Saturday, September 24, 2016

WSJ: China's FDA Now Allowing Keytruda® -- But Only On Its Hainan Resort Island Pilot "Medical Tourism" Basis...

It would seem (per the WSJ, yesterday) that the party elites in China (and I suppose wealthy people throughout Southeast Asia, generally) who can afford to fly to Hainan, and stay on the tony resort island, will now be able to get an immuno oncology agent not yet approved by China's FDA -- for its vast mainland population.

I suppose in the grand scheme of things, Kenilworth's Keytruda® (pemrolizumab) was never going to be offered in a setting affordable, on China's mainland, for perhaps 99.999 per cent of its population. And so in my analysis, the Chinese government has made a decision to keep the elites' spending power inside the confines of the broader Chinese economy on this score. Obviously, but unstated in the article -- if wealthy Chinese oncology patients fly to Australia, Hong Kong or the US -- all that spending power departs the Chinese economy, as they go.

[In this regard, while the hospital itself is required to be 100 per cent non-China owned, all the ancillaries -- the resort hotels, meals, clothing and travel purchases made, while on the island (family included) do clearly benefit some set of these same Chinese party elites, in all likelihood.]

So I suppose it doesn't matter all that much, that the elites will fly to Hainan -- instead of taking their money to Hong Kong. But in my opinion, it certainly reminds the world that there are two systems of health care, increasingly globally now -- the system the elites are able to purchase, out of pocket, and the non-system(s) the rest of the world makes due with. Here is a bit from yesterday's Journal:

. . . .An institution affiliated with Hainan Health and Family Planning Committee announced on its account on the WeChat messaging platform late Thursday that Keytruda will be the first imported drug used in a cancer hospital in the Boao Lecheng International Medical Tourism Pilot Zone in Hainan.

Set up in 2013, the zone sets special rules on foreign investment, such as 100% foreign ownership in hospitals and fast-track approvals for new drugs and medical devices. The hospital gained approval from the China Food and Drug Administration to import Keytruda this March, and will import more foreign cancer drugs based on patients’ need, according to the announcement. . . .

I am not so naive as to think the same sort of rationing doesn't occur world-wide -- and it makes economic sense for Merck to play along -- benefitting its shareholders, but it is an uncomfortable feeling, at bottom, I'm left with: those who have will live longer, and generally better, than those who. . . have not (or have less).

And saying it has always been so, doesn't really make it. . . right. Onward, humbly aware that I am blessed to be as comfortable, and healthy, as I am here. Do go be excellent to one another, whenever you possibly can.


1 comment:

Anonymous said...

Important to note that it is not as if MRK needs to participate as an active partner in what the Chinese government intends for making Keytruda available in Hainan. Once Keytruda was initially approved by the FDA in September 2014 vendors or wholesalers outside of the US could approach US wholesalers or PBMs to purchase Keytruda outside of MRK's remit, for a premium obviously, to make it available to patients able to pay for the drug out of pocket.