China Healthcare Reform and Its Impact on IVD, Medical Device and Pharmaceutical Markets

Date: October 22, 2011
Pages: 167
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Report type: Strategic Report
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China Healthcare Reform and Its Impact on IVD, Medical Device and Pharmaceutical Markets
China’s rapid economic development and numerous steps of reform undertaken by the Chinese central government since 1997 had clear and observable effects upon China’s total healthcare services market and product markets for pharmaceuticals, medical devices, and in vitro diagnostics (IVD). This progress has been augmented by a Reform program in 2009, including increased funding, to improve services.

What are the workings of China's healthcare system? How much progress has been made towards the promised vision of the CPCC in 2008 to provide "convenient and affordable access" to its people? What are the effects on foreign companies seeking to benefit from an increase in healthcare-related funding? Where are the best opportunities in China for marketers. Analyst Emil Salazar focuses on these questions.

The report contains a comprehensive overview of the Chinese healthcare system with important data for marketers to China. It discusses healthcare reform plans and where funds were spent. It also describes the role foreign companies play. As part of its analysis, the report includes the following information:
  • Statistics on Chinese Hospitals, Community Health Centers and Clinics
  • Top and Bottom City Markets for Urban Healthcare
  • Top and Bottom Rural Regions
  • Challenges for Foreign-Owned MNCs in China
  • Government Healthcare Spending
  • Foreign-Invested Manufacturing Enterprises in China
  • Share of Government Funded Healthcare vs. Out of Pocket
  • Domestic Healthcare Industries
  • Population and Age Statistics
  • Incidence Rates for Infectious Diseases
  • Cancer Rates in China
  • Regulation of Drugs and Devices in China
  • U.S. Product Exports to China
  • Key Analyst Conclusions
CHAPTER ONE: EXECUTIVE SUMMARY

Healthcare in China
Healthcare Reform and Market Impact
  Rural Healthcare Market in Era of Reform
  Urban Healthcare Market in Era of Reform
  China’s IVD Market in an Era of Reform
  China’s Medical Devices Market in an Era of Reform
  China’s Pharmaceuticals Market in an Era of Reform
Major Findings

CHAPTER TWO: HEALTHCARE IN CHINA - PRIMARY INDICATORS AND A NEED FOR REFORM

Introduction
Barefoot Doctors and the Rural Cooperative Medical Scheme (RCMS)
China’s Economic Reform Impacts Healthcare
New Rural Cooperative Medical Scheme (NRCMS) and Government Recommitment to Reform
China on the Eve of Contemporary Healthcare Reform

CHAPTER THREE: CHINA’S “REFORM” HEALTHCARE MARKET AND ITS SHAPING OF RURAL, URBAN, REGIONAL AND PROVINCIAL MARKETS

Introduction
China’s 2009-2011 Healthcare Reform in Its Main Features and Provisions
Healthcare Reform on the “Grassroots” Level - The Many Chinas in Focus
  The Contemporary Rural Healthcare Market in China - Major Regions, Institutions and Landscape
  Rural China Healthcare Market from the NRCMS to the End of Healthcare Reform under the 12th Five-Year Plan (2004-2015) - Historical and Projected Market Sizes and Segmentation
  Urban Healthcare Markets in China and their Trajectory through Reform (2004-2015)
Foreign Medical Product Suppliers Penetrate the Chinese Market

CHAPTER FOUR: DIAGNOSTICS IN CHINA - MARKET OPPORTUNITIES AND CHALLENGES THROUGH 2015

Introduction
Demand-Side Drivers in the Chinese IVD Market
  Diabetes
  Cancer
  Allergy
  Infectious Disease
Healthcare System/ Reform Supply-Side Drivers
  Physician Office Laboratories (POL
  Self-Testing
  Hospital and Private Laboratories
  Research and Technology Sector
Market Size and Projections
Market Distribution and The State of The Industry
  Domestic Chinese IVD Industry
Regulation

CHAPTER FIVE: MEDICAL DEVICES IN CHINA - MARKET OPPORTUNITIES AND CHALLENGES THROUGH 2015

Introduction
Demand-Side Drivers in the Chinese Medical Device Market
  Cancer
  Cardiovascular Diseases
  Aging
Healthcare System/Reform - Supply-Side Drivers
  Hospitals
  Specialty Treatment Clinics
  Public Clinics, Health Centers and “Grass Roots” Medical Institutions
Market Size and Projections
Market Distribution and the State of the Industry
  Foreign Manufacturers
  Domestic Chinese IVD Industry
Regulation
  Manufacturing Enterprise Approvals
  Cost Controls for Medical Procedures and Reimbursements
  Device Approval

CHAPTER SIX: PHARMACEUTICALS IN CHINA - MARKET OPPORTUNITIES AND CHALLENGES THROUGH 2015

Introduction
Demand-Side Drivers in the Chinese Pharmaceuticals Market
  Diabetes
  Hypertension and Heart Disease
  Cancer
  Infectious Diseases
  Self-Medication
Supply-Side Drivers (Healthcare Reform) and Market Channels
  Hospital Pharmacies
  Retail Pharmacies
  Other Commercial Channels - Mass Merchants, Mail Order and Online
Market Size and Projections

MARKET DISTRIBUTION AND THE STATE OF THE INDUSTRY

“Big Pharma” - western MNCs in China
Domestic Chinese Pharma Industry

REGULATION

Manufacturing Enterprise Approvals
Pricing Controls at Manfacturer-Level
Pricing Controls at Pharmacy-Level
Drug Approval
Intellectual Property Protection (IPP)

CHAPTER SEVEN: CONCLUSIONS

Conclusion One
Conclusion Two
Conclusion Three
Conclusion Four
Conclusion Five
Conclusion Six
Conclusion Seven

TABLE OF EXHIBITS

CHAPTER ONE: EXECUTIVE SUMMARY

Table 1-1: Government-Run Urban Health Insurance Programs in China
Figure 1-1: Chinese Healthcare Reform Government Funding Breakdown (2009-2011)
Figure 1-2: Rural and Urban China Healthcare Market (Insurance and Out-of-Pocket Payments) (2004-2015) (billion yuan)
Figure 1-3: IVD, Pharmaceuticals and Medical Devices Markets in China (2004-2015) (billions $)

CHAPTER TWO: HEALTHCARE IN CHINA - PRIMARY INDICATORS AND A NEED FOR REFORM

Figure 2-1: Chinese National Population (% Urban/Rural)
Figure 2-2: Chinese Government Health Expenditures (in billion yuan and % of total health expenditures) (1980-2009)
Figure 2-3: Average Inpatient Visit Costs and Bed Utilization at Chinese Public Hospitals (1985-2010)
Figure 2-4: Gross National Income (GNI) Per Capita - China and OECD Member Country Average (1980-2009)
Figure 2-5: Chinese Bureaucratic and Market Divisions (East, Middle, West China)
Figure 2-6: Private Hospitals in China by Region (East / Middle / West) (2010)
Figure 2-7: Number of Private and Public Hospitals in China (1980-2010)
Figure 2-8: Income Sources for Government-Run Hospitals (%)
Figure 2-9: New Rural Cooperative Medical Scheme Enrollment (2004-2010)
Table 2-1: Government-Run Urban Health Insurance Programs in China
Figure 2-10: Government Health Insurance Coverage (2003 and 2008)
Figure 2-11: Hospital Visits in China (millions) (1995-2010)
Table 2-2: Government Healthcare Expenditure and GDP Growth Rates (China and Selected Comparison Countries; 2000-2008
Figure 2-12: Chinese Population by Age (Total; 1990/2000/2009) (%)

CHAPTER THREE: CHINA’S “REFORM” HEALTHCARE MARKET AND ITS SHAPING OF RURAL, URBAN, REGIONAL AND PROVINCIAL MARKETS

Figure 3-1: Chinese Healthcare Reform Government Funding Breakdown (2009-2011)
Figure 3-2: Chinese Rural Healthcare Market by National Market Shares of Province/Direct-Controlled Municipality (2010)
Rural China Healthcare Market (Total Consumer/Out-of-Pocket/Insurance Expenditures) (2004-2010) (billion yuan)
Table 3-1: Rural China Healthcare Market (Total Consumer/Out-of-Pocket/Insurance Expenditures) (2004-2010) (billion yuan)
Figure 3-4: Regional Shares of Reimbursement Funds under NRCMS (2010) (East/Middle/West China) (%)
Figure 3-5: Rural China Healthcare Market (Total Consumer/Out-of-Pocket/Insurance Expenditures) (2010-2015 Projection) (billion yuan)
Table 3-2: Rural China Healthcare Market (Total Consumer/Out-of-Pocket/Insurance Expenditures) (2010-2015 Projection) (billion yuan)
Table 3-3: Top and Bottom Five Provincial Markets for Rural Healthcare by Gain and Loss in National Market Share (2010-2015)
Figure 3-6: Chinese Urban Healthcare Market by National Market Shares of Province/Direct-Controlled Municipality (2010)
Figure 3-7: Outpatient Visits in the Urban Healthcare Market, 2010 (Hospitals, Community Health Centers, Community Health Stations, Clinics, Other) (millions of visits)
Figure 3-8: Composition of Chinese Hospital Sector by Number of Beds, 2000-2010 (percent)
Figure 3-9: Urban China Healthcare Market (Total Consumer/Out-of-Pocket/Insurance Expenditures) (2004-2010) (billion yuan)
Table 3-4: Urban China Healthcare Market (Total Consumer/Out-of-Pocket/Insurance Expenditures) (2004-2010) (billion yuan)
Figure 3-10: Top and Bottom Five Provincial Markets for Urban Healthcare by Gain and Loss in National Market Share (2010-2015)
Figure 3-11: U.S. Medical Product Export Growth to China (1990-2010)
Figure 3-12: Total U.S.-EU Exports to China - Pharmaceutical Products and Medical Devices (2002-2010) (millions of U.S. dollars)
Figure 3-13: Inbound Foreign Direct Investment in Medical Product Manufacturing in China (2002-2010)
Figure 3-14: Foreign-Invested Manufacturing Enterprises in China (1980-2010)
Figure 3-15: Foreign-Invested Manufacturing Enterprises in China by Province/Municipality (1995-2010)

CHAPTER FOUR: DIAGNOSTICS IN CHINA - MARKET OPPORTUNITIES AND CHALLENGES THROUGH 2015

Figure 4-1: Chronic Disease Morbidity Rates in Urban China - Hypertension, Diabetes, Cerebrovascular Disease (Stroke), Chronic Obstructive Pulmonary Disease, Heart Disease (per thousand [0/00]) (2003/2008)
Figure 4-2: Chronic Disease Morbidity Rates in Rural China - Hypertension, Diabetes, Stroke, Chronic Obstructive Pulmonary Disease, Heart Disease (2003/2008)
Figure 4-3: Cancer Mortality Rates in China - Lung, Liver, Stomach, Esophageal, Colon, Leukemia, Brain, Breast, Pancreatic (Per 100,000) (2005)
Table 4-1 Incidence Rates for Top Ten Notifiable Infectious Diseases (2010)
Table 4-2 Selected Preventative Medicine Opportunities
Table 4-3 Selected Disease Prevention Programs in China’s Healthcare Reform (2009-2011)
Table 4-4 Clinical Labs by Instrumentation Type in BRIC Countries
Figure 4-4: Chinese Market for IVD Reagents ($ millions) (2004-2015)
Figure 4-5: Regional Market Divisions for Medical Products in China (Eastern, Northern, Central, Southern, Southwestern, Northwestern, Northeastern)
Table 4-5 Regional Markets for IVD Products in China (Eastern, Northern, Central, Southern, Southwestern, Northwestern, Northeastern), 2010-2015
Table 4-6 IVD Market Segmentation (2009) (% of sales)
Table 4-7 IVD Market Shares by Company (2009) (%)
Table 4-8 BRIC IVD Market Comparison (2010) ($ millions)
Table 4-9 Selected Made-in-China Lab Supplies
Table 4-10 Selected IVD Manufacturers in China
Figure 4-6: IVD Product Registration and Regulatory Flowchart

CHAPTER FIVE: MEDICAL DEVICES IN CHINA - MARKET OPPORTUNITIES AND CHALLENGES THROUGH 2015

Figure 5-1: Cancer Mortality Rates in China - Lung, Liver, Stomach, Esophageal, Colon, Leukemia, Brain, Breast, Pancreatic (Per 100,000) (2005)
Figure 5-2: Chinese Population by Age (Total; 1990/2000/2009) (%)
Figure 5-3: Composition of Chinese Hospital Sector by Number of Beds, 2000-2010
Figure 5-4: Compositional Changes in the Hospital Sector - Private, Third-Level and Specialty Hospitals (2005-2010)
Figure 5-5: Chinese Market for Medical Devices ($ billions) (2004-2015)
Figure 5-6: Regional Market Divisions for Medical Products in China (Eastern, Northern, Central, Southern, Southwestern, Northwestern, Northeastern)
Table 5-1 Regional Markets for Medical Devices in China, $ billions 2010 and 2015 (Eastern, Northern, Central, Southern, Southwestern, Northwestern, Northeastern)
Figure 5-7: China Medical Device Market - Product Segment Shares Percent, 2010 (Surgical Instrument, Disposable, Patient Monitoring, IVD, Imaging, Orthopedic, Other)
Figure 5-8: Foreign-Invested Manufacturing Enterprises in China (1980-2010)
Figure 5-9: Medical Device Registration and Approval Flowchart
CHAPTER SIX: PHARMACEUTICALS IN CHINA - MARKET OPPORTUNITIES AND CHALLENGES THROUGH 2015
Figure 6-1: Chronic Disease Morbidity Rates in Urban China - Hypertension, Diabetes, Cerebrovascular Disease (Stroke), Chronic Obstructive Pulmonary Disease, Heart Disease (per thousand [0/00]) (2003/2008)
Figure 6-2: Cancer Mortality Rates in China - Lung, Liver, Stomach, Esophageal, Colon, Leukemia, Brain, Breast, Pancreatic (Per 100,000) (2005)
Table 6-1 Incidence Rates for Top Ten Notifiable Infectious Diseases (2010)
Figure 6-3: Chinese Market for Pharmaceuticals (incl. Hong Kong) ($ billions) (2004-2015)
Figure 6-4: Regional Market Divisions for Medical Products in China (Eastern, Northern, Central, Southern, Southwestern, Northwestern, Northeastern)
Table 6-2 Regional Markets for Pharmaceuticals in China, $ billions, 2010-2015 (Eastern , Northern , Central , Southern , Northeastern , Southwestern , Northwestern )
Figure 6-5: China Pharmaceutical Market - Patented Prescription, Generics, OTC Market Shares (%) (2010)
Table 6-3: China Pharmaceutical Market (Patented Prescription and Generics only) by Product Segment, 2010 and 2015 (Cardiovascular, Gastrointestinal, Anti-Infectives, Neurotherapetuics, Oncology, Respiratory, Other)
Figure 6-6: Foreign-Invested Manufacturing Enterprises in China (1980-2010)
Table 6-4 Leading Medicinal Manufacturers in China (2009) (%, National Share of Aggregate Pharma/TCM/Nutritional Market)
Table 6-5 Pharmaceutical Price Cuts (2000-2010)
Figure 6-7: Pharmaceutical Approval and Regulatory Flowchart
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