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The time is ripe to double down on local “market-fit” capabilities.
Not all COVID-19 vaccines are created equal. Some are so much better than others in effectiveness. China learned this the hard way, as the pandemic continued to wreak havoc in a whirlwind across the country in December 2022 and leave many victims in its wake.
In retrospect, China could have been much better prepared, starting with better vaccines. There was ample evidence pointing to the superiorities of mRNA vaccines for COVID, as compared to the inactivated vaccines that were the mainstream in China. A study published in Clinical Infectious Diseases based on real-world data from 2.7 million Singaporeans demonstrated that mRNA vaccines were up to three times more effective in reducing infections and up to 11 times more effective in severe symptoms protection.1
Despite the compelling data and proactive pushes, mRNA vaccines were only accessible in small pockets of China, with Hong Kong and Macau as early beneficiaries. Along with Taiwan, these regions acquired mRNA vaccines through a partnership between BioNTech and Fosun Pharma, which was established shortly before a similar pact between BioNTech and Pfizer for the rest of the world. For other Asian markets, while there were fewer regulatory hurdles, supply shortages and cold chain requirements for mRNA vaccines turned out to be challenging for many, especially at COVID’s height.
The industry is now rising to the challenges, with efforts from global majors and local players across Asia. BioNTech, Moderna, Sanofi, and MSD have unveiled plans either to expand footprints or build new facilities in Asia, while Daiichi Sankyo, Shionogi, as well as CanSino and Sinovac are striving to catch up with the latest vaccine technologies. CanSino received China regulatory approval for the world’s first inhaled COVID vaccine as a booster, which was a much-welcomed addition to China’s limited arsenal. The company is also making headway on the mRNA front and boasts a pipeline for a number of infectious diseases beyond COVID.
Indeed, Asia harbors enormous potential and growing unmet needs for novel vaccines across different diseases, given it is home to 60% of the world’s population, with fast-improving healthcare infrastructure and health consciousness. Vaccines like Prevnar and Gardasil have proven to be blockbusters with runaway successes across Asia, and the socioeconomic value of vaccines is well recognized by public and commercial payers alike as one of the most cost-effective means for preventive care and better health.
At the same time though, many Asian markets do feature different sets of regulatory, access, and affordability challenges as well as supply chain complexities. This behooves market-fit approaches to maximize the commercial potential. A first-in-class shingles vaccine for example, was highly successful and visible in markets like Hong Kong and Singapore while falling far below expectations in China after its fast-track approval three years ago. This was partly due to the limitations of its access and go-to-market strategy, which was further compounded by the sporadic supply chain challenges.
To succeed in Asian markets, vaccine players would first need to derive an in-depth understanding of the access landscape, which may differ distinctly from that of other pharmaceuticals. China, for example, has Class I vaccines, also known as Essential Programs for Immunization, with the government as the sole buyer and payer, and Class II vaccines that are vaccinated on a voluntary basis. Class II vaccines are typically the higher-value category and would need to navigate through the tendering process with local centers of disease control, followed by listing at points of vaccination like community clinics, before they can reach recipients or caregivers. Most Class II vaccines have been paid out of pocket, while other payment options are emerging, ranging from public reimbursements at certain regions that are more receptive to preventative care philosophy, to commercial insurances and early bird discount programs, which could go a long way toward improving initial uptake and traction.
Finally, the key opinion leaders and influencers for vaccines could be quite different from those of other pharmaceuticals, hence a systematic and omnichannel approach could be key for effective go-to-market.
Grace Ge, Selene Peng, and Shiying He in Simon-Kucher’s life sciences division in Shanghai contributed to this article.