"In the spring of crazy allergies, going out is like a catastrophe. "Sneezing to doubt life. "People who are not allergic have a beautiful spring in their eyes, and people with allergies can't even open their eyes. ”
The deputy chief physician of the allergy department of Beijing Shijitan Hospital solemnly said that since the beginning of spring 2024, the outpatient volume of the allergy department of her hospital has exceeded 600 people a day, which is equivalent to twice the usual workload.
Allergies become a "new century epidemic"
Xiao Chen, who lives in Beijing, told Zhongxin Jingwei that she starts allergies almost every year on the day the heating is turned off, "and every time it is accurate". "First of all, the eyes are itchy, and one morning when I get up, my eyes are covered with secretions, and then I start to itch unbearably, rubbing my eyes until I can't stop, and my eyes have new cuticles. ”
Xiaolei (pseudonym) recently found that there were a lot of patients when she was consulted in a tertiary hospital in Beijing. Another netizen with an IP address in Beijing recently posted that during the allergy season, there are so many people in the hospital that there is no place to stand.
It was solemnly observed that in her more than ten years of clinical work, the number of allergy consultations and the severity of allergies in the population continued to increase.
She told Zhongxin Jingwei that when a patient's lifestyle changes, the immune system changes and the imbalance is disordered, it is easy to have allergic reactions, leading to the appearance of various clinical symptoms. Taking lifestyle changes as an example, many southerners who live in Beijing will have allergic symptoms after 1-2 years.
An Liang (not her real name) used to work in Beijing, and every spring and autumn she would have severe allergic symptoms, sneezing from morning to night, and her eyes were dry and itchy. Last year, she moved to work in a southern city, and the allergy symptoms that had plagued her for many years were "magical" recovered.
On social platforms, some netizens said, "In March and April last year in Beijing, tree pollen allergy led to asthma attacks, coughing and vomiting every day." In March and April this year, in Shanghai, there was no need to take anti-allergy medicine. "I felt allergic in Chengdu for three days, and when I returned to Luoyang, I immediately relapsed and aggravated, and I took it. ”
So why do you not have allergies before, but also have allergic symptoms? solemnly said that allergies have to go through two stages, the first is the sensitization stage, the allergen attaches to the mast cells through the production of IgE, resulting in sensitization, and the second is the onset stage, after re-exposure to the allergen, clinical symptoms appear, most of which start within 2 to 8 years after exposure to the new allergen.
Looking at the overall data, the number of people with allergies is growing significantly. Taking allergic rhinitis as an example, from 2005 to 2011, the prevalence of allergic rhinitis in China increased from 11.1% to 17.6%, a significant increase in the prevalence rate. Based on a population of 1.3 billion, the number of people affected has increased by more than 80 million.
Hu Liang, deputy director of the allergy department of Changchun Children's Hospital, told Zhongxin Jingwei that the main reasons for spring allergy season include the increase in pollen volume, and many trees (such as birch, cypress, willow, poplar, sycamore, etc.) bloom and release a large amount of pollen, and pollen is one of the allergens, which can cause allergic rhinitis, allergic conjunctivitis and other allergic symptoms. Secondly, climate change, immune factors, and other factors can also play a role in triggering allergy symptoms.
"The continuous growth of the allergic population is related to the process of urbanization, environmental pollution, and vegetation changes, and the increase in the number of patients is also very related to the residents' awareness of medical treatment, which is also known as the epidemic of the new century. Said solemnly.
Anti-allergy drugs sell nearly 3 billion a year
Zhongxin Jingwei noticed that in the spring allergy season, in addition to the increase in the number of patients, the sales of online related drugs also increased.
In late March, Meituan Health Index released the "Spring Allergy Season Outlook Report", which showed that in mid-to-late March, the overall demand for allergy drugs in the country continued to rise, and the demand for allergy drugs was 1.6 times that of the same period last year. From a regional point of view, the prevalence and explosiveness of the north are higher than those in the south.
On April 3, Meituan's health index showed that recent symptoms of facial allergies are mainly concentrated in the central and western regions and the Beijing-Tianjin-Hebei region. Taking budesonide nasal spray, a drug for nasal allergies, as an example, from March 26 to April 2, compared with the previous week, the order volume in Luoyang increased by more than 4 times month-on-week, the order volume in Hohhot, Zhengzhou, Xi'an and Nanjing increased by more than 3 times month-on-week, and the order volume of loratadine tablets in Nanjing also increased by more than double month-on-week. Allergy medication in the Beijing-Tianjin-Hebei region was still stable and in high demand that week.
According to the CMH-Lingsu system of Zhongkang Technology, from March to April 5, 2024, compared with January to February, the average daily sales of systemic anti-allergic drugs increased by 8.6%, with large regional differences. Among them, the northwest region (Gansu, Ningxia, Qinghai, Shaanxi, Xinjiang) has the most obvious growth, at 25.7%, followed by North China, with an increase of 12.4%.
Judging from the sales trend of systemic anti-allergy categories, Zhongkang Technology's CMH-Lingsu system shows that systemic anti-allergy drugs will show rapid growth from 2019 to 2022 and a slight decline in 2023. From 2019 to 2023, the sales will be 2.129 billion yuan, 2.158 billion yuan, 2.475 billion yuan, 2.884 billion yuan and 2.823 billion yuan respectively.
Among them, the top 10 systemic anti-allergic drugs in 2023 are loratadine, desloratadine, levocetirizine, cetirizine, ebastine, dust mites, etc. The sales of loratadine, which tops the list, has exceeded 1 billion yuan since 2018, and from 2019 to 2023, it will be 1.244 billion yuan, 1.259 billion yuan, 1.396 billion yuan, 1.647 billion yuan and 1.630 billion yuan, respectively.
Zhongxin Jingwei checked the State Food and Drug Administration and found that more than 50 manufacturers have loratadine production approvals, including Shuanglu Pharmaceutical, Salubris, Chia Tai Tianqing, etc.
In addition, the sales of cetirizine were not affected by the slight decline in the category in 2023, which will be 151 million yuan, 156 million yuan, 187 million yuan, 222 million yuan and 240 million yuan from 2019 to 2023, respectively.
Desensitization therapy is still a blue ocean
From the perspective of allergy diagnosis and treatment, the "2022 China Allergic Disease Epidemiological Survey Report and Current Situation Analysis" mentioned that the Chinese public and patients have low awareness and attention to allergic diseases, and the reserve of specialists is insufficient, resulting in a low rate of allergic diseases. Many people realize that they may have allergies by the time the condition has deepened.
Solemnly told Zhongxin Jingwei that allergic diseases are not static, for example, allergic rhinitis may progress to asthma, and should be "detected early and treated early". Allergies such as runny nose, sneezing, coughing, wheezing, and skin rashes are recurring, especially in one scene (the same season, the same environment, the same food), then allergies are very likely.
He said that the most effective treatment for allergic diseases is desensitization therapy, which is the only treatment recognized by the World Health Organization that can reverse the course of the disease and slow down the course of the disease.
Hu Liang mentioned that the course of desensitization treatment is generally 3-5 years, and patients need to inject allergens regularly. The effect of treatment usually takes about 1 year to appear, and about 80% of patients can achieve significant improvement or complete remission of symptoms. "In foreign countries, desensitization treatment has been quite developed, involving almost all allergens, but at present, most hospitals in China can only take subcutaneous injection preparations and sublingual drops for dust mites and sublingual drops for Artemisia annua, and many desensitization preparations are not popular. Hu Liang said.
From the perspective of listed companies, the number of listed companies that have deployed desensitization treatment-related products is not large, and they are still in the blue ocean market. In the investor Q&A table disclosed in August 2023, Wuwu Biotech said that there are many technical details in the development of desensitization products, and there are certain difficulties and technical barriers in both pharmaceutical and clinical research.
From the perspective of anti-allergic biologics, omalizumab is mainly used for the treatment of allergic symptoms such as allergic asthma, chronic spontaneous urticaria, sinusitis combined with nasal polyps, allergic rhinitis, etc., and can also be used for desensitization therapy. The product was jointly developed by Novartis and Roche, launched in China in 2017 and entered the medical insurance list at the end of 2019.
At present, some patents for omalizumab have expired in China, but there are not many analogues of omalizumab. Zhongxin Jingwei found in an inquiry with the State Food and Drug Administration that only Mabpharm's omalizumab analogue was approved for marketing in May 2023.
From the perspective of allergy injections used for desensitization treatment, according to the article published by the Yaodu database in September 2023, it is mentioned that up to now, only 4 allergen desensitization treatment products have been approved for marketing in China, namely dust mite drops and artemisia annua drops from Wuwu Biotechnology, as well as house dust mite allergen preparation from ALK-Abello in Denmark and allergopharma injection from Germany.
According to the 2022 annual report of Wuwu Biology, it is mentioned that the only sublingual allergen desensitization preparations approved for marketing in China are "Dust Mite Drops" and "Artemisia annua Pollen Allergen Sublingual Drops" produced by Wuwu.
In September 2023, Haobo, which provides allergy testing products and services, announced that it had signed an exclusive agreement with Inmunotek to introduce the other party's Oraltek series of desensitization drugs into China for sales and registration, and implement new business in the field of desensitization drugs in China. According to the agreement, Hoobo will be solely responsible for the pricing and sales of the OTUOK series products in China, and the term of the agreement is 25 years, which can be automatically renewed after the expiration of the term.
According to the announcement, the Otoke product line is the "sublingual spray desensitization product" produced by Inmunotek, with a total of 12 products, covering a total of 17 allergens including house dust mites, dust mites, cat dander, dog dander, birch pollen, mugwort, etc.
Hao Oubo pointed out that there are 400 million allergy patients in China, and Chinese companies have been able to provide more than 50 kinds of allergen detection products, but the variety of desensitization treatment products is small. With the continuous development of allergy diagnosis and treatment, desensitization treatment will be accepted by more and more doctors and patients as the only causal treatment.
According to a research report released by Huajin Securities in May 2023, the size of China's desensitization treatment market has increased from 360 million yuan in 2015 to 790 million yuan in 2019, showing a rapid upward trend, and the market size of desensitization therapy in 2021 will be about 1.26 billion yuan, with a current penetration rate of less than 1%.
(Source: Sino-Singapore Jingwei)