On the evening of October 30th, the official website of AstraZeneca China announced that Wang Lei, AstraZeneca's Global Executive Vice President, International Business Chairman, and China President, is cooperating with the investigation in China.
This news has caused an "earthquake" in the pharmaceutical industry, as Wang Lei is a legendary figure in the Chinese executive team of multinational pharmaceutical companies. He not only broke the long-standing ceiling of Chinese in multinational pharmaceutical companies, but also led AstraZeneca China, which has repeatedly ranked first in the revenue of multinational pharmaceutical companies in China.
The reason for Wang Lei's cooperation in the investigation has not been officially announced by AstraZeneca.
The undeniable fact is that in recent years, AstraZeneca's lung cancer drug "Terassa" (Axitinib) has repeatedly been involved in insurance fraud scandals in China.
How to cheat insurance with miracle drugs
The China Judgments Online published the first instance criminal judgment of Du Xianqing's fraud and the first instance criminal judgment of Guo's fraud on December 27, 2023 and February 20, 2024, respectively.
Du Xianqing and Guo have both served as representatives of AstraZeneca and were involved in manipulating patients' genetic testing reports to defraud the National Medical Security Fund. The drug involved was osimertinib.
In Guo's case, after investigation, it was found that in January 2021, during Guo's tenure as a pharmaceutical representative at AstraZeneca Pharmaceutical Co., Ltd., in order to improve sales performance, he tampered with the genetic testing report of patient Jin Aishu without authorization, causing the patient to be reimbursed by medical insurance and prescribed the drug Axitinib, resulting in a loss of 33408 yuan to the medical insurance fund.
In March this year, the Jiangxi court also announced a case of using "cancer" patients to defraud insurance on the official account.
It is shown that from November 2020 to February 2021, the defendant Ma, knowing the relevant national medical insurance medication policies, used the method of forging a positive EGFR RT790M gene test result for patient A to help Liu illegally reimburse the cost of purchasing the drug Axitinib through medical insurance, and defrauded the national medical insurance fund of 100397.64 yuan. At the end of November 2020, the defendant Wu used patient B's ID card and social security card to purchase an extra box of the drug Axitinib, and illegally reimbursed the drug expenses through medical insurance. Later, he sold the drug to others and fraudulently obtained 13464 yuan from the national medical insurance fund.
Earlier, on April 23, 2021, the Sichuan Provincial Medical Security Bureau exposed the first typical case of 2021, one of which was a case of Nie, an employee of a designated medical institution in Yibin City, and Li, a medical representative, defrauding insurance by forging and tampering with prescriptions.
According to the investigation conducted by Yibin Medical Security Bureau based on real name reports, it was found that from October to November 2019, pharmaceutical representative Li used forged prescription notes to purchase 5 boxes of Axitinib under the name of patient Yang at Yibin Kangbei Pharmacy and sell them to others. The total amount of medical insurance involved was 67047 yuan, of which 13425.75 yuan had been reimbursed and 53621.25 yuan had not been reimbursed. At the same time, it was found that pharmaceutical representative Li, together with pharmacy employee Nie, forged 66 prescriptions and tampered with 34 prescriptions in 2019, involving 67 people and 100 people, and involving reimbursement of 280166.39 yuan from the medical insurance fund. The Medical Security Bureau has refused to pay the medical insurance fund 53621.25 yuan, recovered the medical insurance fund 293592.14 yuan, and collected a penalty of 694426.78 yuan in accordance with relevant regulations.
Important sources of income
The market size of innovative drugs for lung cancer is huge, and at present, the selection of treatment plans is mainly based on the specific histological subtypes and driver gene mutations of lung cancer.
According to the appearance of cancer cells under a microscope, lung cancer can be divided into two subtypes: small cell lung cancer and non-small cell lung cancer. Non small cell lung cancer cases account for about 85% of all lung cancer patients, and EGFR gene mutations are one of the main factors causing non-small cell lung cancer. EGFR inhibitors have been undergoing iterations since their inception.
Axitinib is an irreversible third representative epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) developed by AstraZeneca.
On November 13, 2015, Axitinib was approved for market in the United States, becoming the world's first third-generation EGFR-TKI lung cancer targeted drug to be launched.
In March 2017, Axitinib was first approved to enter the domestic market, and it only took 7 months from acceptance to approval of the listing application.
As of June this year, there have been four approved indications for Axitinib in China.
In its second year of listing in China (2018), Axitinib was included in the national medical insurance Class B catalog through negotiations. It was successfully renewed in 2020, and as of this year, the indications for first-line, second-line, and postoperative adjuvant therapy have been included in the medical insurance catalog.
After being included in the national medical insurance catalog, Axitinib has undergone multiple price reductions. When it was first approved in China, the price was over 50000 yuan. After medical insurance negotiations in 2018, it was reduced to 15300 yuan, and in March 2021, it was further reduced to 5580 yuan. Starting from March 2023, the medical insurance renewal of Axitinib has been successful, and the price has once again decreased.
Since entering the Chinese market, the sales of this drug have been booming.
According to data from MineNet, the sales of Axitinib in China's three major terminal and six major markets (including public hospital terminals, retail pharmacy terminals, and public primary healthcare terminals) increased from nearly 3 billion yuan in 2019 to 4.8 billion yuan in 2021, and then exceeded 5 billion yuan in 2022.
Over the years, with the growth of income from Axitinib, AstraZeneca China's income has also skyrocketed. AstraZeneca China's revenue climbed from $2.955 billion in 2017 to $5.876 billion in 2023.
It is worth mentioning that in the global market of AstraZeneca, the global sales of Axitinib have reached 5.444 billion US dollars in 2022, and will continue to rise in 2023, reaching 5.799 billion US dollars, still one of the main contributors to AstraZeneca's revenue.