27.5 yuan per shot! HPV vaccine finally becomes as cheap as a cup of milk tea
2024-08-17
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Author of this article:Yun YeThe lottery depends on luck, queuing requires patience, and the allocation of goods requires money.This must be what many people think HPV Impression of vaccines: not only are they expensive, but they are also hard to come by. But times have changed, and now the price of some HPV vaccines is as cheap as the first cup of milk tea in autumn.On August 2, Shandong Provincial Public Resources Trading Center announced the HPV vaccine procurement transaction announcement.The winning bid price is 27.5 yuan/piece, a new low [1]。And 10 days later,August 12 day,One domesticNine-valentVaccine marketing applications are planned to be included in the priority review and are expected to be approved faster [2]。Once the news came out, more peopleI began to look forward to a significant price reduction for HPV vaccines across the board.Image source: Reference 1Phenomenal popularity, but the nine-valent and two-valent vaccines are worlds apartin the country, HPV vaccine was once extremely popular.It all started with the approval of Merck's nine-valent HPV vaccine GARDASIL 9.In 2014, GARDASIL 9 was first approved by the Food and Drug Administration (FDA) in the United States.In 2018, the applicable age and gender of GARDASIL 9 were expanded, and the FDA approved its use in men and women aged 27 to 45 years.In the same year, GARDASIL 9 was approved for marketing in China for the first time for use in women aged 16 to 26, thus beginning its legend in China.Perhaps it is because user education for the nine-valent vaccine was so successful that GARDASIL 9 is extremely popular in China.It became a household name that the drug was not approved in China, and some people went abroad or found purchasing agents to get an injection.Once it was approved domestically, not only did lottery, reservations, and allocation of goods, which are only commonly seen in the sale of houses, cars, and luxury goods, come into play, but it also spawned a lot of news that was also very explosive in the news industry.Image source: WeChat official account of the Cyber Security Bureau of the Ministry of Public SecurityXiao Liu, a graduate student at a university in Nanchang, Jiangxi, helped his girlfriend buy a nine-price drug and showed off on social media, which attracted many inquiries. So, Xiao Liu, who wanted to make a fortune, started writing code and charged 1,000 yuan for each shot. The case ended with Xiao Liu surrendering to the police and being taken criminal coercive measures by the public security organs in accordance with the law. The Ministry of Public Security's Cyber Security Bureau issued a report to end the case as a typical example. [3]。This is just a drop in the ocean. Snatching, smuggling seedlings, and smuggling seedlings from Hong Kong have become an industry where professional scalpers can easily earn over 10,000 yuan a month.The net profit of one order is fifteen hundred yuan, and the spot profit can be as high as two to three thousand yuan.Even if it is 2024, the price of the nine-valent vaccine for three shots will still be close to 4,000 yuan (the price in a public hospital), and if you succeed in the lottery and miss the event, you may not have a chance in the next six months or a year - this will discourage many workers.Wang Anqin (pseudonym), a doctor at the physical examination center of a tertiary hospital in Nanchang, even said,I really envy the level of education for patients with the nine-valent vaccine:"It's very difficult to educate patients to eat less oil and salt, and to take medication for hypertension and diabetes on time and in the right dosage every day, but it's really easy to recommend the 9-valent vaccine to people."“In other words, they don’t need my advice, they all come to consult me on their own initiative. There has never been anything like the nine-valent HPV vaccine, which can make people who don’t even know what HPV is say that the nine-valent vaccine is definitely better than the two-valent vaccine.”As the only manufacturer of the nine-valent HPV vaccine in the world, Merck has naturally benefited greatly. In recent years, its annual reports have specifically mentioned the booming market in China:In 2022, GARDASIL/GARDASIL 9 business will grow 22% year-on-year to US$6.9 billion, and will grow 29% to US$8.9 billion in 2023.Image source: MSD official websiteDespite the tight supply, sales in the Chinese market grew to US$1.5 billion in 2022, accounting for approximately 21%, and continued to maintain high growth, with a growth rate of 27% until the fourth quarter of 2023.Source: Merck 2023 Annual Report
Some Chinese companies have achieved leapfrogging by relying on agents. Zhifei Bio, the exclusive agent of Merck's 9-valent vaccine in China, has a maximum market value of over 360 billion yuan.It is also amazing that a company can quickly become a top pharmaceutical company by distributing a single drug.But all the glory seems to belong exclusively to the Nine Prices.Everyone knows that the higher the price, the better, so everyone wants Merck's GARDASIL 9.The bivalent vaccine has become a complete backup: if the nine-valent vaccine is not available, people will reluctantly choose the bivalent vaccine.It seems that thanks to the age limit, otherwise the second price would have no place to stand.There are enemies outside and volume inside, and prices are hitting the bottom all the wayAlthough the two-valent vaccine is a backup, the domestic nine-valent HPV vaccine is in short supply, and the Merck nine-valent HPV vaccine is indicated for women aged 16 to 26 years.The domestically produced bivalent HPV vaccine is for people aged 9 to 45 years.There is an obvious misaligned race condition.Although the domestically produced bivalent vaccine has to "endure humiliation", it still has its own exclusive market for women over the age of 26, and the actual benefits are still stable happiness.Source: Wantai Bio 2022 Annual Report
But the good times did not last long. At the end of August 2022, Merck's nine-valent HPV vaccine was approved by the National Medical Products Administration for vaccination of women aged 9 to 45 years.As a result, the market with two-price monopoly was gone."My friend was over the age limit and asked me if there was any way to get the vaccine. After he found out that it wasn't possible, he started to complain, saying that if you get married late, you are not eligible for the nine-valent vaccine. What's the logic behind this?"Gu Pingping (pseudonym), a gynecological oncologist at a tertiary hospital in Beijing, said,Many women over 26 don’t want to get the 9-valent vaccine, they just have no choice.It is available now. Even if it is expensive, it is only natural to get the nine-valent vaccine.At the same time, the research and development of other domestic pharmaceutical companies has also begun to bear fruit, breaking the monopoly of Wantai in the bivalent vaccine. The second domestically produced bivalent HPV vaccine will be launched in March 2022, and Watson Bio will join the battlefield.So, what will the battle situation be like in 2023 when the two sides are facing off?The answer is, neither is very good.
In 2023, both annual reports pointed out that the sales of the two-valent vaccine were lower than expected due to factors such as the expansion of the age limit of the nine-valent vaccine and market competition.What market competition factors are there? Of course, it’s the old actor in the world of involution: price war.Initially, the centralized procurement price range for the bivalent HPV vaccine was between 330 and 340 yuan per dose.As a follower, Watson Bio fired the first shot in the price war. In 2022, the Fujian Provincial Government Procurement Network announced that the winning bid price of Zerun Bio, a subsidiary of Watson Bio, was 245 yuan per unit, which was 1/4 lower than that of Wantai Bio. [4]。At that time, Wantai Biological stated in its announcement of stock price changes that it was not a big problem. Its bivalent HPV vaccine sales exceeded 10 million doses, and government procurement accounted for only 1.5%.But the wind direction can change at any time.In July 2022, the National Health Commission began to vigorously promote free HPV vaccination in areas where conditions are ripe, and centralized procurement suddenly became a matter of life and death. [5]。Image source: Reference 5Therefore, in August 2023, Wantai cut its bid price in Guangdong to 116 yuan per dose, a decrease of nearly 65%. It also won bids at low prices in Hebei, Shandong, Sichuan, Chongqing, Jiangsu and other places. Watson Bio is also catching up, and in its 2023 annual report, it specifically mentioned that it will continue to fully support the implementation of the national action plan to accelerate the elimination of cervical cancer.Next stop, ninePrice togetherCome roll2024 is the half year from the 100-yuan war to the first cup of milk tea in autumn.In March 2024, according to the Jiangsu government procurement website, Wantai Biological's bivalent vaccine won the bid at 86 yuan per dose. The Hainan Provincial Center for Disease Control and Prevention announced on April 28 that Zerun Bio, a subsidiary of Watson Bio, won the bid at 63 yuan per dose.[6,7]Today, Watson Bio has finally offered an astonishing unit price of 27.5 yuan (the self-funded market price remains unchanged).This will certainly be very beneficial to the national "Action Plan to Accelerate the Elimination of Cervical Cancer (2023-2030)" -Cheaper products can benefit more people, but it also means a further reduction in the market size.Sharing the same market, the first product to be launched must be more than just the bivalent vaccine. It is also a consensus in the industry that the golden age of the 9-valent HPV vaccine is about to pass.In the foreseeable future, the nine-valent HPV vaccine that is ready to be launched in China will be flooded with people.Wantai Bio, Kangleweisheng, Ruiko Bio, Watson Bio, and Bowei Bio have all entered or completed Phase III clinical trials.JustThe day before yesterday (On August 12, Wantai Biological, which is still at the forefront, showed on the CDE website that its application for the marketing of the nine-valent human papillomavirus (HPV) vaccine is planned to be included in the priority review, and is expected to be launched on the market faster.In April this year, the Phase III clinical study of the vaccine was unblinded, and preliminary analysis results showed that the main results were in line with expectations.[2]Domestic HPV vaccine research status (as of March 29, 2024) Source: Reference 8
A brutal price war is imminent.Price reduction is the way to go. As long as it is cheap, the domestically produced nine-valent vaccine will also have great advantages as a latecomer.On the other hand, although there are pursuers behind, Merck is still making moves.On January 9, 2024, Merck announced that in addition to the previous three-dose vaccination schedule for children aged 9 to 45 years, it will add a two-dose vaccination schedule for children aged 9 to 14 years, which has been approved by the National Medical Products Administration.The WHO's HPV vaccine position paper suggests that in studies comparing immunogenicity results, the GMT of 2 doses for girls aged 9 to 14 years was not inferior to or higher than 3 doses for young women aged 15 to 26 years, and there was no significant difference in the seroconversion rate of the nine HPV types at 7 months.Second doses have also been approved in many countries and regions.[9]
This is also a unique market strategy.Currently, in domestic public hospitals, Merck's nine-valent HPV vaccine costs 3,993 yuan for three injections. After changing to two doses, there is one less injection, which is 1,331 yuan cheaper, which is still attractive.The nine-valent vaccine currently in the late clinical stage in China still requires three doses.The 2-dose strategy is likely to continue to help Merck maintain a certain competitive advantage after these vaccines are launched on the market.But no matter what strategy is used, in the end, a price war will inevitably be fought.Good quality and low price are always the good news we look forward to.plan:Yun Ye｜Producer:gyouza、carolleroTitle image source: Visual China | First published: Dingxiangyuan[9] Zhao Xuelian, Zhao Fanghui. Interpretation of the 2022 World Health Organization HPV vaccine position paper[J]. Chinese Journal of Preventive Medicine, 2023.
