Source innovation and payment problems to be solved How can medical innovation make patients “usable” and “affordable”?

◎Song Ruilin, executive chairman of the China Pharmaceutical Innovation Promotion Association, said that China needs to establish basic research that matches its own drug development and clinical needs, and gradually strengthen source innovation
.

◎Conway, Executive President of the Pharmaceutical Research and Development Committee of the China Association of Enterprises with Foreign Investment, based on international experience analysis, said that commercial insurance products in many foreign countries include supplementary insurance and high-end insurance.

Recently, the China Pharmaceutical Innovation Promotion Association (PhIRDA) and the Pharmaceutical Research and Development Industry Committee of the China Association of Foreign Investment Enterprises (RDPAC) issued the "Building China's Pharmaceutical Innovation Ecosystem (2021-2025)" (hereinafter referred to as the "Report"), which shows that, Medical insurance's expenditure on patented drugs has increased from 11 billion yuan in 2017 to 37 billion yuan in 2020.
Support for reimbursement of innovative drugs has increased the availability of innovative drugs
.

However, there is still a long way to go for the innovation of Chinese medicine at the source.
How to ensure the long-term flow of medical insurance negotiations, build an innovative drug payment system, and improve the level of protection is still a problem to be solved
.
At the press conference, Song Ruilin, executive chairman of the China Pharmaceutical Innovation Promotion Association, said that the purpose of pharmaceutical innovation (with innovative drugs) is to make it available to the common people, and of course it must be affordable.

"Useful": Cooperative mode can be adopted for drug source innovation

At least one innovative drug can reach patients after undergoing R&D, clinical, application, review, and approval
.
In a long process of 7 to 8 years on average, the "source innovation" focused on drug discovery is the beginning of everything.

According to the "Report", the number of Chinese biomedical papers published in 2020 will reach nearly 290,000, but the proportion of papers published in the three top academic journals "Nature", "Science" and "Cell" is only 0.
17%, which is much lower than The leading biomedicine countries in Europe and the United States are generally higher than the 0.
6% level
.
In addition, there is a significant gap between China and European and American countries in terms of the number of leading biomedical talents.

In this regard, Song Ruilin said that China needs to establish basic research that matches its own drug development and clinical needs, and gradually strengthen source innovation
.
At present, the phenomenon of domestic innovation clustering has also appeared in the history of international drug development, but the current situation of clustering in China is more serious, so it is necessary to emphasize source innovation.

As a representative of a multinational pharmaceutical enterprise organization, Conway, executive president of the Pharmaceutical Research and Development Industry Committee of the China Association of Foreign Investment Enterprises, said that from the experience of multinational enterprises, source innovation may require more than ten years or even decades of investment, but the drug research and development model It can be cooperative
.
For example, the mRNA technology that shines in the new crown epidemic is actually the research result of a Hungarian biochemist

"For source innovation, the exploratory spirit of scientists is the most important
.
Now China is already on the way to explore new targets, but there may still be a long way to go and it will take several generations of efforts to achieve it

In fact, based on the status of drug R&D in the business, the industry divides innovative pharmaceutical companies into two camps: Biotech (biotech company) and BioPharma (biopharmaceutical company)
.
Among them, the former takes the research and development of innovative drugs as its core business, and generally does not involve the production and sales links after the product goes on the market; the latter covers the integrated links of research and development, production, and product commercialization

Song Ruilin said that China's pharmaceutical innovation is still in the "climbing" stage, and a large number of newly born Biotech companies still need the professional guidance of CRO (R&D outsourcing organization), clinical design and data statistics services
.
Therefore, the self-built clinical teams of pharmaceutical companies and CROs are complementary, but companies have different needs at different stages
.

"It is very normal for companies like BeiGene and Hengrui Pharmaceuticals that have transformed from Biotech to Biopharma.
They build their own clinical teams and have the clinical R&D capabilities of CRO.
In fact, this will not have much impact on the CRO industry.

"Song Ruilin said
.

"Affordable": Supplementary commercial insurance and high-end commercial insurance will have room for development

In 2018, China's National Medical Security Administration was formally established, and China's medical insurance system has also undergone tremendous changes
.
However, it is worth noting that in the current Chinese medical insurance system, the payment system for innovative drugs is still in the early stage of establishment.
How to match the medical insurance payment system with the development of innovative drugs in China and improve the accessibility of innovative drugs is what the Chinese pharmaceutical industry faces New proposition
.

According to the sales data of China's prescription drug market in 2018, patented drugs accounted for 9% of the value of China's drug market
.
At present, the proportion of patented drugs in European and American countries in the drug market has reached more than 40%.
Turkey, Russia, Mexico, Brazil, Indonesia, South Africa and other countries whose per capita GDP is similar to or lower than China, their patented drugs also account for more than 20%.
%
.

The market share of China's innovative drugs does not match the level of economic development and the development goals of innovative drugs

Image source: Screenshot of "Report"

In order to coordinate the sustainable development of innovative pharmaceutical companies and the availability of medicines for the common people, it is necessary to build a multi-level guarantee system for innovative medicines.
"Increase income and reduce expenditure" is the answer given by Song Ruilin
.

"'Open source' requires the participation of the entire society
.
We cannot reduce the clinical value of drugs because medical insurance funds are insufficient, so that the majority of patients will suffer
.
Therefore, we must separate the clinical value from the ability to pay.
On the one hand, the clinical value On the other hand, the medical insurance department must do what it can to determine the payment standard of medical insurance according to the ability of medical insurance to pay
.
"

Song Ruilin proposed that to establish a new medical insurance payment system for innovative drugs, it is not to throw the burden on the common people, but to establish a social co-governance system, so that the whole society and all stakeholders of the industry chain can join, and establish a clinical value as the core.
The drug research and development, application, review, use, and access system of the company are measured with one ruler
.

Song Ruilin further analyzed that due to the different national conditions of various countries, China cannot fully learn from foreign experience when establishing a multi-level medical security system
.
He believes that it is very important for the community to participate in multiple parties to find a balance between the market and the government-"In the future, when the world’s first country of approval for new drugs is in China, China will become the number one pricing country.

.
Whether our price is appropriate will directly affect the local enterprises' going global
.
"

From the way of participating in commercial insurance, Conway puts forward an idea based on international experience
.
She said that commercial insurance products in many foreign countries include supplementary insurance and high-end insurance.
The former refers to the part of the basic medical insurance that cannot be reimbursed or the reimbursement ratio is small, and forms a good supplement to the basic medical insurance; the latter can be used.
Point to high-end medical services such as single wards
.

"I think that in the future these two types of insurance will have room for development in China's pharmaceutical industry,
" Conway said
.