"The Children of China's Cancer Slum: Drug Costs Putting Young Lives at Risk", 16 Dec 2015

The children of Wujianong are an outgrowth of China’s unprecedented cancer epidemic powered by pollution and sedentary lifestyles. According to the World Health Organization it takes the lives of 2.2 million Chinese a year. It’s also a crisis escalated by high costs for drugs, with patients bearing an unusually large proportion of the burden by international standards…While the public system pays for conditions like a broken foot or a bad cold, expensive foreign drugs for cancer are often not covered…

Jiangsu Hengrui, maker of the chemotherapy drug…launched an aid program in 2011 for poor patients, the company said in an e-mailed statement…adding that it aims to sell Chinese patients treatments at reasonable prices…“Underdeveloped health systems, lags in regulatory approvals, delayed reimbursement, or lack of reimbursement, all create significant barriers,” [Pfizer] said…

China’s public hospital system depends on profits from drug sales to supplement government subsidies, which can fall far short of operational costs…That can create a natural incentive for hospitals to sell patients the most expensive treatments. Drug sales accounted for 40 percent of public hospital revenues in 2012 …“If patients don’t have the money, they don’t get treated,” the doctor said.

…A drug typically goes through two to five middlemen as it is transported from the drugmaker to patients in hospitals. At each level the middleman or distributor takes a cut that can range from five to 20 percent. That means a manufacturer might get only about 40 percent of the retail price, with distributors and hospitals getting the rest…[O]verseas drugmakers also stopped selling certain treatments to hospitals in provinces where prices went too low, according to an industry group. [also refers to Astellas, Roche & Swiss Re]