Chinese urban placebo

The Swiss-based pharmaceutical firm Roche has been in China for a number of years. Its research and development center in Shanghai was set up for innovative drug discovery for the global market. But it focuses on research into Hepatitis B (HBV), which, as a chronic viral infection, has a high prevalence in China and the Asia-Pacific region. Dr Jim Wu, who is with the Roche research and development center in Shanghai, told DW it helps being able to take a local perspective on a worldwide problem, especially in a country that has its own take on medicinal therapies.

DW: How bad is the situation with chronic Hepatitis B in China at the moment?

Dr Jim Wu: People may not realize it, but worldwide there are 450 million people who have chronic HBV infections. And in China alone, there are 85 million chronic HBV patients.

That's quite a percentage of the global figure – and that's chronic patients, which means they will never get rid of it…

Right… Two billion people worldwide are infected with HBV but most get it cleared. So, what we're talking about is chronic viral carriers.

Now, you're based in Shanghai and Roche as a company has been in China for quite some years. So, can you give us an idea of the pharmaceutical market as it's developing in China?

Well, with the increase in living standards, the pharmaceutical market is also growing rapidly. I believe it's predicted that China's pharmaceuticals market will reach $100 billion within three years.

From what level?

Currently, I'd say we're at about $20 billion. So, every year it's increasing by 30 percent.

What is that attributable to?

Well, it's a huge market opportunity for big pharmaceutical companies as well as the local companies. So, the major companies are all taking the Chinese market very seriously. And that's probably the only bright spot in revenue increase each year…

You seem to be alluding to the fact that a lot of pharmaceutical companies and their products are facing this patent cliff [Eds: when they will no longer have exclusive rights to produce and sell certain drugs] and so they're having to find new revenue streams. So, Roche faces that as well?

Actually, Roche is in very good shape. Certainly, that's my personal view, not representing my company…, but I think Roche has a very good protection for all the major products right now.

How does your work interact with China culturally… how does Roche meet the cultural needs of a country that has its own medicinal heritage?

I think Roche is a little different from other pharmaceutical companies. We are really focused on areas such as oncology. In China, we've picked up a disease, which is very prevalent in the Asia Pacific region, meaning HBV - to do the novel drug discovery and try to achieve a cure.

So, it's about going to the region in question and to understand the local needs better?

Absolutely. And also there are more resources to this type of drug discovery because there's a lot of clinical samples and easy access to patients.

Hepatitis B has been a major problem in Asia-Pacific for some time, but do you think it's becoming more of a problem? You say that the market for pharmaceuticals is growing as lifestyles change and adapt. Does this process have the same influence on the illness as well?

Certainly, as people's living standards go up, they have the money to pay for innovative drugs. And many of the chronic HBV patients are aging, so they have a big chance to develop liver cancer. So, the medical need is there and it's urgent for us to work on it, to come up with drugs, to prevent or decrease the risk of developing liver cancer for these patients. In China, about 90 percent of liver cancer cases are caused by chronic HBV infection, so if you can stop the viral infection, you can probably lower the incident rates of liver cancer significantly.

But while you say that as living standards increase more people can afford innovative medicines, do you find there's an issue with some people still preferring to rely on traditional medicines in China?

Chinese medicines are still very popular for local people, especially for diseases that have no cure using Western medicines. So, for example, people who have liver cancer, they may have surgery and after that they may try Chinese medicine.

Is that good or bad? What's your view on that?

I think it's good… I mean, Chinese medicine was developed over thousands of years. So, there are some effects – probably not very specific effects – but it could have a good anti-inflammatory effect, which slow down the progression of a disease.

So, slow down progression, but not cure…

Definitely, not cure… because if we compare Chinese medicine with Western medicine, in Western medicine we target certain molecular targets to cure a disease, while Chinese medicine was truly discovered through its clinical use, so it's most likely not very specific, not very effective. But I think there is some activity there, definitely. Chinese medicine certainly has some pharmacological effect, but it can also provide a placebo effect – it can make you feel good – and I think mental health is very important, too. So, when people take urban medicine, it can make them feel good, and that can improve their condition too – in many cases.

Dr Jim Z. Wu is the head of discovery virology and a senior director at Roche's R&D Center in Shanghai, China.