Payer-Industry Partnerships in Emerging Markets: Best Practices for Successful Market Access of New Pharmaceuticals STUDY EXTRACT: CHINA P3696

Transcription

1 Payer-Industry Partnerships in Emerging Markets: Best Practices for Successful Market Access of New Pharmaceuticals STUDY EXTRACT: CHINA P3696

2 Report written by: Elena Akborisova, Anu Bharath, Cecilia Chui, Binhan Oguz Berksoy, Farah Ramadan, Tania Rodrigues, and Leobaldo Solorzano. Under the supervision of Gaelle Marinoni: Project Manager Research Director: Gustav Ando - Copyright 2012 IHS Global. All Rights Reserved.

3 CHINA TABLE OF CONTENTS Payer-Industry Partnerships in China I. Healthcare System 1.1 Organisation Secondary-Care Sector Primary-Care Sector 1.2 Funding and Expenditure Funding Expenditure 1.3 Public-Sector Insurance Schemes Overview UE-BMI UR-BMI NCMS Medical Financial Assistance (MFA) Gaps in the Basic Health Insurance Schemes and Access to Medicines Pharmaceutical Pricing and Reimbursement Overview of the Pricing and Reimbursement Framework Urban Resident Insurance Programmes Rural Resident Insurance Programmes 1.4 Disease Management II. Payer Landscape 2.1 National Payer Landscape Ministry of Health National Development and Reform Commission (NDRC) Ministry of Labour and Social Security (MoLSS) Disease Management Stakeholders 2.2 Regional and Local Payer Landscape Provincial Health Bureaus Municipal Health Bureaus

4 III. IV. 2.3 Private-Sector Payer Landscape Private Insurance Individuals Defining Partnerships the Payer Perspective 3.1 Defining Partnerships 3.2 Stance towards Partnerships 3.3 Expectations for Partnerships 3.4 Objectives for Partnerships 3.5 Measuring Partnership Outcomes 3.6 Timelines for Partnerships Partnerships the Industry Perspective 4.1 Defining Partnerships 4.2 Stance towards Partnerships 4.3 Expectations for Partnerships 4.4 Objectives for Partnerships 4.5 Measuring Partnership Outcomes 4.6 Timelines for Partnerships V. Experiences with Partnerships 5.1 Current Landscape Data Management Partnerships Disease Management Partnerships Product Development Programmes Health Management Programmes Patient Assistance Programmes Academic Exchange Partnerships Vaccines 5.2 Case Studies China Initiative for Diabetes Excellence China-MSD HIV/AIDS Partnership Shanghai Community Cancer Care Programme Pfizer DMap Hypertension Programme Bayer and the MoH Go West Programme Baxter and the MoH Haemophilia Disease Management System

5 VI. VII. The Future of Partnerships 6.1 Viability of Current Concepts 6.2 Payer Awareness of Emerging Concepts 6.3 Industry Awareness of Emerging Concepts 6.4 Best Practices for Setting up Successful Partnerships Conclusions

6 CHINA LIST OF TABLES Table 2.1 Table 2.2 Table 2.3 Table 2.4 Table 2.5 China: Number of Hospitals by Type China: Healthcare Expenditure China: Overview of the Three Main Health Insurance Programmes China: Oncology Drug Coverage in the NRDL Class A List China: Existing Patient Assistance Programmes (PAP)

7 Payer-Industry Partnerships in China V. Experiences with Partnerships 5.1 Current Landscape Patient Assistance Programmes [XXXXXXXXX] Patient-assistance programmes (PAP) are one avenue that tackle affordability issues of medicines, and prevent delay of treatment based on financial reasons. Eligible patients can receive a partial or fully subsidised treatment, donated by the pharmaceutical companies. They are most common for diseases that are XX XXXXXX. PAPs allow patients in China to initiate and continue treatments either free or at a reduced price after XXXXXX. Setting up a PAP also helps multinational pharmaceutical companies to lower the end-use price without XXXXXXXX. It also allows manufacturers to gain. Drugs leveraging the PAP programmes have been given XXXXXXXX price. [XXXXXXXXXX]

8 Table 2.5 China: Existing Patient Assistance Programmes (PAP) Source:XXXX XXXXXXXXXXXXXXX. NGO Drug Company Indication PAP Scheme XXXXXXXXXXXXXXX XX XXXXXXXXXXXXXXX XXXXXXX XXXXX XXXXX XXXXXXXXXXX XXXXXXX XXXX XXXXXXXXXXXXxXX XXXXX XXXXXX XXXXXXXX XXXXXXX XXXXXX XXXX XXXXXXXX XXXXXXXXXXXXXXXX 1 : XXXXXXX XXXXXX XXXXX XXXXXXXXX XXXXXX XXXXXX XXXX XXXXXX XXXXXX XXXX XXXXXXXX XXXXX XXXXXX XXXXXXXXXXXXXXX XXXXXXX XXXX XXX XXXXX XXXXXX XXX XXXXXX XXXXXX XXXXXX XXXX XXXXXX XXXXXXX XXXXXXX XXXXXXXXXXX 1 XXXXXX is included on the reimbursement list of the following provinces and cities: Guangdong Province, Shaanxi Province, Fujian Province, Hainan Province, Xinjiang Uygur Autonomous Region, Shandong Province and Hangzhou City, Qingdao City.

9 5.2 Case Studies 5.2.4Pfizer DMap Hypertension Programme In 2006, Pfizer initiated a pilot Disease Management Program (DMaP-pilot) with the Shanghai Center for Disease Prevention and Control (CDC) to help manage and reverse hypertension and related cardiovascular risk factors. Cardiovascular disease is the leading cause of death and disease burden in urban centres in China, and the programme is aligned with the Chinese government's aims to develop the national healthcare system at the community level and to cope with the heavy burden of chronic diseases. The DMaP-pilot phase began in July 2006 in four community health centres in downtown Shanghai, helping them to systematically manage more than 1,400 hypertension patients. Throughout 2007, the DMaP-pilot achieved good clinical results and cost-effectiveness. These results were confirmed by third-party evaluation (Sinotrust or Loudon Far East; see below). In 2007, Pfizer China announced encouraging results for two projects, DMaP-HZ (Hangzhou) and DMaP-SH (Shanghai). DMaP-HZ was a six-month hypertension management project carried out in collaboration with the Centre of Prevention of Cardiovascular Disease of Zhejiang Province. DMaP-SH, on the other hand, was a 12- month collaboration with the Shanghai CDC on disease management. Project outcomes assessed by Sinotrust (a third-party market research company) showed that patients from Hangzhou had shown an improvement in the understanding of hypertension, with an enhancement in their self management. Loudon Far East (a third-party consultancy) found that the reported rates of hypertension improved to 100% from the national average of 30 40%, the rate of treatment improved from 80% to 91%, and the rate of control from 37% to 77%. They concluded that the reported results showed that the project was a successful intervention for hypertension, as the costs of treating patients were reduced, which in turn improved the efficiency of local hospitals. Pfizer China and the Health Bureau of Zhejiang Province established a project team that directly worked with community hospitals. The team trained health specialists as disease-management coordinators that interacted directly with clinicians and patients and monitored their progress. They provided related knowledge and assisted them to self-manage their illness through direct, regular contact. Similar to DMaP-HZ, DMaP-SH trained disease-management coordinators to facilitate communication between clinicians and their patients. The project has also developed an online, interactive platform: a self-monitoring tool through which patients are able to

10 assess their details, review their diet and exercise plans, receive related information, and communicate with their coordinators by logging onto their own accounts. The application of this online tool has integrated patients, physicians and health specialists into a user-friendly system. The interim assessment done by the University of Fudan, carried out six months into the study, reported a very promising result. The level of blood pressure of the patients showed a significant reduction compared with the control group, with the average systolic pressure reduced by 11 mm/hg. Given the success of the programme in enhancing the clinical outcomes of patients, Pfizer partnered with the Shanghai CDC for a one-year DMaP extension again in August This enabled the DMaP to be extended to all of Shanghai. This expansion started in September 2008, supported by significantly increased input from the local government. More than 13,000 hypertension patients were enrolled in 49 community healthcare centres.