MSD, which has had a presence in China since 1990, recently appointed Belgian national Anna van Acker to lead its strategically important China business. van Acker takes the helm against the backdrop of change at MSD, with a new global CEO and the abandonment of the company’s COVID-19 vaccine projects. As China head, she will hope to continue the company’s growth trajectory through the introduction of new medicines, especially in oncology, in what has become a crucial market.


van Acker has worked for MSD (Merck in the US and Canada) for over 21 years, holding managerial roles in Belgium, Hungary, the US, and Canada. Her new role as president and managing director for China based at the company’s Shanghai headquarters is not her first in China; from 2012 to 2015 she worked as head of marketing and strategy & business unit lead for the company’s atherosclerosis franchise in the country.


Since 2016, China has grown from MSD’s fifth-largest market to its second, behind only the company’s home market of the US, and today accounts for around eight percent of global sales. In late 2020, Van Acker’s predecessor Joe Romanelli credited this growth trajectory to robust developments in oncology, vaccines, and animal health, as well as continued investment in manufacturing, R&D, and manpower.


Romanelli also foregrounded the importance of expanding MSD’s offerings to new patients through new platforms through the removal of access barriers, whether by enhancing penetration in county-level markets or retail segments. He also touched on the importance of further advancing the company’s digital capacity, a field in which China has been a global leader in several niches.


MSD has had a difficult 2020/2021, with the shelving of its two COVID-19 vaccine candidates, citing inferior immune responses when compared with people who had recovered from the disease as well as those reported for other vaccines. Having entered the COVID-19 vaccine race late, the company is now focusing instead on treatments for the disease.


Moreover, long-serving CEO Kenneth Frazier is retiring on June 30th after almost 30 years at the company to be replaced by former CFO Rob Davis. MSD announced first-quarter 2021 sales of USD 12.1 billion, in-line with first-quarter 2020, a decline of one percent, and expects the full-year 2021 revenue range to be between USD 51.8 billion and 53.8 billion, driven by oncology drugs Keytruda and Lynparza as well as products in its hospital acute care and animal health businesses.


Prostate cancer treatment Lynparza, developed in collaboration with British giant AstraZeneca, was recent granted conditional approval in China after a successful Phase III trial. Prostate cancer is the sixth most prevalent cancer among Chinese men, with approximately 115,000 new patients diagnosed each year.


About seven percent of Chinese prostate cancer patients have germline BRCA mutations and are therefore more likely to have poorer outcomes. Additionally, around 70 percent of prostate cancer patients in China have advanced disease at the time of diagnosis, and for those with metastatic castration-resistant prostate cancer (mCRPC), the median survival is less than two years.


There has been significant change in China’s pricing and reimbursement system in recent years, with the system now updated at a higher frequency, more streamlined, and more data driven. However, pricing pressures remain, with innovative pharmaceuticals expected to be squeezed ever more tightly; something van Acker will have to navigate carefully.