Customers at New York Chinese Medicine Store

Outbreak of new crown pneumonia, surge in demand for Chinese medicine and acupuncture. Clinton Xiao, an acupuncturist and TCM physician in New York City, said the first local confirmed case of new crown pneumonia was reported in New York Since then, the demand for (traditional) traditional Chinese medicine in his clinic has skyrocketed. “It’s like pressing the light switch,” said Xiao Ru, who has prepared enough Chinese herbal medicine for patients. Jinhe Chinese Medicine Co., Ltd., a pharmacy located in the heart of New York’s Chinatown and a long-time supplier of traditional Chinese medicine to doctors such as Xiao, has experienced similar business jumps.

Last year, Chinese medical methods such as acupuncture and Chinese herbal medicine were formally recognized by the WHO, giving more traditional recognition to such traditional therapies dating back more than 2,500 years. At Jinhe Chinese Medicine Company, since the confirmed cases of new crown pneumonia began to spread across the United States at the end of February, customer demand for Chinese herbal medicines for treating flu-like symptoms has doubled. In the recent afternoon, this shop filled with the smell of Chinese herbal medicine was busy: employees weighed Chinese herbal medicine with an old steel bar scale in front of a huge medicine cabinet, and customers were busy buying prescription drugs including honeysuckle and white peony.

Xiao said that since the outbreak began, practitioners of Chinese medicine who have closely followed the situation have shared relevant prevention and treatment formulas. The demand for specific Chinese medicine ingredients has also pushed up the relevant prices. In a small Chinese medicine store in Chinatown, New York, Patrick Shao is receiving a steady stream of customers who are looking at shelves and jars filled with Chinese herbal medicine. He said that a Chinese herbal medicine used to be sold out within two to three weeks, but it is now sold out within a few days. It is difficult to buy best-selling drugs such as honeysuckle and isatis root powder, and these drugs are all going up in price.

Given the high demand, Chinese herbal medicine suppliers and TCM physicians worry that the supply of certain Chinese medicines will become more and more tight, and almost all of these medicines come from China. San Francisco-based Chinese medicine company Mayway said on its website that it is experiencing “unusual growth in order volume”, (hence) requiring customers to limit order volumes, and expects that supply will “because container ships currently leaving China (ports) are limited “And was delayed. “The seller has told us that the order quantity must not exceed half of the usual amount, and a limited supply of Chinese herbal medicine for colds must be provided,” said Thomas Liang, the person in charge of Jinhe Traditional Chinese Medicine Company. The World Health Organization reports that the world now includes TCM The market size of traditional medicine treatment has reached 60 billion US dollars.

Since the outbreak of the new crown pneumonia outbreak, the world has been paying close attention to one thing: when will the new vaccine be developed and produced? People set their sights on those “most capable companies.” GlaxoSmithKline from the United Kingdom, Sanofi from France, Merck and Pfizer from the United States are known as the world’s top four vaccine giants. They firmly control the world’s best-selling vaccine products and sell tens of billions of dollars of vaccines each year. At the beginning of the transmission of the new crown virus, the four giants were silent and disappointed people from all walks of life. In February, Sanofi announced that it would participate in the development of vaccines. GlaxoSmithKline said it would provide technical support to other companies, but did not develop vaccines. Some foreign media said with anticipation that “big pharmaceutical companies are working hard to promote the development of vaccines”; but some analysts said that the first consideration of these companies is whether they can make money, and epidemics often end before the vaccine is produced. Of the massive epidemics that have broken out in the past 20 years, only the Ebola vaccine has been successful.

How they “laughtered all the way to the bank”

“Vaccines are the best-selling products of pharmaceutical giants.” A British Financial Times article once said that if people were asked to say the most profitable product of Pfizer, a biopharmaceutical company in the United States, many people might be talking about Viagra or cholesterol-lowering drugs. Lipitor. If someone is more familiar with the company, they may be able to name the blockbuster drugs such as pregabalin. But they were all wrong. Pfizer’s best-selling product is not a medicine, but a vaccine: a 13-valent Pediatric vaccine used to prevent pneumonia, meningitis, and other infections caused by Streptococcus pneumoniae. In 2015, Peer made US $ 6.25 billion in revenue for Pfizer, almost three times that of Viagra. According to the US Axios website, Peer’s sales amounted to 23.4 billion US dollars from 2015 to 2019.

Pfizer is one of four pharmaceutical giants with large-scale vaccine business units. The other three are GlaxoSmithKline (GSK) in the United Kingdom, Sanofi in France, and Merck (known as Merck in the United States and Canada) ). “Global vaccine production is increasingly centralized.” German “Economic Weekly” reported that data from the German statistics company Statista showed that the market share of the four major vaccine giants accounted for more than half of the world vaccine market. Global vaccine sales totaled 54 billion U.S. dollars in 2019, almost doubling from 2014. The global vaccine market is expected to grow to 60 billion US dollars in 2020, and the global vaccine market size will be close to 100 billion US dollars by 2030.

In an article on the US CNBC website last month, the vaccine market data differed from the German report mentioned above, but the monopoly position of the four giants is still impressive. According to data from asset management company Bernstein, the vaccine market has grown six-fold in the past 20 years, with a current market value of more than 35 billion U.S. dollars, and the four largest companies occupy up to 85% of the market share. “In 94 countries with relatively low income in the world, the net return is $ 44 for every $ 1 invested in vaccines,” said Bernstein analyst Kapadia. “This oligopoly is based on complex production and The huge market formed by the supply chain has been integrated. ”

“Laughter all the way to the bank (make a fortune).” A 2019 article from the US Children’s Health Defense website mentioned another important reason for the rapid development of the four giants: In 1986, the US Congress passed the National Childhood Vaccine Injury Act ”To mitigate potential financial risks for manufacturers in vaccine injury claims to stabilize the supply of vaccine products. Since then, a gold rush for vaccine research and development has begun, and the four major vaccine giants have become the biggest beneficiaries of this environment in the United States. At the end of 2017, the global revenue of GlaxoSmithKline, Merck, Pfizer and Sanofi ranked third, fifth, sixth and seventh among pharmaceutical companies, respectively.

The world’s best-selling vaccines are firmly held in the hands of the four giants, including Pfizer’s Peer, Merck’s cervical cancer vaccine Jiawei Miao, Sanofi’s diabetic-IPV-Hib pentavalent vaccine and influenza vaccine, GlaxoSmithKline’s hepatitis vaccine. CNBC reports that Merck’s vaccine business generated $ 8.4 billion in revenue in 2019, and the business has been growing at a rate of 9% per year since 2010, of which CCV is “the best-selling vaccine ever.” Product sales in 2018 exceeded $ 3 billion. Analyst Bernstein, an asset management company, said: “Given limited competition, Calvados will continue to dominate the cervical cancer vaccine market.” Merck also holds a monopoly position in the combined measles, mumps, and rubella vaccines.

As for the other three giants, CNBC said that both Sanofi and GlaxoSmithKline have stable vaccine combinations, such as pertussis vaccine, polio vaccine and shingles vaccine, and Pfizer’s vaccine business has stalled in recent years. , But its product line is “huge potential.”

According to the “Financial Times” analysis, the reason for the strong growth of the vaccine giant’s business is firstly the expansion of immunization programs in emerging countries such as China. For example, in 2015 Sanofi’s polio and pertussis vaccine sales increased by 33% in emerging markets. “Middle-income countries have great potential,” said Chamel, head of Sanofi’s vaccine division. “Many countries do not yet have immunization programs in the Western world.” In addition, these companies are working to develop vaccines that are more marketable in developed markets. Or expand the coverage of existing products. As children in rich countries have been widely vaccinated, businesses are turning their attention to older groups. For example, herpes is caused by varicella-zoster virus, as is chickenpox, but it is most common in people over 70 years of age. ▲

“Vaccine production is worthwhile only on a large scale”

In early February, GlaxoSmithKline announced a partnership with the Epidemic Prevention and Innovation Alliance (CEPI) to accelerate the development of a new crown virus vaccine and provide it with an “adjuvant” technology proven to be effective in the H1N1 flu epidemic At the same time, it can reduce the amount of immune substances and reduce the cost of vaccine production-Editor’s Note). About 20 days later, the Chinese clover biopharmaceutical company announced a partnership with GlaxoSmithKline, which provided it with an “adjuvant”.

In mid-February, Sanofi announced that it will use its previous experience in developing SARS vaccines to cooperate with the United States Biomedical Advanced Research and Development Agency to accelerate the development of new crown virus vaccines using advanced genetic recombination technology platforms. Loy, executive vice president of Sanofi, said in a conference call that he estimated that he could get the candidate vaccine “in less than six months” and that it could enter clinical trials “in one to one and a half years”. . According to the British Reuters report on the 5th, Pfizer is considering cooperation with German companies to develop vaccines.

“At present, more than 20 companies and the public sector in the world are racing against the clock to develop a new crown virus vaccine. Professionals say that the investment in the next 1 to 1.5 years will be as high as $ 2 billion.” The Financial Times article on the 9th said in this In the competition, the fastest start was the US-based Modena, which took only 42 days from identifying the new coronavirus to developing a vaccine for human testing. The National Institutes of Health is testing whether its vaccine is effective. Modena is a 9-year-old company that is still losing money and has no products to sell. It received CEPI funding because it was unable to bear the cost of developing a completely new vaccine against the new crown virus. If mass production vaccines are needed next, Modena is likely to sign an agreement with a large manufacturer.

“Developing vaccines requires huge capital expenditures.” Vallande, an infectious disease researcher at the Charité Medical School in Berlin, Germany, told a Global Times reporter that during the new crown pneumonia epidemic, large pharmaceutical companies did not compete to invest in research and development. Because the risk is too high. There is also a political push behind the companies currently involved in the work. “Financial Times” said that to a certain extent, the pharmaceutical industry’s response to the epidemic is out of social responsibility and the excitement of solving scientific problems.

Every time an epidemic breaks out, there is a voice in international public opinion criticizing large pharmaceutical companies for their inaction: The BBC ’s mid-February issue was titled “Four Global Manufacturers Keep Silent, New Crown Vaccines Are Hard to Dawn” Text; Peter Bach, director of the Health Policy and Effectiveness Program at the Memorial Sloan Kettering Cancer Center in the United States, told Barron Weekly in the end of January that “the private sector will go to the place with the highest returns, which is obviously not effective in improving the public Healthy direction. ” Sanofi has announced its participation in the development of vaccines, but it has been noted that GlaxoSmithKline, which has also acted, is not trying to start the vaccine development itself.

GlaxoSmithKline’s director of health department Thomas Bloyle said in an interview recently that vaccine development usually takes 8 to 10 years, but due to technological developments in recent years, some companies can produce a vaccine within 3 months , But the testing and approval phase still takes a lot of time, and in the best case, at least 12 to 18 months. GlaxoSmithKline only provides assistive technology because it is difficult to predict the long-term outbreak of the new virus. He emphasized that “only the large-scale advancement of vaccine production is worthwhile.”

The British “Guardian” said that in the past 20 years, the world has experienced outbreaks of SARS, the Middle East Respiratory Syndrome, Zika, Ebola and other epidemic diseases. However, only Ebola-based vaccines have been developed so far, as related R & D efforts have stalled as the epidemic has dissipated. According to the BBC, Merck’s Ebola vaccine was first used in Guinea in 2015, but the vaccine was not licensed at that time, but was allowed to “sympathize” in the country (without other treatments, use A new, unapproved medicine to deal with serious illness-Editor’s Note). The vaccine was not approved by US regulators until last year. Another Ebola vaccine developed by Johnson & Johnson was used last year in the Democratic Republic of the Congo. ▲

What are China’s strengths and weaknesses

International vaccine giants attach great importance to the Chinese market. For example, Sanofi’s vaccine business has been in China for 24 years. The first human rabies vaccine, the first influenza vaccine, and the first influenza b-type Haemophilus conjugate vaccine were introduced. . In 2007, Sanofi established an influenza vaccine factory in Shenzhen to realize the localized market for related vaccine products.

Merck and China also have a story of cooperation. In 1989, the company signed an agreement with the Chinese delegation to transfer the recombinant yeast hepatitis B vaccine technology to the Chinese side, charging US $ 7 million as the cost of training Chinese personnel and paying the labor costs of the US participants, in addition to no royalties and profits. In October 1993, the Recombinant Yeast Hepatitis B Vaccine Workshop of Beijing Institute of Biological Products was officially put into production. Nine years later, China started providing free hepatitis B vaccine to all newborns.

To what extent is the Chinese vaccine industry dependent on foreign countries, especially these international vaccine companies? Yang Zhanqiu, deputy director of the Institute of Medical Virology of Wuhan University, believes that “there is no dependence, but the exchanges and cooperation with foreign vaccine companies are extensive.” He told the “Global Times” reporter that on the whole, China’s vaccine industry is in a good level in the world, but compared with other countries, the market has its own focus. Due to the large population base, China’s vaccine industry is more advanced in the fields of common diseases and frequently-occurring diseases. However, in terms of cervical cancer and other vaccines, China’s related research is not too much and relatively backward.

Chen Xi, an assistant professor of global health policy and economics at Yale University, said in an interview with a reporter from the Global Times that China has more and more advantages in the later period. An important reason for the rapid development of China’s biomedicine in recent years is that in the 1990s, with the funding of the National Institutes of Health, many US research institutions recruited Chinese graduate students, many of whom later returned to China to start their own businesses and give them to China. The development of the pharmaceutical industry has helped.

“In fact, many countries are not reluctant to set up international vaccine companies, but they cannot get the World Health Organization’s” International Pass. “German infectious disease scholar Vallande told the Global Times reporter that China’s annual vaccine production reached One billion doses, it is the world’s largest vaccine producer, with more than 40 vaccine companies, and one of the countries with the most vaccine companies in the world. However, only a handful of companies in China have obtained an “international passport”, which enables related products to enter the United Nations vaccine procurement program and export to the international market.

Chen Xi said that the global vaccine industry is currently very crowded, with universities, research institutions, companies and governments participating. In this field, the United States is stronger, “about 60% of new drugs and therapies in the world come from the American pharmaceutical industry every year.” Compared with the United States, Chinese companies have limited innovation capabilities. One of the reasons is that US SMEs have advantages in financing. For example, Nasdaq can provide financing for small and medium-sized technology innovation stocks. In China, the capital market currently favors large-scale enterprises. enterprise. “The most important thing in the vaccine industry is product development. The proportion of R & D funds in the Chinese pharmaceutical industry is far lower than that of American companies, so many companies have insufficient research and development motivation.” Chen Xi said, but the capital market is a cumulative advantage, not a country that wants to establish It can be built immediately.

Chen Xi told reporters that the reason for the large amount of R & D funds for U.S. pharmaceutical companies lies in their medical insurance system arrangements. For example, part of the price of medicines is borne by the U.S. commercial insurance market. Profits are converted into research and development expenses.

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