Foreign pharma giants go head-to-head as cervical cancer injection enters China
With Chinese women's health consciousness growing and their consumption ability improving, vaccines to prevent cervical cancer, a disease mainly attributed to HPV, are expected to be highly demanded in the country as the drug was allowed to enter the mainland market last year. Aimed at the lucrative market, international drugmakers GSK and Merck & Co, which are currently the only two providers in the mainland of this type of vaccine, have sparked fierce competition by adopting different strategies. However, they are facing pressure from domestic firms, who will soon enter the market and start snapping up shares.
After a long wait of a decade, two kinds of vaccines for the prevention of cervical cancer debuted on the Chinese mainland in 2017, and now, two international pharmaceutical giants are ramping up efforts to take up big slices of the huge potential market for HPV (human papillomavirus) injections.
UK drugmaker GlaxoSmithKline (GSK) announced in July 2017 that Cervarix, the first vaccine for cervical cancer prevention to enter the Chinese mainland - approved by the China Food and Drug Administration (CFDA) a year earlier - has officially been launched in the domestic market.
In May 2017, Gardasil, an HPV vaccine produced by GSK's rival, US-based Merck & Co, was also approved by the CFDA.
Since 2007, around the time when the first HPV vaccine became available, the injection has been gradually entering the medical markets of over 130 countries and regions around the world, including the U.S., the UK, Japan as well as China's Hong Kong Special Administrative Region.
Women from the Chinese mainland would have to visit Hong Kong on three separate occasions to complete the three-dose HPV vaccination series in six months. That indicated a big vacancy for the drug in the mainland market.
However, now that void has finally been filled, fierce competition among the two foreign drugmakers is brewing.
According to the World Health Organization, nearly all cases of cervical cancer, the fourth most frequent cancer in women worldwide, can be attributed to HPV, a common sexually transmitted infection.
China has a population of 557.32 million women aged 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year, 61,691 women are diagnosed with cervical cancer nationally and that 29,526 Chinese women die from the disease annually, statistics from the Spain-based HPV Information Center showed in 2017.
Cervical cancer ranks as the 8th most frequent cancer among all women in China, one-fifth of the world's women, and the 2nd most frequent cancer among Chinese women between 15 and 44 years of age, the center reported.
Also, the huge population of China and ever-rising consumption ability of Chinese women are both contributing to the seemingly lucrative HPV vaccine market since it is the type that citizens are willing to have and pay for.
Data from the Qianzhan Industry Research Institute showed that 44 million people in China are potentially demanding the vaccine, which would lead to a value of 88 billion yuan ($13.9 billion) in the domestic market, based on the expected price of 2,000 yuan per injection and a market penetration ratio of 10 percent, domestic financial news publication Caixin Weekly reported.
Different strategies
In order to encourage the adoption of the vaccination across the domestic market within a short period of time, both GSK and Merck & Co have been developing cooperation with Hong Kong-listed Alibaba Health Information Technology Ltd since last year, through which, streams of traffic, especially that of women, will head toward the vaccine.
The integration of the internet and vaccine awareness can help improve the health of the next generation, said Joe Romanelli, president of Merck & Co.
Zhang Yingwei, vice president of GSK, told Caixin that about 300,000 people have been conducting online consultations about the vaccine since its cooperation with Ali Health five months ago, of which over 50,000 have made an appointment to have the injection so far.
However, the two international players differ in the way they play the game in China. Merck & Co has chosen a domestic partner, Chongqing Zhifei Biological Products Co, which has exclusive rights over its Gardasil, while GSK insisted to be responsible for the whole chain, from research and development to promotion and sales, according to the Caixin report.
"We use our self-established network to promote the vaccine," GSK's Zhang said, as this can guarantee the quality and legal compliance of academic promotion. Besides, "[the network] can guarantee the supply," he noted.
Logistics and supplies play a significant role for the two firms since they are more superior when it comes to research and development but not that strong in abilities to run supply chains and sales channels, Caixin reported.
"The network of Zhifei Biological is more mature and widespread than that of GSK, yet compliance risks of third-party firms should not be neglected," a senior executive from a vaccine firm, who preferred to remain anonymous, told Caixin.
Domestic competition
For the two international giants, how to maximize the advantage of time gaps before homegrown vaccines enter the market has become the most important factor.
GSK's Cervarix is targeted at younger Chinese women aged between 9 and 25. Merck & Co's Gardasil meanwhile is aimed at Chinese women between the ages of 25 and 45.
As such, the two companies' vaccines together have the potential to help women ranging from 9 and 45 worldwide, said the Caixin report.
The difference in targeted age groups resulted from the designs of their clinical trials conducted in China at the early stages.
Both firms are preparing for new clinical trials in order to expand the range of potential customers, meaning their "age gaps" will be quickly filled up and competition will become fiercer, said the report.
Meanwhile, they are under pressure from domestic players who could soon enter the battle.
So far, five domestic firms have already conducted first-phase clinical trials for HPV vaccinations.
For example, the HPV vaccine produced by Shanghai Zerun Biotechnology Co, has been approved by the CFDA for clinical trials.
