Amarin Corp Plc (AMRN)

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Re the China market ...from Bloomberg

So why will Chinese looking to lose weight be paying so much less for Wegovy than their counterparts in the US, where health-care costs can be notoriously sky-high?

Let’s start with the obvious: As many as 95% of China’s 1.4 billion people get basic health insurance through a government agency that controls which drugs get reimbursed. Every year, domestic and foreign drugmakers gather in a nondescript building in Beijing to meet with authorities from this agency to negotiate prices of their drugs. It’s a grueling exercise that ultimately determines whether they earn a spot on the coveted National Reimbursement Drug List, or NRDL.

The agency is known to drive a hard bargain. In 2023, drug companies slashed prices by an average of nearly 62% to get their medications on the NRDL, in a bet that the sales volume it unlocked would be worth the price cut.

It’s common for foreign drugmakers to cut prices in the lead-up to the negotiations, in anticipation of further cuts. Even those who choose not to engage would need to face competitors, including local companies who are increasingly capable of developing me-too versions of their drugs.

And unlike the US, China doesn't have complicated systems for rebates, meaning drug companies don't have to bake in as big of a cut for middlemen.

Wegovy’s $193 price tag in China is likely to fuel more complaints about high drug costs in the US, where Senator Bernie Sanders has accused Novo’s chief executive officer of prioritizing profits over American lives.

Chinese authorities have made clear they don’t intend to reimburse for Wegovy use, meaning most patients will pay out of pocket unless they have commercial insurance. Still, keeping the treatment affordable will likely help Novo make inroads among the 140 million Chinese adults estimated to live with obesity by 2030.

Kiwi