Pfizer, in collaboration with Shanghai Branch of PICC Health Insurance and the Shanghai MediTrust Health, launched China’s first pay-for-performance (P4P) model featuring its blockbuster breast cancer drug Ibrance – ‘Bo’ai Xin’an – Patient Benefit Management Program’ – in late January 2019.

Against this backdrop, Prashant Khadayate, Pharma Analyst at GlobalData, offers his view on Pfizer’s market strategy in China:

“Pfizer intends to strengthen its position in China market by bringing innovative drugs as well as innovative ways to deliver them to patients. The P4P model for Ibrance is evident of its long-term goals in the country. This is a China specific market strategy as the P4P model for Ibrance is not available in the US and other geographies where Ibrance was launched. China became the 87th country in which Ibrance was launched after receiving approval from the China National Drug Administration (CNDA) in July 2018. Globally, the drug registered US$4,118m in sales with a growth rate of 32%, out of which emerging markets (including China) accounted for US$226m with a growth rate of 58% in 2018. As per Globocan 2018, new cases of breast cancer in China constitute approximately 20% of the overall new cancer cases identified in the female population, which is equal to approximately 0.37 million new cases for breast cancer. As a result, it becomes inevitable for Pfizer to focus on the Chinese market.

“Under the model, which currently covers 34 cities, only 500 patients could be enrolled within 28 days of beginning Ibrance treatment in combination with an aromatase inhibitor. Pfizer promises to reimburse enrolled patients up to 33.5% of Ibrance treatment cost if they metastasis within 126 days of treatment initiation. Only patients who have had no previous first-line hormone therapy treatment are eligible for P4P. It will be interesting to know whether the P4P model is extended to other diseases within China or in other markets. Moreover, Pfizer will look to optimize the first mover advantage on the breast cancer patient’s treatment with Ibrance and also from P4P model perspective. The P4P models are primarily common in the US and European countries compared to Asian countries.

“The P4P model can also be seen as Pfizer’s gesture towards the government’s ‘Healthy China 2030’ initiative and commitment towards working together for a healthier China. At present, its coverage is very limited and may not be enough considering the breast cancer population in China. Nevertheless, the launch has attracted significant media buzz, which can help Pfizer in its long-term approach towards patients, payors and physicians. Since Pfizer’s Ibrance approval in China was based on pivotal trials data conducted outside China, the P4P model provides Pfizer an opportunity to further understand Ibrance response on the Chinese patients and can further help in generating post-marketing data or real-world data for Ibrance.”