China’s Industry Challenges - Informa
China’s IndustryChallengesARTICLE PACK
Pfizer Unveils Upjohn Global HQ In China Amid UnprecedentedPricing PressuresExecutive SummaryIn an effort to get closer to customers, Pfizeropens Upjohn global headquarters in Shanghaiamid a fast-changing environment, the US-Chinatrade standoff and potentially increased priceerosion.Getting closer to customers and responding tolocal needs fast is what executives had in mindas they decided last year to locate the globalheadquarters of Pfizer Inc.’s established productsunit, Upjohn, in Shanghai, the hub of the pharmaindustry in China.With a fast-aging population and rising incidenceof chronic diseases, success in the country iscritical to a suite of 20 mature Pfizer products,ranging from the antihypertensive Norvasc(amlodipine) and cholesterol drug Lipitor(atorvastatin) to pain treatments Celebrex(celecoxib) and Lyrica (pregabalin).The move is a bold one. Out of a total of 12,000Upjohn employees, 5,000 will be based in China,including at the new Shanghai base, a formulationand manufacturing plant in the northeast cityof Dalian and at sales and marketing networksacross the country.But there area also some ominous signs aroundthe timing. While Pfizer made the decision tochoose China’s commercial megacity as its globalanchor last July, nearly one year later the US drugmaker is facing a much different environment inChina, both commercially and policy-wise.First, the country late last year initiated themassive “4 7” centralized bidding mechanism2 / July 2019in major cities for dozens of widely prescribedoff-patent drugs, including multiple statins andother cardiovasculars against which Pfizer Upjohnproducts are currently competing.Then the trade dispute between China and theUS, which started around a year ago, has nowescalated significantly, with trade negotiationsbreaking down and no immediate end in sight.Does China still offer attractiveness for such alarge-scale corporate move? Executives think so.“China is critical for us,” noted Michael Goettler,group president of Pfizer Upjohn, during anopening ceremony in the brand new Shanghaiheadquarters on 30 May.Calling Shanghai a strategic location, the CEO saidthe China decision would allow the company torespond to local needs fast and to attract talent inan increasingly competitive market.Embracing The StormTo combat the impact of the 4 7 biddingmechanism, Pfizer Upjohn has cut prices for someof its best-selling drugs in China and is addingmore resources to explore the so-called broadmarket in smaller cities.The price of Lipitor has been reduced by 30%but the drug still lost out in the bidding processto domestic maker Jialin Pharma, a subsidiary ofLuye Pharma, which slashed its atorvastatin priceby 83%.Pfizer hopes the price cut will still be able toattract more self-pay patients, offsetting thenegative impact. “We didn’t win the bid in the 11cities process,” noted Goettler, adding “the volumeis expected to decrease.” Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
Lipitor is the top-selling product in China, growingby 16% in 2018, according to IQVIA data collectedfrom hospitals with over 100 beds. Combinedwith a similarly strong showing for Norvasc, it haspropelled Pfizer to the ranks of top multinationalpharma firms in China. (Also see “Calm BeforeThe Storm: Pharma Opens 2019 With A Bang InChina” - Scrip, 9 May, 2019.)Going Beyond The PillDespite the focus on price-cutting and volumes,Pfizer Upjohn executives emphasized at theopening increasing efforts to go beyond the pill.“Price is not the first concern,” stressed Goettler,who added that improving patient awareness anddeepening the In China, For China strategy formpart of the larger picture.In other provinces such as Hubei, where the4 7 process has not yet started, Pfizer is alsoreportedly lowering prices of 15 products, rangingfrom 3.4% to 10.2%. Going forward, the companysaid it can’t predict further cuts.Despite years of uncovering patient needs,demand in China for cardiovascular treatmentsremains large. One signature program run bythe company is “Bending the Curve”, a multi-yearpartnership started seven years ago betweenPfizer China and China’s health ministry. This isdesigned to raise awareness, patient educationand early screening for cardiovascular conditionsincluding hypertension and strokes.Deepening ‘In China, For China’ ApproachThe ongoing US-China trade dispute, whichhas had only limited impact so far on thehealth products sector, has prompted more UScompanies to adopt an “In China, For China”strategy, noted a recent business survey.As many as 35% of American companies in thecountry are adopting localized manufacturing andsourcing to mainly serve the China market, notedthe American Chamber of Commerce (AmCham)in China in a survey released 22 May. “Suchstrategy constitutes a rational choice for manycompanies to insulate themselves from the effectsof tariffs while maintaining their ability to pursuedomestic market opportunities,” it noted.Despite pharma being less impacted by the raisingof tariffs, the lingering trade war could eventuallydisrupt the business, noted Goettler.Roughly one quarter of surveyed businesses saidthe increases so far in US and Chinese tariffs werehaving no impact, but 43% of AmCham memberssupported a return to the status quo, showingthat members want a trade deal and a return tothe pre-tariff predictability and stability in the USChina trade relationship.3 / July 2019In a bid to sharply cut rising mortality rates fromcardiovascular diseases, the program includeslarge-scale screening of populations with high-riskfactors. While incidence and mortality have turneddownward in the US, these keep rising in Chinaand the multi-year initiative aims to turn the tide.The goal is to reach out to millions with conditionsthat have not been diagnosed and treated, and inthe meantime to expand the reach of therapiesfrom large cities to lower-tier cities, the so-calledbroad market that has yet to be fully tapped.(Also see “Merck KGaA, Pfizer Dance To ChinaDigital Health Beat” - Scrip, 29 Jan, 2019.)There is unmet need “not only in rural areas butalso in big cities.we believe we can be part of thegrowth going forward,” Goettler told reportersduring a press round table at the opening. To thatend, the company is adding 600 staff in 2019 tofurther explore China’s broad market segment.With annual cardiovascular patient numbersexceeding 270 million in China - meaning one infive adults suffer from such disorders and roughly Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
three million associated deaths - the need forearly diagnosis and preventative care seems huge.Despite the company having previously partneredwith Sinopharm to reach out to lower-tier citiesand counties, “We are big in big cities but smallin small cities,“ conceded Tianxiang Miao, PfizerChina’s general manager. To change that, hesaid the company will combine digital tools with4 / July 2019additional on the ground sales people.Predicting “turbulence in the short term,” Miaosaid closely aligning with the central government’sHealth China 2030 strategic plan would be keyto success in China’s fast-changing environment.Pfizer’s strategy is “synchronized with thegovernment,” he said. Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
Value Assessment Vexes Pharma As China Costs Soar, PricesFallExecutive SummaryTraditionally a low-cost manufacturing haven,China has seen pharma R&D costs increaserapidly although prices for pharmaceuticals havenot gone up, forcing officials and executives toexplore value assessment and market accessapproaches in a toughening environment. 1,000 in the US,“ Zou told attendees at the DrugInformation Association’s China annual meeting,held 22-24 May in Beijing.Jiangsu Hengrui Medicine Co. Ltd. is widelyconsidered a national champion for the pharmaindustry in China, having not only licensed ananticancer asset to US firm Incyte Corp. in a 900m deal, but also developed its own oncologydrugs that have gained several approvals in China.Assessing a novel drug’s proper valuation is thusseen as key in pricing policy and negotiations,especially during this time when China is buildingup to including many additional new drugs inits National Drug Reimbursement List (NDRL),a process that started this April and will becomplete in September. Any products that havebeen approved in the country prior to 1 Januaryare eligible for the coverage.In the first quarter, Hengrui reported its revenuesjumped by 29% to CNY4.97bn ( 719m), drivenby new launches including anticancer drugIruini (pyrotinib), and another oncology product,apatinib, that was launched earlier.On the other hand, the Lianyungang-basedcompany also reported that R&D expenses greweven faster than sales, up 57% compared to thesame period in 2018; its quarterly R&D costsreached CNY662m.Zou’s reference to the large price gap reflects awidening view that China’s price control policies,including steep price reductions in exchange forreimbursement coverage, could potentially deterinnovation in the sector.The process is divided into two stages, one forlow-priced drugs that will be added withoutpricing negotiations and another for high-pricedproducts, for which many are expected to gothrough multiple rounds of pricing negotiations.Out of 17 anticancer drugs that were coveredusing a similar mechanism in the past, the averageprice reduction was 55%.This relative level of R&D spending (equivalent toaround 13% of sales) puts Hengrui in the sameleague as its overseas peers, the only issue beingthat it can’t command the same price premiumsfor novel new drugs as these companies, notedJianjun Zou, a vice-president at the company.R&D Cost ConsiderationEntering May, China is kicking into high gear forthe NDRL update and drug companies are busypersuading medical experts about the value oftheir products.“Our R&D expenses are on a par with largedrug makers but the product price in China,for instance, is like CNY200 [ 30] compared toDoing so needs a large amount of epidemiologydata which needs to be assessed with a holisticview, Kun Zhao, director of Health Technology5 / July 2019 Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
Assessment (HTA) at the China National HealthDevelopment Research Center, told the DIAmeeting.Real world evidence, and not only data fromclinical trials, is playing a growing role indetermining product value, noted Zhao, whileciting uncertainties in these studies. “Is it aniceberg or just the tip?” he asked.Furthermore, a clear mechanism and transparentprocess are needed, so guidelines andmethodology should be publicized to convincethe public, stressed the expert. For drug makerslike Hengrui, experts should take R&D costsinto consideration in order to provide a fairassessment, Hengrui’s Zou said.Market Access IssuesAside from such assessments, market access alsoposes a major challenge for high-priced drugs inChina, including the world’s best-selling biologics.AbbVie Inc.’s Humira (adalimumab) may have 20bn in worldwide sales but just 20m - 0.1% ofthis figure - in China, noted Ning Li, CEO of JunshiPharmaceutical Group.“There is more that can be done besidesquantifying a product’s value using HTA analysis,especially when it comes to drug pricing,” Liproposed during a panel discussion at theannual gathering. Such options include patientassistance programs (PAPs) and local provincialreimbursement schemes.Li’s company is one of four makers of immunooncology products that have been launched in6 / July 2019China, where its Tuoyi (toripalimab) became thefirst domestic IO agent to be approved. However,it is priced at CNY7,200 per 240mg vial, lessthan half the level of Merck & Co. Inc.’s Keytruda(pembrolizumab), which costs CNY17,918 per100mg in China. This in turn is already nearly 50%lower than the drug’s US price.Better PositioningPricing aside, both domestic and foreign drugfirms routinely provide PAPs to qualified patientsin China, with Merck and Junshi having suchschemes in place that award free drugs after acertain amount of purchases.Pricing, PAP and private insurance are knownas the “three Ps” for both multinational andinnovative domestic companies wanting toexpand product access in China.Despite the national reimbursement schemeoffering potentially large volume uptake,companies are also now actively looking to getlocal coverage that will help new drugs get topatients faster. Both Keytruda and Tuoyi, forexample, were recently added to Zhuhai city’scoverage scheme for cancer treatments. Thismeans a patient can get 90% of the cost coveredfor the purchase of listed anticancer drugs pricedin a range of CNY10,000 to CNY300,000.The combination of pricing strategy, local schemecoverage and PAPs will hopefully provide buffersfor pharma companies to feel better positionedentering negotiations for NDRL coverage, or somemight even forgo the process altogether. Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
How To Deliver Your China Growth Story: Trends To WatchExecutive SummaryCaught between a grueling centralized biddingprocess and now potentially in trade war crossfire,foreign pharma firms have a lot on their platesin China. To succeed in this highly uncertainenvironment, observers point to the need topursue excellence in multiple areas: productlaunches, medical coverage, the broad market anddigital health.Barely a day goes by without major developmentscoming out from China, and an escalating tradedispute with the US and a slowing domesticeconomy are among the most recent headlines.For the pharma sector, the rapid roll-out of amassive centralized bidding scheme in majorcities is adding to the growing list of operatinguncertainties.Although pharma companies have so far largelyavoided the impact of the brewing trade warbetween the world’s two largest economies, Chinahas vowed to retaliate with more tariffs. Chinaimports finished drugs and medical devices fromthe US, and although medicines are far belowaircraft and large machinery in total monetaryvalue, some worry that the higher tariffs couldexpand to such products.In the past, the Chinese government has actuallylowered import tariffs for imported anticancerdrugs, in a bid to make them more affordable tolocal patients.Meanwhile, in the first three months of 2019,China continued to deliver as a growth enginefor the multinational pharma industry, providingnorth of 20% growth for several firms includingAstraZeneca PLC, Pfizer Inc. and Sanofi. Merck &7 / July 2019Co. Inc. reported its sales in the country rose by ajaw-dropping 66% in the periodSeveral underlying factors contributed to thestrong growth, including increased uptake ofnew products, but there are looming challenges,the biggest of which is the “4 7” centralizedprocurement scheme for 11 major cities. (Alsosee “Drug Price Waterloo: China’s New BiddingProcess Hits MNCs Hard” - Scrip, 11 Dec, 2018.)Against this fast-developing background, there areseveral needs and trends in China that pharmacompanies should pay close attention to, localanalysts say.New Product LaunchesAmid China’s positive regulatory reforms andhigher numbers of new drugs gaining approvals,companies need to have a multi-channel strategyto generate the most “bang for the buck.”“A lot of these [strong Q1 growth rates] weredriven by newly launched innovative products,as a result of expedited regulatory processes toget products registered in China,” Justin Wang, apartner at consulting firm L.E.K.’s Shanghai office,told Scrip. Such products included AZ’s Tagrisso(osimertinib) for lung cancer, and Merck’s HPVvaccine Gardasil and PD-1 inhibitor Keytruda(pembrolizumab).“These new products are able to addresssignificant unmet clinical needs and have beenlong expected by the China market. Successfulmarket education, as well as additional patientassistance programs, are also driving the rapiduptake,” Wang noted.Oncology and vaccines are two areas that haveseen significant growth in China in recent years. Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
The new generation of immuno-oncology agentshas also gained the spotlight and generatedexcitement in China, where cancer incidence andmortality rates are steadily increasing.According to the China National Cancer Center’smost recent data, 3.9 million people werediagnosed with cancer in the country in 2015,when there were 2.3 million deaths.Access IssuesGiven there is no immediate or automaticinsurance coverage for new drugs in China,companies may need to craft patient assistanceprograms that enable expanded access and arealso able to accumulate actual clinical use datafollowing launch. These can take the form ofprovision of product or other effective subsidiesto out-of-pocket costs.But seeking reimbursement remains animportant potential catalyst for sustaininggrowth. In 2019, China’s Medical Insurance andSupport Administration will expand the NationalReimbursement Drug List (NRDL) to includeselected drugs approved before 31 December2018. For high-priced products, such inclusion willonly come along with price negotiations, whichin a previous case for 17 anticancer drugs led toprices being slashed by an average of 57%.While NRDL coverage provides potential volumegains, the associated price reductions may alsoprompt manufacturers to weigh the risk ofrapid and substantial price erosion. “Most MNCpharmas will certainly prioritize NRDL listing fortheir market access efforts, but there is certainly asubset of international pharmas that would preferto stick to their global pricing band,” said L.E.K.’sWang.During Merck’s quarterly earnings call, chiefcommercial officer Frank Clyburn noted that whilethe US firm hopes to have its newer products such8 / July 2019as Gardasil, Keytruda and others covered by thelist, strong market positioning was still possiblewithout this. “A listing would open up an excitingopportunity to expand volumes. But even withoutthat, we feel that we’re very well positioned forKeytruda in China with the only PD-1 that has afirst-line lung cancer indication,” he commented.Broad Market, Digital HealthAnother important potential growth area formultinationals in China is the so-called “broadmarket” of smaller but still sizable cities, which hastraditionally been defined as tier 3 cities but nowextends down to tier 4 and 5 cities.“Many also say that multinationals were able [inthe first quarter] to exploit opportunities fromnew channels (eg, lower-tier cities, retail anddirect-to-patient) that offset volume declines intheir core markets,“ said L.E.K.’s Wang.Known for being particularly price-sensitive,the lower-tier market will be hard for many tocrack. To that end, many foreign companies areincreasingly integrating digital technology intotheir commercial strategy, for products rangingfrom HPV vaccines to consumer health brands.The latest example involves GlaxoSmithKlinePLC and AliHealth, which on 2 April signed a jointbusiness plan covering big data, and new salesmodels and services. Consumers will receiveonline information on respiratory and painmanagement products, plus web-based medicalconsultation and education, the aim being toimprove medication awareness.Novartis AG on 22 March also signed on withmajor Chinese e-commerce group Tencent to useartificial intelligence technology to provide heartfailure solutions. The agreement is expandedon previous agreement on chronic diseasesmanagement. Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
Other multinationals including Merck KGaA andPfizer are also getting aboard the digital health9 / July 2019train in China. (Also see “Merck KGaA, Pfizer DanceTo China Digital Health Beat” - Scrip, 29 Jan, 2019.) Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
Calm Before The Storm: Pharma Opens 2019 With A Bang InChinaExecutive SummaryProducts old, new and reimbursed were thedriving force for foreign drug firms includingAstraZeneca, Merck and Pfizer and Sanofi tosmash growth in China in the first quarter.Pharma multinationals have started off strong inChina in the first quarter, helped by growth forboth mature and newer products, but several arealso issuing cautions that there may be a generalslowing in growth amid broader changes in theeconomy. A new competitive bidding schemein major cities in particular is expected to putconsiderable further pricing pressures on somecompanies and products.AZ’s 1bn Quarter In ChinaPointing to a historical high growth rate inemerging markets in the first quarter, AstraZenecaPLC said this was being driven by China, whichsoared by 28%, but also a strong showing acrossall such markets globally.The UK-based company’s overall EM sales brokethe 2bn mark, with more than 1bn coming fromChina for the quarter. This was driven mainly byoncology star Tagrisso (osimertinib), which inemerging markets delivered 138m, with Chinacontributing more than half of this after beingincluded in the national reimbursement drug list.But the tide may be changing. “We want to flagthat we expect China to still continue growing ata fast clip but not as fast as we have experiencedlately because we will start being impacted,as other companies, by the changes in themarketplace,” cautioned CEO Pascal Soriot duringa 26 April earnings call with investors.10 / July 2019The biggest market change in China is the socalled “4 7” centralized procurement scheme, amassive tendering process that is being rolled outin 11 major cities and is expected to significantlyslash drug prices, and in one extreme examplehas led to a 96% reduction.AZ’s Crestor (rosuvastatin) and Iressa (gefitinib)were both selected in the first round of bidding,but while Iressa won, Crestor lost out to adomestic maker. “In the second half [it] will beCrestor because we lost a tender so certainly,that product will be impacted,” Soriot noted.When asked about a recent report that China andthe US have agreed to set the data exclusivity timeframe for biologics at eight years in China, theCEO considered it progress instead of detriment.“I think the fact that we are debating eight years or10 years or more is actually reflecting that thereis a discussion around IP [intellectual property]rights [in China], which is a good discussion tohave.”Pfizer Sees Headwinds AheadPfizer Inc.’s first quarter earnings in China showthat established products continued to grownicely. The US drug maker, which has a separateestablished products unit, Upjohn, said overallbusiness revenues in the country grew 1%operationally in the quarter.“We believe Upjohn will help us seize thetremendous opportunity we see in the emergingmarkets,” noted company chief financial officerFrank D’Amelio during Pfizer’s 30 April quarterlyresults call with investors.“As the global middle-class continues to rapidlyexpand, and as awareness and diagnosis and Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
treatment options continue to improve, webelieve the Pharmaceutical segment will continueto enjoy significant expansion in Greater Chinaand other emerging markets.”Upjohn is managing 20 products in 65 marketswith its leadership located in China, wherethe government has vowed to up efforts todrive generics and biosimilar approvals andmanufacturing.Mature products with growth in China singledout by the executive were largely cardiovasculars,namely Lipitor (atorvastatin), Norvasc (amlodipine)plus Celebrex (celecoxib).Despite the growth, the company also saidheadwinds are coming and that a bumpy ride isin store. The 4 7 bulk procurement scheme isexpected to negatively impact drug makers with alarge established products portfolio.“Our guidance continues to reflect expectedheadwinds in China due to pricing reform, whichis now being implemented,” said the CFO. Pfizerdid not win the bids for Norvasc and Lipitor in the4 7 bidding process due to their relatively highprices.Although novel products are expected to offsetsome of the losses, given that there is noimmediate reimbursement for newly launcheddrugs in China, there will be time delays, analystssay.Novo Sees 90% Growth For VictozaDanish diabetes specialist Novo Nordisk ASsaw Q1 China sales increase by 9% at constantexchange rates, driven by its insulin preparationsand GLP-1 products, for which sales rose 9% and90% respectively.The company benefited from high market growthin long-acting basal insulins and fast-acting insulin11 / July 2019lispro. Riding the wave, Novo’s pre-mixed insulinssales grew by 10% in the quarter, although humaninsulin were down by 3%.Novo’s latest addition to its product mix in China,the GLP-1 agonist Victoza (liraglutide), reported90% growth in the three months, showingthe strong demand for newer anti-diabetestreatments in China.Merck & Co ‘Only Scratching Surface’Emerging markets also represent a large growthopportunity for Merck & Co. Inc., but so far the UScompany is only just getting started, said CEO KenFrasier.“We believe that we’ve only scratched the surfacein terms of the opportunity in key markets suchas China, where we are seeing significant growth,”noted the CEO on the 30 April earnings call.Overall, Merck growth was strong in both theUS and international markets in the quarter,but especially in China, where sales soared 67%year-over-year, driven largely by newly launchedproducts such as human papillomavirus vaccineGardasil and immuno-oncology agent Keytruda(pembrolizumab), among others.The local demand for the HPV vaccines is suchthat many clinics are running out of stocks,prompting Merck to reevaluate and rearrangesupplies. Keytruda’s recent approval for firstline for non-small cell lung cancer also give anadditional boost to the company. (Also see “ChinaAppetite For HPV Vaccine Delivers Surprise ForMerck” - Scrip, 2 Aug, 2018.)Given what it sees as a good outlook in Chinafor two other new oncology products, Lynparza(olaparib) in collaboration with AZ and Lenvima(lenvatinib) with Eisai Co. Ltd., the company isfeeling rosy about its prospects in this market. Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
China has initiated a medical reimbursementpolicy that aims to cover more and neweroncology and rare disease treatments, and Merckexecutives say they are on board. (Also see“Cancer, Rare Disease Drugs To Be Covered AsChina Expands Reimbursement” - Scrip, 15 Mar,2019.)Q1 Strongest For Sanofi?China remains a key driver for French groupSanofi, which saw broad-based growth of 22%in China in the quarter, driven partially by itspediatric vaccines, whose sales grew by 26%,with the five-in-one vaccine Pentaxim particularlystrong.“We will be working through the NRDL [nationalreimbursement drug list] listing process with theChinese regulators. And given the timing of ourlung cancer approval, we’ll have to see if NRDLlisting is a possibility this year,” Frasier said.However, the company also cautioned thatthe 4 7 scheme is expected to affect companyrevenues in China over the rest of the year.The reimbursement qualification requiresproducts to have been approved on or before 31December 2018, putting Keytruda - which gainedits first approval in China in 2018 for melanomaand then the NSCLC indication this March - in anunpredictable situation.“A listing [on the NRDL] would open up an excitingopportunity to expand volumes. But even withoutthat, we feel that we’re very well positioned withKeytruda in China with the only PD-1 that hasa first-line lung cancer indication,” noted chiefcommercial officer Frank Clyburn.He also pointed to the breadth of thedevelopment program for the molecule, as seen inother markets, noting “We plan to bring additionalindications to China, which we think positions usvery well for future growth.”12 / July 2019“Looking ahead [the new scheme] is expected toresult in lower growth rates for Plavix [clopidogrel]and Aprovel [irbesartan] for the full year of 2019.As a result, the first quarter performance will likelybe the strongest quarter of the year for China,”noted CEO Olivier Brandicourt in the 26 Aprilquarterly earnings call.Sanofi’s head of emerging markets and China,Olivier Charmeil, pointed out that roughly onethird of its business in China will be impacted bythe centralized bidding program.“So how will we look at it at the end of the year,given the new volume-based procurementsystem is going to impact Aprovel and Plavix inroughly 30% of the total market? So we are stillexpecting overall good growth for 2019, but it’slikely, as Olivier alluded to, that the first quarterperformance will be the strongest in the year,”Brandicourt said. Informa UK Ltd 2019 (Unauthorized photocopying prohibited.)
Divest, Refocus, Transition: Multinationals Embark OnUncharted Path In ChinaExecutive SummaryFacing unprecedented pricing pressures in China,multinationals are embarking on a major shiftaway from mature products to focus more oninnovative drugs, but there are major challengeslinked to the transition that won’t be easy tonavigate, notes a new report.After years of pondering, now comes concreteaction.Amid unprecedented pricing pressures in China,pharma multinationals operating in the countryare transitioning to focus more on innovative newdrugs rather than relying on their traditional cashcows of branded but off-patent products.Eli Lilly & Co. has become the latest to divestselected established products to a domestic drugfirm in China, to help focus resources on newtherapies. The US major announced an agreementwith China’s Eddingpharm International HoldingsLtd. worth 375m, under which it is handing overexclusive local marketing rights to two antibiotics,Vancocin (vancomycin) and Ceclor (cefaclor) inmainland China.Furthermore, Lilly will also sell off its cefaclormanufacturing site in Suzhou, Jiangsu Province tothe Chinese company. (Also see “Asia Deal Watch:Shionogi Finds Commercial Partners For SymproicIn US, Europe” - Scrip, 23 Apr, 2019.)It’s the second time in six months that Lilly hasbeen in the spotlight for such moves. T
critical to a suite of 20 mature Pfizer products, ranging from the antihypertensive Norvasc (amlodipine) and cholesterol drug Lipitor (atorvastatin) to pain treatments Celebrex (celecoxib) and Lyrica (pregab
WEI Yi-min, China XU Ming-gang, China YANG Jian-chang, China ZHAO Chun-jiang, China ZHAO Ming, China Members Associate Executive Editor-in-Chief LU Wen-ru, China Michael T. Clegg, USA BAI You-lu, China BI Yang, China BIAN Xin-min, China CAI Hui-yi, China CAI Xue-peng, China CAI Zu-cong,
1 Informa PLC 2020 Half-Year Results and COVID-19 Action Plan informa.com Informa PLC Press Release 21 September 2020 2020 Half-Year Results and COVID-19 Action Plan Stability and Security through 2021 & beyond Informa (LSE: INF.L), the Information Services, Advanced
2 Informa PLC 2020 Full-Year Results informa.com He added: "This Transition Year will be defined by continued strength and improving growth in our subscriptions-led businesses, further growth in B2B digital services and a progressive reopening of physical events, led by Mainland China and North America, which will ensure we deliver our revenue
Asia China 1048 Young man eating a bowl of rice, southern China. 1 7 Asia China 1049 Boy eating bowl of rice, while friend watches camera. 1 7 Asia China 1050 Finishing a bowl of rice while a friend looks over. 1 7 Asia China 1051 Boy in straw hat laughing. 1 7 Asia China 1052 fr213536 Some of the Flying Tigers en route to China via Singapore .
Chifeng Arker Pharmaceutical Technology Co., Ltd. China E6G92 Chifeng Sunrise Pharmaceutical Technology Co., Ltd. China W1B40 China Chinopharma Ltd. China E1K20 . Council of Europe – EDQM FRANCE TBC CSPC PHARMACEUTICAL GROUP LIMITED China W1B08 Da Li Hou De Biotech Ltd China E5B50
China SignPost 洞察中国 18 May 2011 Clear, high-impact China analysis Issue 35 Page 1 The ‘Flying Shark’ Prepares to Roam the Seas: Strategic pros and cons of China’s aircraft carrier program China SignPost 洞察中国–“Clear, high-impact China analysis.” China’s budding aircraft carrie
Air China (Beijing), China Eastern (Shanghai), China Northwest (Xi'an), China Northern (Shenyang), China Southwest (Chengdu) and China Southern (Guangzhou). CAAC was the nominal owner of these airlines, in the name of the state. Accompanying these reforms was growth in the number of regional airlines, which were usually established by local
Independent Personal Pronouns Personal Pronouns in Hebrew Person, Gender, Number Singular Person, Gender, Number Plural 3ms (he, it) א ִוה 3mp (they) Sֵה ,הַָּ֫ ֵה 3fs (she, it) א O ה 3fp (they) Uֵה , הַָּ֫ ֵה 2ms (you) הָּ תַא2mp (you all) Sֶּ תַא 2fs (you) ְ תַא 2fp (you
