While much of PharmaBoardroom’s recent report on Hong Kong and the Greater Bay Area looks at how Hong Kong is attempting to position itself as a development and financing hub for health tech start-ups, just as important are the multinational pharma companies with commercial operations in the city, providing Hong Kong’s healthcare system with the medicines it needs. Here, four territory managers give their take on the strengths and specificities of this small but important local market.
Hong Kong Healthcare: ‘A Well-Oiled Machine’
“The Hong Kong market, despite its size in terms of population and GDP, is a dynamic and fast-growing one, with a growth rate of four to six percent annually. This growth is driven by a strong middle class that is health-conscious and seeks the best standard of care for themselves and their families. The city has a well-established healthcare ecosystem, supported by 40 government hospitals and a plan to build even more in the coming years. The government’s Primary Healthcare Blueprint further emphasizes early detection and prevention of diseases like hypertension, diabetes, and high lipids, which are prevalent among the middle-income population.
“The healthcare system in Hong Kong is like a well-oiled machine that focuses not only on the quantity of care but also on improving the quality of care. The authorities are actively involved in supporting the industry and educating patients, ensuring that they have easier access to primary care services through District Healthcare Centres (DHCs). The focus on prevention and early treatment helps improve the long-term prognosis for patients and contributes to the sustainable growth of the healthcare sector.
“Moreover, Hong Kong’s private healthcare sector is well-established and highly regarded for its quality of care. The city has a significant medical tourism industry, with many patients from mainland China seeking treatment here. The reputation of the healthcare system and the trust it instills are crucial factors in attracting both local and international patients.
“Additionally, the Hong Kong market has safety nets in place, such as Samaritan funding and community funding, to provide reimbursement for treatment to individuals below the poverty line. These safety nets ensure that even those in vulnerable situations can access necessary medications and healthcare services.”
An Early Adopter of Innovation
“In Hong Kong, MSD’s immuno-oncology drug is not only the immuno-oncology class market leader in terms of patient usage, but physicians also appreciate it and the value it can bring to patients. It is not just a single product but has multiple indications that can treat many types of tumours. We are busy working with the regulatory authorities and the Hospital Authority to demonstrate this value and file for new indications continuously.
“Some of these new indications have received FDA and EMA approvals, and we are looking to see how we can bundle approvals for more new indications, rather than submit them one by one. Thankfully, by working closely with the Department of Health to drive efficiency, last year we had 8 indications approved at once which was record-breaking.
“The priorities are to continue enlarging further indication approvals because expanded indications approval can allow more patients to benefit from our affordability solution mentioned beforehand. Therefore, we are identifying the patient journey and the willingness of doctors to offer the therapy. We have a strong oncology pipeline, so we are excited for the years to come.
“MSD’s immuno-oncology medicine has started to also become the backbone of many cancer therapies in conjunction with other medicines for cancer patients and we are working with our strategic alliance partners e.g. Eisai to provide them here. Furthermore, MSD is developing its own pipeline of innovative cancer medications that can be used as combination therapies.
Beyond Commercial Operations Alone
“Previously, many pharmaceutical companies mainly focused on commercial operations in Hong Kong due to the limited market size. Nevertheless, we have seen changes in recent years that engagement with different key stakeholders is now more important than ever for strategically leveraging the position of Hong Kong. We are not only supplying medicines, but also driving scientific collaborations with academia and medical experts working together for building an evermore favourable ecosystem. The industry has been making significant investments and commitments.
“Hong Kong has top notch scientific and medical experts leading in different areas on the international stage. While pharmaceutical companies supply innovative and efficacious medicines for patients, medical research and new scientific findings have been contributing to advancing treatments and therapies for ever-better outcomes.”
A Strong Ecosystem for Orphan Drugs
“Hong Kong is a relatively good market for rare diseases if we compare it to other developing ecosystems. There is funding support provided by the government and the payer is willing to invest in this area, which is not the case everywhere in the world as affordability is always an issue. While there are some restrictions on reimbursement, Hong Kong has made a good start. Since the acquisition of Alexion, the rare disease portfolio has been a big part of our local business.
“The situation is quite different in the Greater Bay Area, as there are currently no actors willing to pay for rare disease medications. We would like to explore any opportunity to help those patients in need.”
Regulatory Upgrades Needed
“Regulatory approval for advanced therapy products (ATPs) is a separate pathway, although we still need certificates of pharmaceutical products (CPPs) from two separate regulatory bodies, such as the US FDA or EMA in Europe, before a therapy can be approved here.
“We understand, there are ongoing discussions to accelerate the approval timeline for drugs by considering the experience of neighbouring areas as a point of reference. One example of this is the implementation of rolling submission in Macau. It allows drug developers to submit the application dossier for review while other supplementary documents or the certificate CPP can be submitted later before final approval. This process enables patients to receive the products much earlier, typically just a few months after US FDA approval.
“I would suggest that the Hong Kong regulatory authority consider adopting the rolling submission approach. This means that the drug dossier can be submitted for review after receiving the first CPP. Once the second CPP approval is completed, or other equivalent requirements have been fulfilled, the product can be made available to patients. Currently, patients in Hong Kong have to wait approximately 1.5 years after the drug is available to be used in the first approved country.
“To promote Hong Kong as an international biomedical hub and position it as the first region to approve the drug in the Asia Pacific, it is crucial to expedite the entire process”