Drugmakers cut prices on average by more than 60% to get on China’s 2022 NDRL list

China’s National Reimbursement Drug List (NRDL) is a crystal clear example of the country’s bargaining power in the biotech and pharma market, as more firms have reportedly agreed to cut their prices for 67 new medicines to be included in its national medical insurance coverage starting in January.

Being on the list is lucrative. Essentially, if a biotech or pharma company gets on this list, they’re covered by the biggest insurance network in the country. Given China’s vast population, the Chinese government has significant leverage to decide which medicines can make a profit. While domestic drugmakers are quite willing to play that game, cutting prices significantly in exchange for getting on the list, international companies don’t do it as often.

As part of a new round of negotiations, the 67 drugs, which include Eli Lilly’s psoriasis treatment Taltz and J&J’s multiple myeloma drug Darzalex, had their prices cut by more than an average of 60% to get on China’s list — 61.7% to be exact, according to Reuters.

And at a news conference, China’s National Healthcare Security Administration officials said that the biggest price cut was 94%, with the product in question remaining unnamed.

That said, here are some of the new drugs and indications on the list for next year:

Some of BeiGene’s drugs got added to the list, it announced last night, this time for three drugs: the anti-PD1 antibody tislelizumab in three new indications; the BTK inhibitor Brukisna in one new indication; and the first listing for pamiparib, a PARP inhibitor.

Hutchmed, a Hong Kong biotech, got to keep its metastatic CRC cancer drug Elunate on the list, while adding Sulanda, a treatment for ‘non-pancreatic neuroendocrine tumors’ (or NETs).

Domestic biotech RemeGen, based in Yantai, China, got two of its drugs approved to the list: Telitacicept, a dual-targeted TACI-Fc fusion protein for systemic lupus erythematosus and metastatic gastric cancer ADC Disitamab Vedotin.

Shanghai’s Junshi also announced that its drug already on the list — toripalimab, an anti-PD-1 monoclonal antibody — is getting two new indications approved: recurrent or metastatic nasopharyngeal carcinoma after failure of at least two lines of prior systemic therapy, and locally advanced or metastatic urothelial carcinoma, after failure of platinum-containing chemotherapy or progression within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy.

Innovent and Lilly got an expansion of sintilimab, its monoclonal antibody also known as Tyvyt for three new indications:

in combination with chemotherapy for first-line treatment of advanced or recurrent non-squamous NSCLC without sensitizing EGFR mutations or ALK rearrangements;

in combination with chemo for treating advanced or recurrent squamous NSCLC;

and in combination with Byvasda (bevacizumab biosimilar injection) to treat unresectable or advanced hepatocellular carcinoma (HCC).

Finally, Ascletis announced that its oral direct anti-HCV therapy Asclevir got added to the list.

While oncology researchers have long pursued the potential of cellular immunotherapies for the treatment of cancer, it was unclear whether these therapies would ever reach patients due to the complexity of manufacturing and costs of development. Fortunately, the recent successful development and regulatory approval of chimeric antigen receptor-engineered T (CAR-T) cells have demonstrated the significant benefit of these therapies to patients.

Merck’s new antiviral molnupiravir (Quality Stock Arts / Shutterstock)

After South African scientists reported a new Covid-19 variant — dubbed Omicron by the WHO — scientists became concerned about how effective vaccines and monoclonal antibodies might be against it, which has more than 30 mutations in the spike protein.

‘I think it is super worrisome,’ Dartmouth professor and Adagio co-founder and CEO Tillman Gerngross told Endpoints News this weekend. Moderna CEO Stéphane Bancel echoed similar concerns, telling the Financial Times that experts warned him, ‘This is not going to be good.’