Cancer is one of the main causes of morbidity and mortality in global population. April 15-21 this year is the 26th National Cancer Prevention and Control Week in China. The Bureau of Disease Prevention and Control of the National Health Commission (NHC) called on the whole society and the pharmaceutical industry, on the theme of “Joint Action for Cancer Prevention and Control”, to widely perform cancer prevention popularization and promotion and improve the awareness and ability of cancer prevention and control in the whole society, to effectively contain the social harm resulted from cancer and reduce the burden of cancer diseases.
“Under the guidance of the Healthy China strategy, China has continuously made great progress in drug innovation, and healthcare industry, so have cancer prevention and treatment, which is mostly attributable to the new cancer therapy, including the previous surgery, chemotherapy, target therapy and the latest tumor immunotherapy, gene therapy, etc., and drug innovation also plays an important role.” Kang Wei, the Managing Director of China Association of Enterprises with Foreign Investment R&D-Based Pharmaceutical Association Committee (RDPAC) also said “however, we have also seen that the current cancer prevention and control in China is still faced with considerable challenges. There is still a significant gap between the domestic and international level of drug accessibility for patients with cancer, accompanying with the prominent problem of cancer burden. We believe that with the deepening of China’s healthcare system reform and continuous acceleration of the review and approval procedures for innovative drug registration, more and more patients with cancer will benefit from it.”
Accelerate the R&D and introduction of innovative drugs to address the challenge of cancer
The difficulty of cancer prevention and treatment is the high recurrence and metastasis rates of cancer, serious side effects and poor precision of cancer therapy. At present, the 5-year relative survival rate of malignant tumors in China is about 40.5%, which is about 10% higher than that 10 years ago, remaining a large improving space compared with the 5-year relative survival rate of 70% in the United States. Therefore, it is necessary to continue to accelerate the introduction of innovative drugs, improve the accessibility of anticancer drugs, and let more Chinese patients benefit from the world-class achievements of drug innovation at the same time.
On September 23, 2019, 10 ministries and commissions, including NHC, National Development and Reform Commission, the Ministry of Education, Ministry of Science and Technology, Ministry of Finance, Ministry of Ecology and Environment, National Healthcare Security Administration, State Administration of Traditional Chinese Medicine, National Medical Products Administration, and the State Council Leading Group Office of Poverty Alleviation and Development, jointly issued the “Healthy China Action-Cancer Prevention and Control Implementation Plan (2019-2022)”, which clearly required to improve the accessibility of anticancer drugs, establish a sound and comprehensive clinical evaluation system of anticancer drugs, speed up the approval of the registration of new anti-cancer drugs both in China and foreign countries, promote the simultaneous marketing of overseas new drugs in China, and unblock the temporary import channels of anticancer drugs urgently needed in clinical.
At present, China has promoted the accessibility of new anticancer drugs through policies such as encouraging innovation and accelerating the reform of review and approval system. Consequently, results by stages have been achieved. Accelerating the policies related to overseas new drugs urgently needed in clinical has become one of the focuses of drug administration reform, providing a smooth highway for the approval of anticancer drugs in China and benefiting patients as soon as possible.
Obviously, there is still a significant gap between the domestic and international level of drug accessibility for patients with cancer, and the introduction of new anticancer drugs in China still needs to be further accelerated. A study report of RDPAC showed that, according to incomplete statistics, the FDA of the US, EMA of the European Union and PMDA of Japan have approved 623 innovative drugs in total from January 2009 to June 2019, 169 of which were new drugs approved by EU, the US and Japan. Of these 169 innovative drugs, 84 were approved by China, and 85 innovative drugs “gaps” are still remained. Moreover, the analysis of the main indications of these 85 products showed that there are 33 antitumor and immunomodulatory agents, accounting for 39%.
Deepen the reform of healthcare security system and reduce the burden of cancer by multi-funding
Cancer not only brings health threat to patients, but also huge economic burden to individuals and the society. So in order to solve issues in the difficult and expensive cancer therapy, the “Healthy China Action-Cancer Prevention and Control Implementation Plan (2019-2022)” clearly required to improve the dynamic adjustment mechanism of National Reimbursement Drug List (NRDL), and include the qualified anticancer drugs in NRDL according to the procedures, so as to ensure the clinical drug needs of patients with cancer and reduce patients’ burden of medication.
Based on the latest data from National Cancer Center, the morbidity of cancer in China has been increasing continuously in recent decades, with an increment of about 3.9% per year. With the increasing morbidity of cancer, the current annual medical expenses of malignant tumors in China have exceeded 220 billion. Therefore, for the current cancer prevention and control work in China, to improve the healthcare insurance policy and raise the efficiency of fund use is of great practical significance to meet the drug needs and reduce the drug burden of patients with cancer.
The current economic influence caused by the COVID-19 will have an impact on the financing of medical insurance funds. To improve the efficiency of medical insurance fund use under the limited resources, and meet the urgent needs for clinical treatment in time by the means like reducing fund wastes are particularly urgent in NRDL management under the current pandemic background.
In the long run, the expenses of drugs and vaccines are not costs, but investment. Under the guidance of Healthy China 2030 strategic goal, China’s investment in health care is expected to increase from 6.57% of GDP in 2018 to the developed countries level of 9-10% with the continuous growth of China’s economy and improvement of public health system.
In the meanwhile, it is necessary to develop multi-level healthcare security to establish a sustainable healthcare security system suitable for China’s conditions. Previously, a survey conducted by the China Development Research Foundation and the National Bureau of Statistics involving 20000 patients in three cities and 43 municipal units showed that, the most important reason that basic medical insurance cannot meet patients' treatment needs was “difficult to reimburse for major diseases”, accounting for 36.2%, followed by “low reimbursement ratio”, accounting for 35.8% and “narrow scope of medical insurance reimbursement”, accounting for 23.7%. Against this background, Opinions on Deepening the Reform of the Healthcare Security System was issued by the State Council in March this year, which for the first time listed charitable donation, mutual medical assistance, basic medical insurance, medical aids, supplemental medical insurance and commercial health insurance as part of the multi-level healthcare security system.
Accelerating the research and development of innovative anticancer drugs and improving anticancer drugs' accessibility have multiple positive significance for prolonging survival of patients, improving the patients’ quality of life and reducing the disease burden to the society, which requires the joint efforts of the government, pharmaceutical companies, hospitals and medical personnel. As a leader in the field of pharmaceutical innovation, RDPAC will work together with member companies to actively promote cross-sector cooperation, and achieve the goal of cancer prevention and control in China and the vision of “Healthy China 2030”.