In this field, the United States is still far ahead.
Text: the sound of trees and grass in the forest
Proofreading: Chao Gan/Editor: Guo Licheng
Houston, an American city no stranger to China, is well-known for its rocket team and space city. People are deeply impressed by its developed petrochemical industry, staggered pipelines and busy factory ports.
There are more than rockets and oil behind Houston’s prosperity.
(Photo: shutterstock)▼
But to say that Houston’s most prosperous industry, it has to be the following:
The annual output value is as high as $14 billion, more than 90,000 people go to work, and many top medical institutions and researchers gather. By the way, one of the largest medical complexes in the world supports a quarter of Houston’s hotel business.Dezhou medical center.
Texas Medical Center "supported" a city on its own.
(Photo: Yitu. com) ▼
This achievement of Texas Medical Center was not achieved overnight, but was a leader in the industrial transformation of the United States for decades. Due to the large number of well-known hospitals gathered here, the supporting medical equipment, industry exhibitions, health consultation and other industries have also developed.
Compared with today’s depressed Great Lakes rust belt, Houston is still full of vitality.
Industrial explosion in the aging era
Houston’s success in the pharmaceutical industry, on the one hand, benefits from the strong strength of universities, scientific research and talents, but as an industry, the most fundamental reason for its rise is stillFundamental transformation of social population structure.
76 million people were born in the "baby boom" in the United States from 1945 to 1964, and the average age of the American population has been rising since then. Despite the continuous immigration supplement, compared with the obviously increased elderly population, the incidence of a series of diseases such as diabetes, cancer and Alzheimer’s disease is bound to increase, and the pharmaceutical market is bound to expand.
The baby boomers are getting old.
Directly raised the average age of the American population ▼
Aging is not exclusive to Europe and America.With the inevitable trend of economic development and fertility decline, China is no exception.. Moreover, China people’s awareness and demand for health are also obviously improving, which can be seen from the financial market: in the past 20 years, the pharmaceutical and biological industries have increased sevenfold, ranking among the top five in all industries; The scale of biomedical ETF(512290) is also rising step by step.
The pharmaceutical and biological industries are growing rapidly ▼
Biomedical ETF▼
In the age of aging, diabetes and obesity have become a problem that almost everyone has to face. At present, there are about 537 million people with diabetes in the world aged 20-79. Nowadays, the sale of all kinds of sugar-free drinks and foods on the market is a manifestation of people’s worries.
The treatment of diabetes, a chronic disease, is a worldwide problem. Otherwise, there will be no so-called "ancestral secret recipes" flying all over the sky. However,The emergence of GLP-1 drugs will be a blessing for patients..
GLP-1 (human glucagon-like peptide -1) is a protein secreted by human intestinal cells, which can promote human insulin secretion. However, GLP-1 secreted by human body is easy to be decomposed by other enzymes, and will not act for a long time. Then, if we improve the structure of GLP-1 so that it is not easy to be decomposed, won’t it promote insulin secretion for a long time and treat diabetes?
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Science magazine listed the related research of GLP-1 as the top ten scientific breakthroughs in 2023.Among them, the most famous drug is undoubtedly Smegliptide, which has occupied half of the field of diabetes..
(Note: At present, this drug is only approved for the treatment of diabetes in China, but it has not been approved for weight loss! )
Smegliptide also shows great potential in the prevention and treatment of Alzheimer’s disease, nonalcoholic hepatitis, cancer and kidney disease, and it is quite aspirin-like "cure all diseases". In October last year, after Novo Nordisk announced the "positive experimental results" of smegliptide in the treatment of diabetic nephropathy, the share prices of many dialysis manufacturers fell. And this story has happened many times in the medical field.
The announcement shows that the efficacy of smegliptide has reached the expectation.
Therefore, the experiment was terminated early ▼
Lilly, a pharmaceutical giant, was originally a small company, but relied on its keen sense of smell to take the lead in obtaining insulin patents and monopolize the global market. However, in the 1980s, Novo Nordisk insulin injection pen went on the market, and this convenient and easy-to-use product sold well when it went on the market, which opened the era of hegemony in the diabetes drug market.
All these remind people that technology is constantly reshaping this market.An innovative achievement may create a new giant.; Another case is the wave caused by the listing of oral version of smegliptide in China in early 2024.
The oral version is also only approved for diabetes treatment.
Not approved for general weight loss!
(Photo: National Medical Products Administration) ▼
Massive capital investment and endless new achievements have created a vibrant biomedical industry today. In the past few decades, China, the fastest growing economy in the world, actually has a long-term shortcoming in the biomedical industry.Can you make up this short board?
China medicine, difficult to move forward.
Taking medicine when you are sick is something that everyone has to experience. However, the expensive drug price has become a pain in patients’ hearts. The dilemma in Dying to Survive may happen to each of us.
The reason why the drug price is so high is related to the current high cost of drug research and development:10 years, 1 billion dollars. For a long time, the pharmaceutical industry has been dominated by a group of large multinational pharmaceutical companies. On the one hand, it has high research and development costs and technical barriers. On the other hand, monopoly status means strong pricing power. Such a market situation has created amazing profit margins for large pharmaceutical companies: in 2023, the annual sales of smeagoutide reached $21.142 billion.
Novo Nordisk Meglumine Peptide Related Products Financial Report ▼
The pharmaceutical industry in New China originated from the eldest son of the Republic medicine-Shijiazhuang Huabei Pharmaceutical FactoryThe first batch of domestic penicillin in China was born here. However, due to our late start and weak foundation, we have never had any industrial advantages except for traditional Chinese medicine products with local characteristics for a long time. When foreign pharmaceutical companies with strong R&D strength and mature business model enter China, they are like wolves in the flock. If they don’t catch up, the pharmaceutical market of more than one billion people will be completely lost.
Chinese medicine is a symbol of moderns in Shijiazhuang ▼
At that time, China’s R&D ability was very weak, so we could only start with the production of basic raw materials for drugs. The ingredients of the raw materials are fixed, and the production process is relatively mature. As long as you are willing to do it, you can produce products. But the middle and lower reaches of this international industrial chain can receive a large number of orders only because of low labor costs. Moreover, the technological level was limited at that time, and the pollution in the production process was very serious.
This is obviously not a long-term solution. The vast market of all kinds of new drugs attracts China enterprises. Since they can’t make high profits in developing new drugs, let’s start with generic drugs and get a slice of the huge market first. Nowadays, many backbone enterprises in the pharmaceutical industry in China (such asHengrui Pharma, the heavyweight stock of biomedical ETF), it is in these two waves that the initial accumulation has been completed and it has moved to the upper reaches of the industrial chain.
From generic drugs to self-developed drugs
Enterprises need a certain amount of time to accumulate and precipitate.
(Photo: Picture Worm Creativity) ▼
At this time, the pharmaceutical industry in China has made great progress. But after all, I still follow in the footsteps of others, and I only earn a fraction of the big international pharmaceutical companies. If you really want to gain a foothold in the biomedical industry, you need to come up with your own things and change the old thinking and industrial model as a whole.Only by thoroughly remoulding oneself can we really grow up.
It is not only an economic and commercial issue to enlarge the local pharmaceutical industry. Even in the era of high globalization, the regional differences of health problems in different countries need the developed biomedical industry in their own countries.
For example, the Texas Medical Center mentioned at the beginning
Has the largest cancer center in the United States
(Photo: MD Anderson)▼
For example, due to the differences of environment and living habits in different countries, the incidence of cancer, the big health killer in the aging era, is different in different countries. The incidence of lung cancer and nasopharyngeal carcinoma in China is obviously higher than that in Europe and America, and esophageal cancer patients account for half of the world. Only by establishing an independent biomedical industry system can we better provide targeted treatment for patients.
Make your own medicine
Cancer, in most people’s minds, is equated with terminal illness. But the progress of modern medicine is enough to make this an old yellow calendar.
One of the major difficulties in cancer treatment is that cancer tissue has a strong ability to deceive, and it will "hide" itself under the guise of the identification mechanism in the human immune system to prevent cannibalism. In other words, if drugs can be used to "remind" the immune system and "catch the mole", it can play a role in preventing and treating cancer.
"There is a mole, terminate the transaction."
(T cells surround identified cancer cells)
(Photo: NICHD/J. Lippincott-Schwartz)▼
Research in this field has been carried out for decades, among whichPD-1/PD-L1 has attracted much attention from scientists.. Cancer cells will suppress T cells through this in vivo inhibitor, making it think it is a "friendly army". Scientists have developed drugs to block the inhibitory signal pathway between T cells and tumor cells, so as to "restart" the human anti-cancer mechanism.
Microscopically, PD-L1 positive lung adenocarcinoma cells
(Photo: wiki)▼
Such drug development requires high technology and in-depth study of human immune system. In the past, it was estimated that multinational pharmaceutical companies developed and sold high prices, and then domestic pharmaceutical companies waited for the patent period to pass a wave of imitation. However, times have changed.
By the end of 2023, 17 PD-(L)1 products have been approved for listing in China market, of which more than half are domestic products. In addition to PD-1 target, drugs such as PARP and CDK4/6 have also been successfully developed. Hengrui Pharma is one of the most important manufacturers in this field in China. Its biopharmaceutical products cover lung cancer, nasopharyngeal carcinoma and other high-risk cancer categories in China, and a large number of drugs are in the clinical research stage.
Some cancer-related drugs in Hengrui Pharma.
(Photo: Hengrui Pharma) ▼
But at present, the human response rate of PD-(L)1 drug is not high enough, and scientists are still improving it.
Since antibodies can recognize tumor tissues, people naturally think: Can you directly use it with chemical drugs to accurately find cancer cells and give him a "total annihilation"? After all, no matter how hard you work, you are afraid of a kitchen knife: no matter how tough a cancer cell meets a high dose of chemical drugs, it will only disappear.
Schematic diagram of the action mechanism of antibody-coupled drugs
(photo: ADCREVIEW)▼
This is antibody-based coupled drugs (ADC), which is one of the main anticancer drugs at present.. The principle is simple, but there are many difficulties in research and development: how do protein primers connect with "toxins" that attack cancer cells? How to ensure that you don’t play your medicine too early on the way to the "enemy camp"? How to "exit" in case of entering normal cells of human body? As a result, ADC drugs with complex structures have become research and development black holes. Once the research and development fails, it is difficult to find out which link has a moth.
How to design the parts of antibody conjugates
It is a big problem to maximize the drug effect ▼
In the past, this was the natural technical moat of large multinational pharmaceutical companies, which could greatly increase the price of drugs; But now, this is still the stage for China pharmaceutical companies to show their fists:At the end of 2023, BL-B01D1, an ADC dual-antibody drug for lung cancer and breast cancer, was developed by Bailey Tianheng, which set a record for China drugs to go to sea. Successfully went to sea with a down payment of $800 million and a potential price of $8.4 billion..
China’s biomedical industry has not only quickly caught up with the world-class phalanx, but also achieved a leading position in some fields.
Bai Li Tian Heng represents China Biomedical Haoheng.
(Photo: Bai Li Tian Heng) ▼
Both PD-1 and ADC use drugs to enhance the immune cell ability of human body or kill cancer cells. Then, directly enhancing the recognition ability of human immune cells can also achieve anti-cancer effect? It sounds like science fiction, but it has been realized in reality: using genetic engineering technology to inject receptor genes that can recognize the corresponding tumor cell antigens into immune T cells, so that they can accurately identify cancer cells. This is the CAR-T cell therapy technology.
Process diagram of CAR-T cell therapy technology
(Photo: MUSC)▼
At present, CAR-T is mainly used for the treatment of hematological cancers, including well-known leukemia. There are only ten models on the market in the world, and China has four models, including Regiosai injection of Wuxi PharmaTech, which is heavily held by biomedical ETF. In addition to the treatments already on the market,There are hundreds of CAR-T therapies being developed in China, the largest number in the world..
China’s bio-pharmaceutical industry, which once could only follow the big international pharmaceutical companies, has finally grown up.
Reggiorense injection is the second CAR-T product approved in China.
It is also the first CAR-T product of Class 1 biological products in China.
(Photo: Wuxi PharmaTech) ▼
The overall progress of this industry is inseparable from the joint efforts of this huge industrial chain. The listing of any drug requires sufficient clinical trial evidence and approval of relevant departments. For a long time, the approval speed of new drugs and new medical devices in China is slow, and a large number of drugs to be approved often pile up. In the high-speed development of drug research and development track, any time delay will miss business opportunities.
Since August 2015, the State Council issued the Opinions of the State Council on Reforming the Examination and Approval System of Medicines and Medical Devices, and a series of reform measures have been introduced one after another. In 2019, the newly revised Drug Administration Law established the MAH system for listed licensors, which mobilized the enthusiasm of more new drug research and development. The response of the market and industry is also extremely rapid, and various breakthroughs of biomedical enterprises in China have emerged in succession.
The core of MAH system is to separate drug marketing license from drug production license.
Allow pharmaceutical production enterprises, R&D institutions or researchers.
Become an independent drug marketing license holder
(Photo: Drug Administration Law) ▼
Go out to sea and look to the future.
The breakthrough in the related fields of innovative cancer drugs is only one aspect of the rapid progress of the biomedical industry in China. With the deepening of people’s cognition, medicine is more than just taking medicine to see a doctor; The future medicine will be a whole from genes to society. The biomedical industry in China is also making all-round progress.
Biomedicine in China is making efforts.
(Photo: Yitu. com) ▼
Since the 21st century, people have made many breakthroughs in cancer treatment. But no matter how to treat it, it is a process of suffering for patients. It would be best if it could be prevented.
At present, the human papillomavirus vaccine (HPV) is the only vaccine that has an obvious preventive and therapeutic effect on cancer (cervical cancer). Originally, it was expensive and all of it relied on imports. Many cities were in short supply and even went to Hong Kong to fight. nowDomestic bivalent HPV vaccine has been put on the market, and the cost of vaccination has been greatly reduced..
Bivalent HPV vaccine independently developed and produced by watson biological.
A needle costs less than 400 yuan.
(Photo: released by Kunming) ▼
People’s recognition of domestic vaccines is real.Zhifei Bio and watson biological held by Biomedical ETF.They all rely on relevant vaccine products to achieve good results in the capital market. It can be expected that this market will continue to grow after the domestic nine-valent vaccine is listed around 2025.
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Under the constant technical update,The pharmaceutical industry will continue to reshuffle and opportunities will continue to emerge..
An unprecedented wave of aging has arrived, and the biomedical industry with long-term sustainable development potential is undoubtedly the biggest outlet under this trend. Houston Medical City has proved to us that this industry has unlimited potential and long-term stability, and it is also a great opportunity for the city to realize industrial transformation. For individual investors, this is a win-win choice to support national health and obtain stable investment income; For practitioners, the market is changing with each passing day, and there are many opportunities but fierce competition.
To win the hard bones in the field of medicine, we need to unite from policy to market, as well as various therapies and all directions. Various fields with great prospects will gradually merge into one. It should be only a matter of time before China has its own world-class medical center.
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* The reference to individual stocks is for reference only and does not constitute investment advice.
* The content of this article is provided by the author and does not represent the position of the Earth Knowledge Bureau.
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