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Q. How fast is diabetes increasing in China and why?

Almost 12 percent (11.6%) of China’s adults have diabetes and more than half (50.1%) have pre-diabetes. That represents 114 million and 493 million people respectively. Changes in lifestyle, (i.e., diet, reduced physical activity, urbanization, etc.), plus pollution are all contributing factors to this increase.>

The projected cost of diabetes treatment for Western Pacific patients (predominantly Chinese) in the year of 2030 is estimated to reach USD$60 billion, mainly for the treatment of diabetic complications and end-stage diseases.

Recent research paints this picture of diabetes patients in China:

  • It’s hard to find a patient with type 1 diabetes in China who had lived with their disease for 30 years or more.
  • Only 25.8% percent diabetes sufferers receive treatment for their condition.
  • There is no national level or systematic approach to prevent diabetes.

Q. The IDF says diabetes treatment is an unmet medical need in the Western Pacific, which includes China. What are some of the barriers to effective treatment and what can drug developers do to improve market access in China?

There have been delays in drug approvals. Some drugs, for example DPP-4 inhibitors, were approved in China many years after they were approved in the European Union and United States, with fewer indications. Other drugs approved in the West are not recommended by Chinese Diabetes Society (CDS) because there is lack of clinical trial data from Chinese subjects.

The relatively high cost of some diabetes medicines is a factor, as are reimbursement rates that vary by province and insurance scheme.

Working with government to build capacity in the primary care system to manage patients with type 1 and type 2 diabetes is a priority, but steps can be taken that don’t rely on a “top-down” approach.

Q. Are there any other perspectives or actions that drug developers should consider when tailoring their development programs for diabetes patients in Asia?

Research indicates that ethnic Chinese develop diabetes at a lower body mass index level than do ethnic Caucasians – with many diabetes treatments developed and approved using clinical research data from the latter group. In addition, ethnic Chinese suffer worse b-cell deterioration in the early stage of diabetes compared to Caucasians.

Strategies to prevent and treat diabetes among Chinese should address the physiological, cultural and societal features of China.

There is an opportunity for both multinational and local biopharmaceutical companies to lead in China-focused clinical trials, help shape treatment guidelines and better enable physicians in China to individualize treatment for their patients.

Prevention is most efficient way to reduce the scourge of diabetes, and that means more patient education and arming them with the tools for self-care.

The biopharma industry needs to more proactively pursue the collection of evidence-based data through observational studies as part of broader trial initiatives. These data can be used to persuade regional and national governments, and payers, about the value of new and better medicines – versus just looking at their costs. Showing value is crucial to saving lives and improving the quality of life for individuals with diabetes, while doing so in an economically sound manner.