionable consumer goods, even with hierarchical chains
of contempt.

How far are we from "HPV vaccine freedom"?

The field of vaccines has always shown an oligopoly pattern for many years, and the four giants GlaxoSmithKline (GSK), Sanofi, Merck and Pfizer together occupy more than 90% of the global vaccine market share
.
The HPV vaccine is no exception
.

The main reason for the high degree of upstream concentration is that high technical requirements, high R&D investment bring high barriers to entry and moats, and the listing of vaccines requires a license, which artificially sets the entry threshold
.

The expansion of hpV vaccine capacity is limited by three factors: capital investment, construction cycle, and continuous expansion of
production capacity.

The construction of the industrialization base invests a lot of money and talents, and also requires a certain cycle of construction, just the capacity began to be released to climb the slope to the planned mass production requires a long period
.

In particular, vaccines are an extremely complex biological product, DNA testing and vaccine immunogenicity testing are cumbersome and complex, and there are multiple batches of clinical trials and effect feedback in the later stage, running through the entire process, the process often takes years and decades
.

This is also one of the reasons why as of now, there is no vaccine for nine-valent HPV in China, after all, we have laid out too late
.

Fortunately, domestic vaccine manufacturers are also actively entering the game
.

On December 30, 2019, the State Food and Drug Administration approved the listing of the divalent HPV vaccine Xinkoning of Xiamen Wantai Canghai Biotechnology Co.
, Ltd.
through the priority review and approval procedure, becoming the first domestic HPV vaccine
in China.

This "homegrown" bivalent HPV vaccine in China, like Merck's quadrivalent HPV vaccine and GSK's divalent HPV vaccine, has experienced a long period of more than 10 years from research and development to marketing, and from the price level, the unit price of domestic vaccines is nearly half
lower than that of imported vaccines.

In April 2020, Wantai Bio landed on the main board of the Shanghai Stock Exchange, and the stock price rose by 44% on the first day of listing, and then recorded 26 consecutive limit increases
.

At the same time, it is Zhong Shuishui, who has won the king and won the richest man in China with the help of this vaccine, and everyone knows that Zhong Issho is the man behind Nongfu Spring, but it is rare to understand that he actually controls a huge health industry map, that is, He himself directly holds 18.
17% of the shares, and indirectly holds about 56.
98% of the shares through the Yangshengtang
.

Many people exclaimed that the big guy's side business did not expect to make so much money, which made people hopeless, the big guy was ostensibly a porter of nature, but in fact, he was doing high-level leading industries
such as health care, vaccines, and great health.

On 17 November 2020, the WHO (World Health Organization) launched a global strategy to accelerate the elimination of cervical cancer, and the 194 member states that have committed to join the strategy, including China, will vaccinate 90% of girls against HPV by the age of 15 by 2030
.

Since last year, Ordos in Inner Mongolia, Xiamen in Fujian, Jinan in Shandong, Guangdong Province, Wuxi in Jiangsu and other places have successively promoted free or subsidized HPV vaccines for women of appropriate age (mainly bivalent), which has accelerated the promotion
of domestic bivalent vaccines to a certain extent.

At the same time, the research and development of domestic nine-valent HPV vaccines is also in
full swing.

At present, there are 4 companies that have opened the phase III clinical trial of the nine-valent HPV vaccine, and according to the general schedule, they are expected to be put into the market as early as 2025, namely Wantai Biological, Ruike Biological, Bowei Biological and Connaught Guardian
.

From the clinical endpoint, all 4 players were very consistent: CIN2+ lesion (cervical intraepithelial neoplasia grade II and above).

In the face of a huge market gap, the 4 players have a certain domestic replacement space in the future, and the only suspense is who can take the lead in rushing the line
.

According to the data released by the China Commercial Industry Research Institute, the current penetration rate of domestic bivalent vaccines is 0.
26%, quadrivalent vaccines are 0.
6%, and nine-valent vaccines are 0.
65%, and the
market is still in a super blue ocean.

After the applicable population of the nine-valent HPV vaccine is expanded to 9-45-year-old women, the number of women of appropriate age will soar directly from 70 million to 360 million, and for Merck, "age expansion" has further released China's already vast market space, nearly 5 times
.

However, to supply to more than 70 countries around the world, Merck currently has insufficient production capacity, and Merck has also cut off hpved vaccines
in some parts of the world.

The setting of the age of hpV vaccine and the perennial shortage of supply are the core problems behind the game and balance of
commercial interests.

In the pharmaceutical market, the scope of indications, changes in the mode of administration, etc.
, have never been purely scientific problems
.

But at the same time, the 26-year-old "age dead line" was stretched to 45 years old, an extra 19 years, objectively speaking, giving 4 players a chance to
breathe or even turn over.

All those who can help have helped, and they can only help here, gentlemen: the revolution has not yet succeeded, and comrades still need to work hard
.

Write at the end

It is worth mentioning that the nine-valent HPV vaccine belongs to the national immunization program project in many countries, including the United States, Australia, the United Kingdom and other countries, which is equivalent to our free first-class vaccine, and the vaccination rate is more than
90%.

At present, we have not even achieved "free self-payment", to include the age of free, in addition to financial subsidies, domestic vaccine manufacturers need to continue to work hard, and work hard to work harder
.

At present, three vaccines in china's mainland has not been approved for male vaccination, bivalent vaccines against HPV16 and HPV18 caused by cervical cancer, in principle, men may also carry these two viruses, Europe and the United States and other countries men have already been hit
.

Ladies preferred
.
After female friends achieve "HPV vaccine freedom", will men volunteer to get it?