Why is Nintedanib more expensive than pirfenidone?

Nintedanib (Nintedanib) is used to treat pulmonary fibrosis and interstitial lung disease related to systemic sclerosis. Nintedanib and pirfenidone are the only two disease-modifying therapies currently available for this condition, with nintedanib used as first-line treatment after diagnosis to slow the progressive loss of lung function.

In real-life settings, both drugs, nintedanib and pirfenidone, were effective in reducing decline in forced vital capacity and diffuse vital capacity at 24 months. Decreases in FVC and DLCO were significantly higher in the control group compared with the combination treatment group (p=0.0053 and p=0.037, respectively), with no significant differences between the two treatment groups. Compared with patients with more advanced disease (GAPI stage), patients in GAP stages II and III showed significantly higher declines in FVC and DLCO regardless of drug. Similar side effects were reported in patients treated with nintedanib and pirfenidone (5% and 7%, respectively), while mortality did not differ between the three groups. Compared with pirfenidone, nintedanib produced more QALYs due to fewer exacerbations and was better tolerated.

The original drug of nintedanib is marketed in China as nintedanib ethanesulfonate soft capsules and is covered by Class B medical insurance, but reimbursement is limited to patients who meet the indications. SpecificationsThe price of each box of 150mg*30 capsules may be more than 4,000 yuan. Nintedanib Original drug available overseas has Turkish version and Indian version, specificationsThe price of 150mg*60 capsules per box may be more than 5,000 RMB (the price may fluctuate due to the exchange rate). There are also nintedanib generic drugs produced overseas in other countries. For example, the price of 150mg*30 capsules produced by BDR Pharmaceutical Factory in India may be several hundred yuan per box (the price may fluctuate due to exchange rates). Its pharmaceutical ingredients are basically the same as those of the original drugs sold domestically and abroad.