THE GEORGE INSTITUTE FOR GLOBAL HEALTH

Health Care in China Today:Challenges and Opportunities

John Knight5th August 2015

Sydney

The George InstituteAustralia’s high impact medical research organisation

SCIMAGO Research Impact Rankings 2011

The George Institute for Global HealthWhy we are number one

We study human beings - people all round the world, suffering from the major serious chronic diseases

– Heart disease– High blood pressure– Diabetes– Stroke– Kidney failure– Accidents and injuries– Back pain– Diseases of poverty and disadvantage

www.georgeinstitute.org

The George in China

Office established in 200780 staff in BeijingResearch partners across China

Large scale studies of key health issues

ORBIT 20,000 subjects type II diabetesSASS 20,000 subjects high salt diet

Large registration and phase IV trials for top 10 pharma

China Centre for mHealth Innovation

www.georgeinstitute.org.cn

the ORBIT study: 209 hospitals in 10 provinces

A visit to the doctor in Australia

Your GP: a 10 yr trained professionalKnows you and your family wellAccess to online information.Often bulk bills to MedicareOften a one stop shop - blood tests - imaging - physio / nurse - pharmacyReferral to specialist/hospital rarelyMedications 100% high quality supply

3.3 doctors per thousand populationone GP for every 900 Australians

A visit to the doctor in China

Large queues in outpatients:a very long wait leads to a very brief consultation8yr trained professionals - hospital basedConnected to the web by their smart phonesDrug treatment is very often prescribed – but the quality?

1.8 doctors per 1000 populationone GP for every 17,500 Chinese

China’s health care system: a snapshot

STRENGTHS CHALLENGES

Good numbers of well trained doctors Lack of general practice structure / staffPoor doctor-patient relationships

Universal health insurance with co-payGood access to advanced Western medicine (in larger cities)

Long delays – loss of productivity, frustrationService quality reduced in remote areas(rural health practitioners)

Good HCP & consumer web access to health information via smartphones

Outdated hospital infrastructure / technology

Significant expenditure5.4% of GDP* = US$540 billion

Drug dispensing in hospitals – 15% surcharge – can comprise up to 40% of hospital income.

Increasing number of hospitalsbuilding 20,000 new ones

Lack of private sector facilities / choice

Excellent numbers for clinical trials Slow registration of new drugs by China FDA

*OECD average 9.3%Australia 9.4%

Key planning documents p1. Five year plans2. China Australia Free Trade Agreement

The 12th 5 year plan 2011-2015

Strengthen public healthcare infrastructureStrengthen healthcare service networkDevelop a comprehensive medical insurance systemImprove drug supply systemReform the public hospital systemSupport the development of Chinese Medicine

The 13th 5 year plan 2016-2020*

1. More general practitioners2. More hospital beds3. More private sector services4. De-link doctor and hospital

incomes from drug prescriptions

5. Prevention and control of chronic disease

TARGETS• Increase basic medical

insurance cover from 320 to 380 RMB per person per year

• Six hospital beds per 1000 people (up from 4.55 in 2013)

• Double the number of primary care doctors per capita

• Two hospital beds per 1000 provided by the private sector

*not yet finalised

The China Australia Free Trade Agreement (ChAFTA)

Final version signed: text available at DFAT website and awaiting endorsement by parliament

Now the subject of a political battle : there will be two separate parliamentary enquiries, but China has said it will not accept any changes

dfat.gov.au/trade/agreements/chafta

ChAFTA on Health Care

Pharmaceuticals, including vitamins and health products: elimination of tariffs up to 10 per cent, either immediately on entry into force or within 4 years.

Health and aged care services: China will permit Australian service suppliers to establish profit-making aged care institutions throughout China, and wholly Australian-owned hospitals in certain provinces. This will greatly expand the Australian private health sector’s offering of medical services through East Asia.

dfat.gov.au/trade/agreements/chafta

Opportunities for Australian business

Aged care / private hospitals RamsayGeneral practice training, systems, models

RACGP, HealthScope, medical schools,corporatised polyclinics

Pharmaceuticals CSL, AspenMedical devices ResMed, Cochlear,

• George Clinical is a wholly owned commercial subsidiary of The George Institute

• We do high quality global commercial clinical trials for big pharma – especially in Asia

• 48 people in Beijing and Shanghai• We can do your clinical trial, and we can do it in China• And we can help you get your product registered in China,

– we know the regulatory system and we have the contacts

www.georgeclinical.com

Key points

1. The Chinese health care system is impressive and delivers good health outcomes for the Chinese people

2. There are still significant challenges in capacity, in health care delivery and in the business model

3. The 13th 5 year plan for health care (2016-20) will recognise the challenges and will set out to tackle them

4. The sheer size of the Chinese health marketplace, and the planned changes, create significant opportunity for Australian health care businesses

5. With our strong track record of scientific excellence and strong presence in China, the George Institute and George Clinical are well placed to help you achieve your business goals in China

Affiliated with the University of Sydneyand the Peking University Health Science Centre

THE GEORGE INSTITUTE FOR GLOBAL HEALTH