\u3000\u30001. Global epidemic situation under Omicron epidemic?
The severe and mortality of Omicron were significantly reduced. Compared with Delta, the emergency treatment rate of Omicron decreased by 29.4%, the hospitalization rate decreased by 66.9%, the hospitalization rate in ICU decreased by 67%, and the proportion requiring mechanical ventilation decreased by 71%; According to the statistics of the whole population, compared with Delta, the hospitalization rate of patients infected with Omicron decreased by 50%, the hospitalization rate in ICU decreased by 75%, and the risk of death decreased by 91%. Omicron is no more deadly than flu. In countries with high vaccination proportion / high population infection proportion, natural infection or immune barrier brought by vaccine has significantly reduced the severe mortality. The severe mortality rate in China is less than 0.1%, and the proportion of asymptomatic infection is more than 40%;
Omicron weakened the protective effect of the vaccine, and the epidemic situation was repeated: the protective effect of two injections of inactivation and two injections of mRNA was insufficient, the epidemic situation in European and Asian countries rose, and the pressure of prevention and control in China increased;
The mortality rate of people who have not been vaccinated by Omicron is far higher than that of people who have not been vaccinated by Omicron, and the mortality rate is far higher than that of people who have not been vaccinated by Omicron, The high infection coefficient and lethality to the elderly over the age of 60 make it impossible for China to treat Omicron as an ordinary influenza;
China will continue its dynamic zero policy: the natural infection rate of the Chinese population is far lower than that of western countries. The immune barrier established entirely by vaccination has not fully verified its protective effect on the population. China is short of medical resources and prone to medical run. It will continue to be cautious about liberalizing control until vaccination is widely strengthened, specific drugs are not popularized, and the overseas epidemic has not subsided;
\u3000\u30002. What investment opportunities does the change of covid-19 diagnosis and treatment guide bring?
Small molecule specific drugs and neutralizing antibodies will quickly replace the new antiviral drugs used by old drugs and proved ineffective (such as ribavirin, interferon, abidol, etc.) and become the main force of covid-19 treatment;
Mild diseases do not need hospitalization, and oral specific drugs + Chinese patent medicine will become the core treatment for mild patients;
The diagnosis and treatment guidelines of the United States take two neutralizing antibodies as preventive drugs after exposure. Although such recommendations are not made in the Chinese guidelines, a safe preventive drug will help to block the invasion of the virus in the early stage of contact with the virus, reduce the number of viruses in the respiratory tract of positive individuals and reduce the infectivity. It will also become the development direction of the Chinese guidelines;
\u3000\u30003. Research and development status of covid-19 specific drugs in China, which small molecule drugs can come out, and the potential market size?
At present, the small molecule specific drug with the fastest clinical progress is azvudine, which has completed phase III. vv116 of Shanghai Junshi Biosciences Co.Ltd(688180) is undergoing global multicenter phase III in patients with mild and moderate diseases with high risk. In addition, prochloramide, which failed in the mid-term analysis in the United States, has also changed its entry conditions. In the international multicenter phase III clinic with high risk factors among people over 45 years old, Xiansheng pharmaceutical, gelly pharmaceutical Guangdong Zhongsheng Pharmaceutical Co.Ltd(002317) , Yunding Xinyao and other companies’ 3CL protease inhibitors are also making vigorous plans to promote them into clinical practice; At the same time, the state has approved Pfizer’s paxlovid for the treatment of light and ordinary patients with high-risk factors in China, and has started the first round of procurement; In addition, yanyeyi’s 3CL protease inhibitor also showed significant inhibitory effect on the virus, which is expected to be introduced into China.
According to the experience of historical epidemic situation, the government will reserve epidemic prevention drugs according to the proportion of the total population, and there is a serious overbought phenomenon in developed countries. We speculate that the reserve of covid-19 small molecule drugs in China can reach 8-10% of the population, and the total reserve may be 112140 million;
We expect that in consideration of drug safety and providing patients with the best drug choice, the types of reserved drugs will cover drugs with multiple mechanisms of action, and drugs with multiple mechanisms of action such as RdRp and 3CL may be included;
Pay attention to the small molecule drugs with the fastest progress in each action mechanism. 3CL suggests focusing on Pfizer, RdRp suggests focusing on Junshi vv116;
Focusing on nasal spray polypeptide drugs, we believe that the most urgent problem to be solved in the current epidemiological characteristics of Omicron and its variants is the problem of high infectivity. Reducing the transmission coefficient of the virus will be the next promising development direction. If the nasal spray drug is successfully developed, it will become a preventive drug for asymptomatic infected people and healthy people. Through external nasal spray, it can prevent the virus particles in the nasal cavity from invading cells in the early stage of contact with the virus, help establish mucosal immunity, play a safe and effective preventive role for uninfected people, significantly reduce the virus load of saliva and nasal exhaled gas and reduce infectivity for infected people. Therefore, we believe that nasal spray polypeptide drugs have great market prospects;
\u3000\u30004. Are neutralizing antibodies still available?
In addition, ritonavir in Pfizer’s paxlovid has a certain impact on liver function, which is not applicable to some patients with other diseases who need to take other drugs metabolized by the liver and patients with liver function injury, which leaves a certain market space for the use of neutralizing antibody. Neutralizing antibody is an important part of China’s current treatment plan. It is suggested to continue to pay attention to tengshengbo medicine.
Risk tips:
With the development of the epidemic, the risk of future policy control; Drug R & D progress and clinical data are less than expected risks; Covid-19 drug price negotiation results are less than expected risks; Risk of deterioration of competition pattern;
