Three years ago, oncologist and cancer researcher Steven Rosen took a leadership role at City of Hope, the cancer hospital and research institution near Los Angeles.
One of the first things he did was gather his new colleagues together to discuss where the hospital should focus its burgeoning international health focus.
It didn’t take long for everyone to agree where they should concentrate.
“It’s not about excluding others, but we decided to put our energy into a relationship with China,” Rosen told Healthline.
Since that consensus, Rosen said, the hospital’s 10-person Center for International Medicine has established alliances with several prominent cancer hospitals in China.
These partnerships enable City of Hope to share its quality care practices and training with China.
In return, City of Hope benefits from the breadth of knowledge of Chinese physicians.
The alliances also create jobs and establish friendships between two of the most powerful nations on Earth.
“I’ve been to China twice as part of this endeavor, and I have been so impressed with the quality of people I’ve met,” Rosen said. “The people we have recruited in this alliance are humble, bright, and talented. The friendships have evolved quickly.”
Second opinions halfway around the world
The two primary goals of the hospital’s alignment with China, Rosen explained, are to advance global cancer research, therapy, and diagnostics, as well as to make sure individuals in China have access to the best cancer care available in China and the United States.
Among the programs being launched is a “remote second opinion” program for people with blood cancers at Tongji Hospital in Wuhan, the most populous city in the central China province of Hubei.
In this scenario, City of Hope doctors will review diagnoses and provide second opinions to the Tongji Hospital’s doctors.
They won’t, however, communicate directly with the patients because the U.S. doctors are not allowed to practice medicine in China.
City of Hope is also working with a private company in China to oversee cancer care at a new hospital being built in Shenzhen, one of China’s largest cities.
“Shenzhen is a relatively young and affluent city,” Ed McCarthy, the City of Hope vice president who runs the Center for International Medicine, told Healthline. “It’s an innovation and knowledge hub, but it doesn’t have strong healthcare institutions. If you’re a patient with cancer in that city, there’s a good chance you will drive somewhere else to be seen. There’s a gap in care there.”
Number one goal: Save lives
One of the most fruitful endeavors of the initiative so far, City of Hope executives tell Healthline, is the partnership with the Second Affiliated Hospital of Zhejiang University (SAHZU) in Zhejiang, a province in eastern China.
City of Hope doctors and scientists participate in educational exchanges with SAHZU physicians and scientists.
They also provide additional consultation on the treatment plans of people with cancer being treated at SAHZU.
When Dr. Yuman Fong, City of Hope's chair of surgery, and one of the world's most respected cancer surgeons, announced the partnership with SAHZU, he said the shared knowledge and training between the two hospitals “help save lives.”
Rosen added that the decision to reach out to China made sense for many reasons, including the demographics of the hospital’s surrounding neighborhood.
A quarter of the patient population at City of Hope, he said, is of Asian ancestry, mostly from greater China.
A new age in healthcare cooperation?
While political relations between the two nations may be strained, it’s a different story on the healthcare front, where relations are positive and collaborative.
Rosen said these international partnerships benefit both nations as well as the entire world.
“When China and the U.S. are aligned, the planet is safer,” he said. “If China and the U.S. are not aligned, then you have to pray. God knows what will happen. The people of both countries have a spirit that you can embrace, both are clearly focused on benefitting all of humanity in different ways.”
Cancer drug companies join forces
In China, a nation of about 1.4 billion people, cancer is the number one cause of death.
People in China have profoundly unmet needs in healthcare, including lack of access to quality treatments — especially among its poorest citizens.
The government, while pro-science and pro-research, can still sometimes apply excessive restrictions on foreign entry into China’s marketplace.
Drug companies from the United States have found it difficult to get their products into China.
But that’s changing quickly.
Several U.S. biopharmaceutical companies with treatments on the market or in clinical trials have established partnerships in the past few years with Chinese companies to co-develop and sell cancer treatments in China and globally.
And it’s already been a productive and collaborative 2017.
In January, Kite Pharma, the California-based biopharmaceutical company, announced a joint venture with Shanghai Fosun Pharmaceutical to develop and commercialize Kite’s CAR-T cell immunotherapies for blood cancers in China.
The venture, Fosun Pharma Kite Biotechnology Co., is expected to be a world leader in advancing the CAR-T technology, which harnesses the power of the body’s immune system (T cells) to recognize and kill cancer tumor cells.
In clinical trials, CAR-T is generating headlines for the high percentage of complete responses and durable remissions the treatment is producing in people with lymphoma and leukemia.
Helen Kim, Kite’s executive vice president of business development, told Healthline that for Kite, China represents a “significant future market, given the population and high incidences of certain cancers. Kite is committed to bringing its transformational therapies to patients worldwide.”
She added that China is embracing innovative technologies for healthcare, including therapies for unmet needs like cancer.
“The Chinese regulators have demonstrated flexibility in requirements to get innovative therapies to market,” Kim said. “Large regional pharmaceutical companies such as Fosun Pharma are actively seeking collaborations to bring technologies to China.”
Kim cited another recent U.S.-China venture between Fosun and Intuitive Surgical, the Northern California-based global leader in robotic-assisted, minimally invasive surgery.
The collaboration will help the companies develop and sell innovative, robotic-assisted, catheter-based medical devices.
“We are pleased to expand our partnership and advance the development of medical tools to enhance the wellbeing of global populations, including those in China that suffer from increased rates of lung cancer,” Chen Qiyu, chairman of Fosun Pharma, said in a statement.
Meeting healthcare needs
CASI Pharmaceuticals, the Maryland-based biopharmaceutical company, has adopted China’s unmet medical needs as its primary focus.
The company, which plans to bring several drugs to the Chinese market, announced in July 2015 that it had licensed Zevalin, an FDA-approved, radio-immunotherapy for non-Hodgkin’s lymphoma, and plans to commercialize it in Hong Kong and, eventually, greater China.
Zevalin, which is owned and sold in the United States by Nevada-based Spectrum Pharmaceuticals, will be available at hospitals such as Hong Kong Sanatorium and Hospital.
In China, it will be supplied by CASI and its local partner, Global Medical Solutions Hong Kong Limited.
“We are very excited to work with Hong Kong Sanatorium and Hospital to make Zevalin available to patients,” Ken K. Ren, CASI’s chief executive officer, said in a statement.
He added that while Hong Kong is a relatively small market, it provides the company with clinical knowledge and experience for Zevalin in a Chinese patient population, “which we believe will have a positive impact in market penetration when Zevalin is approved and becomes available in our greater China markets.”
Clinical trials in both countries
In February, Denovo Biopharma, a precision medicine company with offices in San Diego and Hangzhou, announced it will launch a phase III clinical trial in China and the United States for its lead drug for diffuse large B-cell lymphoma (DLBCL).
“China will play a very important role in the biomarker-driven DB102 trial, and we have successfully submitted the Investigational New Drug application to the China FDA,” Isabel Han, head of Denovo's clinical operations in Beijing, said in a statement.
FierceBiotech reported last month that Hong Kong-based Hutchison China MediTech and U.S. pharmaceutical partner Eli Lilly have seen positive results in trials of the drug they’re co-developing for people with certain colorectal cancers.
In phase III trials of more than 4,500 patients in China, the treatment showed a significant increase in survival rates. The partnership is expected to file for approval with China Food and Drug Administration (CFDA) within a few months.
Spending billions for U.S. companies
China’s pharmaceutical industry is still far behind the United States, but China healthcare companies and investors are spending billions of dollars to acquire U.S. healthcare companies.
According to PitchBook, there have been 214 deals made in the past five years between Chinese investors and healthcare companies based in the United States.
Bloomberg reported that last year China’s Humanwell Healthcare Group, which makes anesthetics and contraceptive drugs, spent more than a half a billion dollars to purchase New York-based generic drug maker Epic Pharma last year.
OncoImmune, a Maryland-based biopharmaceutical company, is working with China investors to develop new immunotherapies for cancer, inflammation, and autoimmune diseases.
OncoImmune’s recent funding round of $15 million was led by 3E Bioventures Capital, a healthcare-focused investor in China.
Nonprofits’ link to China
The Children’s Treehouse Foundation, a Colorado-based nonprofit whose sole mission is to assist children who have a mother or father with cancer, is already in 77 cancer hospitals in the United States.
And it is now in Hong Kong and hopes to increase its presence in greater China.
The foundation’s CLIMB Program, which in scientific studies has been shown to greatly improve kids’ ability to cope with a parent’s illness, is installed at the Hong Kong Cancer Fund, a patient advocacy organization.
Denis Murray, executive director of the foundation, said there is great need for patient support in China, where cancer has grown at alarming rates in the past 30 years.
“It is telling that countries like China have to go halfway across the world to find models for psychosocial support,” Murray told Healthline. “Because of the internet, international organizations can find us, learn about CLIMB, and get trained so they can use it with their cancer patients.”
In the long run, Murray said, mutual benefits should result from this exchange.
“Other countries can benefit from models developed in the U.S., and we can learn how to make our programs more culturally appropriate for cancer patients here and across the globe,” he said.
Cognoa, the California-based consumer healthcare company, announced last month that it raised $11 million in its latest round of funding to design apps that assess child development and behavioral health.
Most of that money came from Morningside, the Hong Kong-based venture capital and social responsibility firm.
Nonprofit brings companies together
The US China Innovation Alliance (UCIA), a Texas-based nonprofit, is immersed in this global trend.
The organization works to bring innovative U.S. and Chinese companies together.
At its upcoming summit next month, the organization expects to host about 200 companies from China. More than half are either in the healthcare field or interested in investing in it.
Xinxin Li, director of development of the nonprofit, said that among the drivers of this growing trend are hospital reforms in China and the needs of China’s aging population.
“China focusing on healthcare innovation and reforms have contributed to this trend,” she told Healthline.
Hospital systems in China can go private now, Li noted, “compared to before, when they were only managed by the government. Most hospitals are still public, the change is slow, but this reform has created opportunity.”
Another driver for these new U.S.-China healthcare alliances, Li said, is China’s changing demographics.
Not unlike America’s baby boom generation, Li noted, “China’s aging population is creating emerging needs for healthcare and the U.S. is the largest [research and development] and innovation generator.”
Li said that people in China who are her parents’ age don’t just want good medicine, they want well-being.
“My parent’s generation, who are of retirement age, are living longer after retiring, and they need better care, and they can afford that kind of care,” she said. “This demand is driving the market. Hospitals in China are seeking more information about overseas health care experiences.”