By Andrew Silver
BEIJING (Reuters) -Some doctors in China want national insurance coverage for weight-loss drugs to tackle endemic obesity, medical professionals told Reuters in rare instances of public advocacy, halfway through a decade in which the number of people considered overweight is set to increase.
Obesity is China’s sixth leading risk factor in disability and death, yet long-term weight-loss drugs that doctors have said could help reduce its prevalence can cost half a patient’s salary.
“Rising obesity rates combined with the high cost of treatment drugs are straining the healthcare system, prompting physicians to address access gaps,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations.
Unhealthy meals and stressful or less physically demanding jobs are pushing the rate of overweight or obese people to over 65% by 2030, in the world’s second-most populous country with 1.4 billion people.
The government introduced its first set of guidelines last year to standardise the diagnosis and treatment of obesity. Yet it does not plan to include weight-loss drugs in the national medical insurance scheme, instead directing funds elsewhere.
However, calls to subsidise weight-loss drugs in a field where professionals are usually reluctant to be associated with public campaigns highlight the risk that weight-related problems pose to the healthcare system.
“If you are able to put them in medical insurance, you can help patients, help considerably more impoverished patients to persevere,” Shao Xinyu, an endocrinologist in the eastern biotech hub of Suzhou, told Reuters.
“There must be many doctors with the same opinion, more or less,” said Shao, who supports coverage for patients with a body mass index (BMI) above 32.5 and no other health issues or lower for people who have serious health problems.
Obesity is associated with increased risk of health problems such as cancer and heart disease. In China, a BMI – an estimate of fat based on the ratio of weight to height – from 24 is regarded as overweight, and from 28 is obese.
Cost makes patients hesitate to use weight-loss drugs for an extended period, said endocrinologist Jin Jie in the southeastern coastal county of Ninghai. Jin said she bought medicine for a patient who could not find work due to obesity.
A year’s supply of a weight management drug from one drugmaker can cost up to 35,040 yuan ($4,919), a Reuters calculation showed. That is equivalent to about 50% of the average annual wage of urban private-sector employees last year.
In particular, a type of weight-loss drug known as GLP-1 should be subsidised to benefit obese patients with serious comorbidities, or multiple health issues, said cardiologist Zhang Yuqing in Beijing.
The National Healthcare Security Administration did not respond to a request for comment.
PRICE PRESSURE COULD MAKE UP FOR LACK OF SUBSIDY
China is home to several producers of weight-loss drugs, such as Innovent Biologics, Huadong Medicine and Shanghai Benemae Pharmaceutical. However, the market share of the different drugs is opaque.
“The (China) market is not growing as much as we had anticipated… It’s predominantly because we have never launched a previous version of obesity drugs in that market,” Novo Nordisk CEO Mike Doustdar said at a briefing.
Doustdar also cited the challenge of competitors.
“If you have a mega brand, then it’s a very different picture,” he said.
The expiration next year of a key patent for Novo’s blockbuster weight-loss drug Wegovy could increase competition as drugmakers including CSPC Pharmaceutical and Hangzhou Jiuyuan Genetic Biopharmaceutical develop their own versions of the treatment.
In the absence of subsidies, competition from such generics could help make weight-loss drugs more affordable.
“Single-target GLP-1 without clear differentiation could be subject to the pricing pressure from the generics,” Goldman Sachs analysts wrote in a report.
($1 = 7.1230 Chinese yuan renminbi)
(Reporting by Andrew Silver; Editing by Miyoung Kim and Christopher Cushing)
