“這是一個很好的疫苗，只是不值那個價錢。”
The drug's price has tripled to about $1,000.
供應緊縮只是中國需求的巨大規模如何影響香港生活的最新例子。 2013年，內地購物狂熱導致了城市商店嬰兒配方食品短缺。在那之前的一年，醫院病床不足，因為有許多中國女性來到這個城市分娩。......
Bloomberg
The drug's price has tripled to about $1,000.
BLOOMBERG.COM
Chinese Tourists Drain Hong Kong's Supply of Vaccine Against Cancer-Causing Virus
China's Vaccine Tourists Drain Hong Kong's Supply of Cancer Drug
By and
Medical tourism has been a great business for Manna Wang, an insurance agent in Shenzhen who’s been helping Chinese women travel to Hong Kong for a vaccine against the human papillomavirus, or HPV, which can cause cervical cancer.
Business has been so good, in fact, that the medicine is running is out.
In the two years since Merck & Co.’s Gardasil 9 became available in Hong Kong, about 2 million mainlanders have come for the shots, according to the Xinhua News Agency. With the drugmaker unable to keep up, some clinics are turning away Chinese patients, and angry mainlanders have protested at Merck’s local office. The cost of the vaccine has more than tripled to HK$8,000 (about $1,000) and complaints have flooded the city’s consumer protection agency.
“The vaccine price is crazy,” said Wang, who last month stopped booking reservations for mainland women seeking the drug. “It’s a good vaccine, just not worth that price.”
The supply crunch is just the latest example of how the sheer scale of Chinese demand has the power to disrupt life in Hong Kong. In 2013, a buying spree by mainlanders caused shortages of baby formula at city stores. The year before that, there were shortages of hospital beds because so many Chinese women were coming to the city to give birth.
“Hong Kong will always get hit by unexpected demand from Chinese consumers,” said Fielding Chen, a Bloomberg economist in Hong Kong. “It’s always difficult to forecast.”
The events that led to Hong Kong’s vaccine scramble began last summer when Merck was the victim of a cyber attack that disrupted production of Gardasil 9, which is the top-of-the-line HPV vaccine because it offers the broadest range of protection.
The city isn’t the only place in the region where supplies are tight. Some clinics in New Zealand and Singapore have also reported shortages.
Unintended Consequences
But Hong Kong’s supply squeeze has been worsened by increased demand from China, where cervical cancer killed 30,000 women in 2015. Starting the next year, mainland regulators began approving several older and less efficacious versions of the vaccine by Merck and GlaxoSmithKline Plc. The moves raised awareness about the risks of the human papillomavirus and had the unintended effect of sending women in search of Gardasil 9, which was available in neighboring Hong Kong.
Things came to a head in April, when a surge in requests for appointments forced the government-supported Family Planning Association of Hong Kong to announce it would no longer give the shots to people who weren’t local residents.
“We just couldn’t handle all the phone calls and incoming emails,” said Michelle Chak, press officer at the association.
Gardasil 9 requires three injections over 12 months. Numerous private clinics say they have run out of vaccine, leaving some patients unable to complete the regime.
Gardasil 9 HPV vaccine inoculation.
Source: Imaginechina via AP Photo
That’s led to an increase in complaints to Hong Kong’s Consumer Council, which received over 400 vaccine-related claims in the first four and a half months of the year, compared with 478 for all of 2017.
A confrontation on June 6 between a group of about 10 mainlanders and staff at a Kowloon clinic turned violent, according to Apple Daily and other local media, with several people reported injured.
For women concerned about getting their Gardasil 9 shots, there’s no relief in sight. Merck, known as MSD outside North America, expects supply constraints to continue “throughout the coming year,” the company said in an emailed statement. The drugmaker said it had called on city clinics to stop vaccinating new patients.
Those calls come as the drug maker builds its HPV business in the mainland. Gardasil 9 was approved by China’s regulators in April and last month a hospital in Hainan Province’s city of Boao became the vaccine’s first mainland provider, charging 5,800 yuan ($900) for the three shots.
New Market
“To support a limited launch in Hainan province, a small amount of Gardasil 9 doses from our existing global manufacturing network was provided to China,” Merck said in a statement.
On a May 1 call with analysts, Merck’s president of global human health Adam Schechter was asked whether sales in China could double HPV vaccine revenue, which last year totaled $2.3 billion.
“We’re off to a very strong start,” Schechter said. “But we’re going to have to really wait to see a period of time to understand if that demand will continue.”
Eventually the availability of Gardasil 9 in the mainland should ease pressure on Hong Kong’s clinics, but the city government is warning not to expect a quick return to normal. The Department of Health “will continue to request MSD to increase the import quantity of the vaccine to meet the needs of the local private health-care market,” a spokesman said in a statement.
Across the border in Shenzhen, vaccine tourism agent Wang hasn’t given up hope that the business will recover.
“I’ve suggested my clients wait for a few months till the fervor fades,” she said.
— With assistance by Emma Ockerman, and James Paton
醫療旅遊業一直是深圳的保險代理人Manna Wang的一項重要業務，Manna Wang一直在幫助中國婦女前往香港接受針對人乳頭瘤病毒或可導致宮頸癌的HPV疫苗。
事實上，生意非常好，藥品運行已經結束。
據新華社報導，在默克公司的Gardasil 9在香港上市的兩年內，約有200萬內地人來拍照。由於製藥商無法跟上，一些診所正在拒絕中國患者，憤怒的大陸人士在默克的當地辦事處抗議。該疫苗的成本已經翻了三倍，達到8,000港元（約合1000美元），投訴也淹沒了該市的消費者保護機構。
“疫苗價格瘋狂，”王說，他上個月停止了大陸女性尋找藥物的預訂。 “這是一個很好的疫苗，只是不值那個價錢。”
供應緊縮只是中國需求的巨大規模如何影響香港生活的最新例子。 2013年，內地購物狂熱導致了城市商店嬰兒配方食品短缺。在那之前的一年，醫院病床不足，因為有許多中國女性來到這個城市分娩。
彭博經濟學家菲爾丁表示，香港將一直受到中國消費者意想不到的需求打擊。 “總是很難預測。”
導致香港疫苗爭奪的事件發生在去年夏天，當時默克是網絡攻擊的受害者，該網絡攻擊擾亂了Gardasil 9的生產，Gardasil 9是頂級的HPV疫苗，因為它提供了最廣泛的保護。
這個城市不是該地區供應緊張的唯一地方。新西蘭和新加坡的一些診所也報告了短缺。
意想不到的後果
但是由於中國需求的增加，香港的供應緊張狀況進一步惡化，2015年宮頸癌導致3萬名婦女死亡。從第二年開始，大陸監管機構開始批准默克和葛蘭素史克公司開發的幾種較舊且效果較差的疫苗。這些舉動提高了人們對人類乳頭狀瘤病毒風險的認識，並帶來了婦女尋找鄰近香港的Gardasil 9的意想不到的影響。
四月份的事情發生了，當時任命請求激增迫使政府支持的香港計劃生育協會宣布不再向非當地居民投訴。
“我們無法處理所有的電話和收到的電子郵件，”協會新聞官Michelle Chak說。
Gardasil 9需要三個注射超過12個月。許多私人診所表示，他們的疫苗已經用完，一些病人無法完成治療。
Gardasil 9 HPV疫苗接種。來源：Imaginechina via AP Photo
這導致了香港消費者委員會的投訴增加，該委員會在今年頭四個半月收到了400多份疫苗相關索賠，而2017年全年的數字為478。
據蘋果日報和其他當地媒體報導，6月6日，一群約10名內地人和一名九龍診所工作人員的對抗變得暴力，有數人報告受傷。
對於擔心獲得Gardasil 9桿的女性而言，看不到任何緩解。該公司在電子郵件聲明中表示，默克在北美以外被稱為MSD，預計供應限制將在“整個未來一年”繼續。該製藥商表示，它已經呼籲市區診所停止接種新患者。
這些呼籲來自製藥商在大陸建立其HPV業務。 Gardasil 9於4月份獲得中國監管部門的批准，上個月海南省博鰲市的一家醫院成為該疫苗的第一家大陸供應商，三次出手收費5800元（900美元）。
新市場
“為了支持海南省的有限發布，默克在一份聲明中表示，為我們提供了來自我們現有全球製造網絡的少量Gardasil 9劑量。
在5月1日與分析師的電話會議上，默克公司全球人類健康總裁Adam Schechter被問到在中國的銷售額是否能使HPV疫苗收入增加一倍，去年總計為23億美元。
“我們的開局非常好，”Schechter說。 “但是，我們必須等待一段時間才能理解這種需求是否會繼續下去。”
最終Gardasil 9在大陸的可用性應該會緩解對香港診所的壓力，但市政府警告不要期望快速恢復正常。衛生署“將繼續要求MSD增加疫苗的進口數量，以滿足當地私營醫療保健市場的需求，”發言人在一份聲明中表示。
在深圳境內，疫苗旅遊代理王先生並未放棄希望該業務能夠復甦。
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