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Series B-4: Curriculum requirement

The following discussions are according to The Basic Education Curriculum Reform Outline (Ministry of Education, 2001) [1], and the 2016 OECD report mentioned previously.

 

  • Primary education

 

The primary school curriculum should consist of courses that encourage all-around development of individual learners. This document suggests that schools offer courses like morality and life, Chinese, mathematics, physical education and art to primary students in lower grades. Morality and society, Chinese, mathematics, science, foreign language, comprehensive practical activity, physical education and art should be offered to primary students in higher grades.

 

  • Junior secondary education

 

The curriculum for junior secondary students mainly includes morality, Chinese, mathematics, foreign language, science (or physics, chemistry and biology), history and society (or history and geography), physical education and health, art and comprehensive practical activity. Schools are encouraged to choose comprehensive courses, and to offer optional courses as well. The government emphasizes that Chinese, art and painting courses in compulsory education should attach more importance to Chinese character (script) writing.

 

  • Senior secondary education

 

When it comes to senior secondary school, the government suggests that schools offer various elective subjects in addition to the compulsory subjects. The requirements in elective subjects should be different from the requirements in compulsory subjects. Throughout primary and secondary education, the comprehensive practical subject is emphasized as a compulsory subject. The subject covers information technology, research study, community service, social survey, and labor and technology for primary and junior secondary school students. It covers research study, community service and social practice for senior secondary students. The comprehensive practical subject aims at improving students’ creativity and research capability, as well as helping students develop a sense of social responsibility through practical experiences.

[1] http://old.moe.gov.cn//publicfiles/business/htmlfiles/moe/moe_309/200412/4672.html

Series B-3: Enrollment

The following discussions come from a 2016 OECD report “EDUCATION IN CHINA: A Snapshot”[1].

 

In China, students usually enroll in pre-school at age two or three, and leave pre-school at the age of six. Pre-school education is not compulsory, and many pre-schools are privately owned. However, the government has taken on a more proactive role in promoting access following a national commitment to progressively universalize one to three years of pre-school by 2020.

 

In China, students must complete nine years of compulsory education. Most students spend six years in primary school, though a few school systems use a five-year cycle for primary school. Primary education starts at age six for most children. This is followed by three to four years of junior secondary education.

 

After finishing compulsory education, students can choose whether to continue with senior secondary education. Senior secondary education takes three years. There are five types of senior secondary schools in China: general senior secondary, technical or specialized secondary, adult secondary, vocational secondary and crafts schools. The last four are referred to as secondary vocational schools.

 

Although senior secondary education is not part of compulsory education in China, in 2014, 95% of junior secondary graduates continued their study in senior secondary schools (National Bureau of Statistics of China, 2015). This figure is notable because in 2005 only around 40% of junior secondary graduates attended senior secondary schools (National Bureau of Statistics of China, 2005).

[1] http://www.oecd.org/china/Education-in-China-a-snapshot.pdf

Series B-2: Number of schools in Chinese K-12 system

According to China’s Ministry of Education (MOE) statistics for 2017,

 

  Number of schools
Pre-school Education[1] 254,950
Primary Schools[2] 167,009
Junior Secondary Schools[3] 51,894
Regular Senior Secondary Schools[4] 13,555
Secondary Vocational Schools[5] 8,181

 

[1] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344728.html

[2] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344722.html

[3] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344763.html

[4] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344797.html

[5] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344778.html

Series B-1: Number of students in Chinese K-12 system

According to China’s Ministry of Education (MOE) statistics for 2017,

 

  Entrants Enrolment Graduates
Pre-school Education[1] 19,379,530 46,001,393 16,526,663
Primary Schools[2] 17,665,544 100,936,980 15,658,999
Junior Secondary Schools[3] 15,472,209 44,420,630 13,974,699
Regular Senior Secondary Schools[4] 8,000,548 23,745,484 7,757,292
Secondary Vocational Schools[5] 4,515,235 12,542,893 4,063,981

 

[1] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344717.html

[2] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344720.html

[3] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344762.html

[4] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344796.html

[5] http://www.moe.gov.cn/s78/A03/moe_560/jytjsj_2017/qg/201808/t20180808_344777.html

Series A-5: What problems are these companies facing in hiring talents, conducting trials or launching products?

 

  • Talents

The lack of talents has been a well-recognized problem for China’s biotech industry[1]. China lacks seasoned experts with at least 10 years’ industry experience, say insiders. Companies are especially keen on experience in translational medicine, early-stage clinical trials and antibody manufacturing. Start-up biotech firms need experienced managers at every level, from clinical trials to drug manufacturing processes, to help build their companies[2].

 

This path from multinational drug company to biotech is clearly seen in the bios of many of the more ambitious start-up founders. Returnees with a few years under their belt in China and an ability to effectively navigate the system are far more valuable to employers than new arrivals. It becomes fairly common that multinational biopharma firms are finding themselves battling Chinese biotechnology startups to attract talent38,[3]. Those startups flush with cash from venture-capital financing are willing to pay top dollar (and upsides with options).

 

  • Trials

In terms of conducting trials, a historical lack of clinical research infrastructure in China has led to problems adhering to Good Clinical Practice, the international gold standard for maintaining ethical and quality standards in clinical trials. As an example, nearly all clinical research sites in China are hospitals, as there are no private practices. Because of that, clinical trial participants are treated exactly the same way as regular patients. That’s a problem because study staff — who are regular hospital employees — don’t have experience complying with Good Clinical Practice, putting the trial’s integrity, not to mention patient protection, at risk[4],[5].

 

Meanwhile, the rapid growth of Wuxi AppTex (and its affiliated Wuxi Biologics) has made itself one of the largest CRO/CMO players in the world[6], helping to facilitate drug discovery/development/manufacturing globally.

 

  • Launches

 

As most Chinese biotech startups are still in the r&d stage, only a few were approved recently. The most relevant example here might be the PD-1/PD-L1 space.

 

CFDA has long been seen as “slow” in terms of new drug approvals. A 2016 discussion quoted that usually a new drug needs 5-10 years for approval[7].

 

However, for the recent domestic PD-1 drugs for cancer, the approval speed was amazingly fast. Junshi won the first made-in-China PD-1 drug approval by NMPA (formerly CFDA) in December 2018[8]. Ten days later, the second PD-1 drug by Innovent was approved[9]. Each took 284 and 255 days respectively[10].

 

Two foreign PD-1 drugs, Merck’s Keytruda and Bristol-Myers Squibb’s Opdivo, were approved earlier in 2018. During 18Q3, Keytrude and Opdivo recorded ¥150 and ¥190 million in sales respectively[11].

 

Junshi started its sales in February 2019 and recorded nearly ¥80 million in the first quarter[12]. Innovent’s PD-1 launched its sales in March 2019 and finished the first quarter with $9.9 million in revenue, both of which are deemed as successful in media reports[13].

[1] https://www.kornferry.com/institute/download/download/id/17053/aid/219

[2] https://www.huamedicine.com/upload/down/5870180130135508.pdf

[3] https://www.ft.com/content/d3a2de0e-6fbb-11e8-92d3-6c13e5c92914

[4] https://www.statnews.com/2018/08/03/china-clinical-trials-infrastructure-transparency/

[5] http://www.appliedclinicaltrialsonline.com/running-clinical-research-china

[6] https://explorebiotech.com/top-cros-usa-contract-research-organization/

[7] http://journal.healthpolicy.cn/html/20160304.htm

[8] https://endpts.com/junshi-wins-the-race-for-first-made-in-china-pd-1-approval-as-execs-reap-394m-ipo-harvest/

[9] https://endpts.com/china-greenlights-second-homegrown-pd-1-in-10-days-as-innovent-celebrates-its-first-drug-ok-with-eli-lilly/

[10] https://www.bjcancer.org/Html/News/Articles/9321.html

[11] https://www.yicai.com/news/100135300.html

[12] https://xueqiu.com/8965749698/125984469

[13] https://finance.sina.com.cn/roll/2019-05-06/doc-ihvhiews0153982.shtml

Series A-4: Are companies building drugs for the Chinese market or the western/US market?

Mostly Chinese.

 

According to IMS, China’s spending in medicine has been growing fast, reaching $137 billion in 2018[1].

 

 

Another research database shows that in 2018, China’ exports in medicine was $17.4 billion[2] and imports was $29.6 billion[3].

 

Although they might use different sources/measures, we could roughly estimate that in 2018, non-import medicine consumption was 137-29.6 = 107.4 billion and domestic medicine production was 107.4+17.4 = 124.8 billion.

 

Therefore, 86% of Chinese drug companies’ production was for the domestic market while 14% was for exports in 2018.

 

For the more modern (or newly funded) innovative biotech/drug companies in China, they are targeting the global markets. Usually they will divide the commercial rights by regions and retain the greater china rights while sell the rest (another source of funding). Some innovative drug candidates’ global rights ex china have already been licensed/acquired by western/US pharmaceutical companies. Most Chinese biotech companies don’t have the capability to develop/commercialize outside the greater china area.

[1] https://www.iqvia.com/institute/reports/the-global-use-of-medicine-in-2019-and-outlook-to-2023

[2] http://s.askci.com/news/maoyi/20190624/1150071148256.shtml

[3] http://s.askci.com/news/maoyi/20190625/1430421148825.shtml

Series A-3: What is the IP regime in China and how does it affect innovation?

According to a 2017 research “Evaluation of China’s intellectual property regime for innovation: Summary Report”[1]:

1) China’s IP laws and regulations have improved significantly over the years, and currently are generally in line with international standards.

2) Despite the surge in the quantity of patents in China in recent years, patent quality has not risen proportionately. Proliferation of low-quality patents can restrain China’s ability to

transition towards an innovation-based economy.

3) Based upon our quantitative and qualitative research, we find that, generally speaking, the courts in China handling IP disputes are more efficient and effective today than in the past. Despite these positive developments in IP enforcement in China, the effectiveness of judicial IP enforcement remains undermined by the low damages traditionally awarded in IP cases

 

In terms of IP regime for the pharmaceutical industry in China, several improvements have been made recently:

  • Patent Term Extension

Generally, the patent term in China is 20 years, similar to that in the US. But China didn’t provide other protections such as Patent Term Extension for drugs.

For drugs, which require years of premarket development and marketing approval before they can be commercialized, additional protections are usually available. In the US, a pharmaceutical patent may be extended by up to 5 years to compensate for any clinical trials and FDA regulatory time. However, the amount of time that a manufacturer has both patent and regulatory exclusivity cannot exceed 14 years. A study for 170 top-selling drugs that had a generic approved from 2000 to 2012 shows that nearly half (49%) of those drugs received a patent term extension, with a median extension of 2.75 years resulting in a total exclusivity period of 13.75 years[2],[3].

The State Council in China announced its intention to extend patent protection (and other improvements) in October 2017 《关于深化审评审批制度改革鼓励药品医疗器械创新的意见》.[4]

On April 12 2018, the State Council meeting said that 5-year patent term extension will be available for innovative drugs which apply for commercialization on domestic and oversea markets simultaneously[5].

In December 2018, the patent term extension was part of the fourth amendment (draft) of China’s IP Law[6].

 

  • Data exclusivity

Also an important protection for drug innovation, data exclusivity is newly structured in April 2018, following the October 2017 opinion[7].

The protection (6 years) was in place before, but can be applied only in limited circumstances[8].

Innovative drugs that are approved to enter the domestic market will be entitled to enjoy a data protection period of six years, doubled to 12 years for innovative biological products for curative uses, which is comparable to that of the United States and exceeds the ten-year protection period in the European Union

The exclusivity protection may be reduced or revoked under any of the following circumstances[9].:

  1. when a drug application uses data from an international multi-center clinical trial in China and the drug application filed in China is later than those outside of China, the exclusivity period is one to five years, depending on the delay, and if the delay is more than six years, there is no data exclusivity;
  2. if the drug application uses data from clinical trials conducted outside of China without involving any Chinese patients, the data exclusivity period is 25% of the foregoing;
  3. if the drug application is supplemented with clinical trial data in China, the data exclusivity period is 50% of the foregoing; and
  4. if a company fails to launch an approved drug into the market within one year of obtaining regulatory approval, the data exclusivity will be revoked.

Generally speaking, the recent reforms are pretty much playing a “catch-up” with the drug protection/exclusivity in the US. They serve both as a way to protect multinational drug companies and a way to promote domestic innovation. China’s own pharmaceutical industry has long been seen as a market filled with generic drug makers. But it is expected that more innovative drugs/therapies will be developed in China.

 

Another thing worth noting – China joined ICH in 2017. The ICH Assembly approved the CFDA as a new Regulatory Member in June 2017[10],[11]. China’s signing of the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use now exposes Chinese companies to litigation if registered patents are not honored19. This will make Chinese drug makers operating higher standard stand out and raise the play field for all the companies.

[1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3118079

[2] https://www.uspharmacist.com/article/patent-and-regulatory-exclusivities-the-two-keys-driving-generic-and-followon-market-availability

[3] https://www.raps.org/news-and-articles/news-articles/2019/2/study-patent-term-restoration-extends-drug-patent

[4] http://www.gov.cn/zhengce/2017-10/08/content_5230105.htm

[5] http://www.gov.cn/guowuyuan/gwycwhy/20180412c06/index.htm

[6] http://www.phirda.com/artilce_19014.html?cId=1

[7] https://www.yigoonet.com/article/22344782.html

[8] https://www.hankunlaw.com/downloadfile/newsAndInsights/a180eb45f6f6f4a7c3530da2cdd6b463.pdf

[9] http://www.zhonglun.com/Content/2019/04-16/1353562780.html

[10] https://www.fda.gov/media/108538/download

[11] http://www.xinhuanet.com/health/2017-06/19/c_1121171609.htm

Series A-2: What diseases are they working on?

UBS summarized in its China’s biotech report – “Oncology: A driving force for innovation in Chinese biotech”.

An article by Pharmacodia in 2017 said the top 3 therapeutic areas for biologics in China are cancer, rheumatoid arthritis (RA), hepatitis B virus (HBV)[1].

Another bluebook in 2017 outlined the five focus areas for China’s biotechnologies[2]: 1) vaccines, 2) mAb and protein drugs for cancer, cardiovascular, neurodegenerative, diabetes, autoimmune diseases, 3) diagnostics and screening for major diseases, 4) gene therapies, cell therapies, 5) regenerative medicine

China suffers from an unusually high incidence of cancer, which has been the country’s leading cause of death since 2010. Nearly all companies (five out of six) went onto HKSE in 2018 are investing in oncology (except for Hua Medicine focusing on diabetes).

Among all the cancers, lung cancer is the most targeted disease due to the high incidence rate in China.

Globally, oncology is also the No.1 focus for the overall industry, accounting for more than 1/3 of the total pipeline, according to a 2018 report[3].

To develop cancer treatments, biotech companies usually focus on developments in mAbs (monoclonal antibodies), immuno-oncology, CAR-T therapies, etc.

Other breakthrough researches & developments including Qinghaosu (or Artemisinin), discovered by the team led by Youyou Tu to fight malaria.

[1] http://classic.hsmap.com/news_info/4080.html

[2] https://hsmap.com/static/bluebook.pdf

[3] https://pharmaintelligence.informa.com/resources/product-content/sitecore/shell//~/media/informa-shop-window/pharma/files/pdfs/pharma-rd-annual-review-webinar-2018-slides.pdf