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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Outdated hospital infrastructure / technology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%
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