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Asia Health and Wellness News Summary – May 2010

May 25, 2010 | Written by rfasia

Medical Reform

Business Initiative

Health & Awareness

Public Health

Additional News from the Greater China and Other Markets:

Hong Kong

Taiwan

Korea

Singapore

Medical Reform

The Economic Observer reports that the new medical reform has expended 390 billion yuan in a year:

  • According to the National Development and Reform Commission, as of the end of February this year, various levels of fiscal authority in China have already expended 390.2 billion yuan. This investment has provided basic healthcare coverage to 1.2 billion individuals. In addition, the grassroots healthcare system has beeninitially established. The bad news is that the problems of healthcare access and affordability remain.
  • When the new medical reform plan was announced last year, the total investment over the three-year period was budgeted at 850 billion yuan. The 390 billion yuan expended in the first year represents close to half of the total budget. However, skepticism remains. Mr.Wang, a sales manager at a Beijing medical sales company, reported that the cost of an 80-day hospitalization for his father is only 1,000 yuan less than the year before. The manager acknowledges an improvement in healthcare access though.
  • As for the 30% drug price reduction, it is not unusual that manufacturers of low-priced medications often forfeit the winning bid. As a result, only high-price drugs remain on the essential drug list.
  • Another point of public discontent is that at community health centers, residents are only reimbursed for the cost of drugs and not for consultation fees or hospitalization. The cost of hospitalization has increased by 10 yuan to 18 yuan, according to Mr. Wang.
  • Link to full Chinese text

Oriental Morning Post reprinted a commentary that the new medical reform should not just focus on investing while neglecting fairness and efficiency. The commentator wrote:

  • In spite of the 390.2 billion yuan investment, the public remains unsatisfied. The recent expose´s on overpriced drugs show that if loopholes continue to exist in drug and medical regulation, no amount of fiscal input can address the problems in the healthcare market. Fiscal spending while neglecting investment fairness and efficiency will only benefit a select few and interest parties; patients will gain very little and risk receiving “negative benefits.”
  • This shows that fiscal investments without money management and accountability systems would have difficultydelivering positive results on the medical reform. It seems as though the current public discontent over healthcare services has yet to alert and pressure health authorities. In order to rectify the currentsituation, another reform would be needed.
  • Link to full Chinese text

The profit margin of a cancer treatment drug is found to be 2000%. CCTV’s News 1+1 reported:

  • Ondansetron, a cancer treatment drug, is found to cost 80 yuan when its manufacturing cost is less than 4 yuan. This easily overtakes an earlier expose´ that found a drug to enjoy a profit of 1300%.
  • Industry insiders pointed out that inflated drug prices reflect two problems. The first is that consumers lack bargaining power in the drug supply and purchasing chain. This is why the government needs to regulate the market. The second problem is that government regulation in itself has problems. Price guidance (published by the government) is already inflated.
  • Link to full Chinese text

The CPC Central Committee Political Bureau convened a learning meeting to discuss global medical development trends and China’s medical reform. Hu Jintao pointed out during the meeting:

  • The central government has affirmed five key tasks for the near-term medical reform work. Party committees and government offices of all levels should effectively target key issues to improve the accessibility and affordability of healthcare.
  • The five key tasks that the central government has identified include:
  1. Acceleration ofa basic medical security system, gradually expanding its coverage to include all urban and rural residents.
  2. Initial establishment of a national essential medicines system toensure reasonable prices,quality, and safety of basic medicines.
  3. Improve the primary care and health service system. Direct more financial and material resources as well as human resources and technology to the grassroots communities. Increase the service capability of primary health services.
  4. Promote the gradual equalization (fairness)of basic public health services. Maximize efforts on disease prevention.
  5. Advance the pilot reform of public hospitals to optimize the structure of public hospitals to secure public satisfaction.

The National Development and Reform Commission plans to introduce four measures to lower drug prices. According to People’s Daily:

  • The four measures aim to intensify regulation of drug prices and expand efforts to crack down on ill-intentioned price increases and profiteering activities. These measures aim to further lower inflated drug prices.
  • The four measures include:
  1. For businesses that determine their own prices, [the government] will intensify the investigation of market purchasing and distribution prices;
  2. For drug prices that follow government price guidance, [the government] will intensify the audit and review of production prices;
  3. Establish an adjustment system for basic medicine activities; and
  4. Research methods to improve drug price management.

The China Net reported that the Ministry of Health plans to introduce five measures to combat high drug prices and crack down on commercial bribery. The measures include:

  1. Further reform and perfecting of the online centralized purchasing system for drugs.
  2. Advance the implementation of the national essential drug system.
  3. Standardization of medical diagnosis and treatment service conduct.Bottom of Form
  4. Investigation of commercial bribery cases.
  5. Collaborate with pricing authorities to lower prices on drugs and medical procedures.

The Outlook Weekly reported on a 10-day seminar attended by key planners of the medical reform. The article concluded by asking if Taiwan’s experience with using private hospitals to break the monopoly of public hospitals, which resulted in greater benefits for the public, may replay itself again. The article wrote:

  • The seminar was organized for provincial-level leaders and represented the highest level of seminar on medical reform since the new plan was implemented a year ago.
  • Seminar instructors included the Minister of Health Chen Zhu, Deputy Minister of Finance Wang Jun, Deputy Minister of Human Resource and Social Security Hu Xiao-yi, Director of the Center of China Study Hu An-gang, and Professor Li Ling of Peking University’s National School of Development, among others.
  • Responding to the news expose´s on inflated drug prices, one seminar participant and deputy bureau director of the National Food and Drug Administration Bureau commented that the “key is to break down the profit chain in the drug supply channel.”
  • Another commented that the most effective measure might be through centralized and direct distribution, instead of the current provincial-based centralized purchasing model. This proposal was criticized as being a backtrack to the centralized planned system in 2008.
  • Another issue discussed was the financing scheme for public hospitals to make up for the shortfalls from the elimination of sales margins on hospital-dispensed prescription drugs. The drug sales margin is a main source of hospital financing.
  • The former Minister of Health GaoQiang wrote in a 2008 article that government financing represents 7% and sometimes only between 2% to 3% of a hospital’s operating budget. Hospitals need to generate the rest of the budget.
  • On the topic of allowing private investments in hospitals’ operation, on May 13th, the State Council published an opinion on encouraging and directing private investments in health development. Many private investors were excited by the news.
  • Professor Li Ling commented that private investment is a good direction. However, since private hospitals can only be supplementary organizations, we should not place our hopes on private hospitals. That would be unrealistic.
  • Link to full Chinese text

Business Initiative

Largest scale cardio-cerebrovascular disease prevention management system is launched in Chengdu:

  • The system is a joint effort by MSD and the Health Office of Sichuan province. This is the first provincial-level prevention management system for managing cardiovascular risks. The program will take five years and will cover the entire provincial elderly population.
  • According to 2008 government data, cardiovascular-caused deaths account for 40.27% of all deaths in China and are the leading cause of death in China. Every year, cardiovascular diseases result in 3 million deaths nationwide. Data from 2007 showed that the medical cost for managing cardiovascular diseases had already reached 130 billion yuan, representing a six-fold increase compared to the cost in 1993. A 1998 WHO report also showed that unless controlled, by 2030, the incidence of cardiovascular diseases will increase by 3.7 times compared to the year 2000.
  • The program aims to:
  1. Standardize the management of three key risk factors for cardiovascular diseases.
  2. Realize the collaboration and work allocations of health service center, Level III hospitals and regional health authorities.
  3. According to MSD, the program represents a unique public-private partnership model that the company has developed. The model has enjoyed a long-established history of collaboration with various government and health authorities worldwide.
  4. At the conclusion of the five-year period, MSD will transfer all rights of the program to Sichuan’s Health Office.

Health & Awareness

China Commercial Times reported that since 2005 a string of product quality issues involving multinational brands are challenging consumer confidence in global brands. The paper cited:

  • Incidents involving Kraft, SK-II, Johnson, Colgate, and Honda.
  • Kraft was profiled for the controversy involving the doublestandard applied on genetically modified ingredients in its products for China, which is different from the standards used for European markets.
  • On safety issues, Novartis, Johnson&Johnson, Protector&Gamble, and Nestle are named.
  • A pending legal case involving Novartis’Sebivo was extensively profiled. The article commented that the incident revealed the arrogance and prejudice of foreign brands toward Chinese consumers.
  • A survey conducted by Sina.com on the question of “Do you trust baby healthcare and bathing products by Johnson &Johnson, Pampers reported that of the 163,000 responses, 50.9% indicated that they do not trust these brands, and another 62.7% indicated that they will not purchase related products.
  • Link to full English text

Public Health

China Disease Prevention and Control Center reports:

  • Based on data from the first few months of 2009, the number of mental illness patients exceeds 100 million in China.
  • Patients with serious psychological disorders exceed 1.6 million.
  • Public awareness of various mental illnesses is less than 5%.
  • Link to full Chinese text

According to a government official of Sichuan Provincial Health Office:

  • 85% of medical disputes in China are due to hospital infections:
  • Hospital infections and doctor-patient relations are two of the biggest challenges faced by hospitals.
  • A doctor reported that that 4 million patients in China per year contract infections while in the hospital.
  • A key measure to lowering hospital infections is by improving the hygiene practices of hospital workers.
  • Link to full Chinese text

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Asia Health and Wellness News Summary – April 2010

April 25, 2010 | Written by rfasia

Medical Reform

Business Initiative

Health & Wellness

Public Health

Additional News from the Greater China and Other Markets:

Hong Kong

Taiwan

Korea

Singapore

Medical Reform

Beijing has completed the public review of the medical reform plan. According to the Legal Evening News:

  • A dozen supplementary medical reform measures will be introduced before the unveiling of the final reform plan, including the establishment of a municipal hospital management bureau; reform and improvement of the emergency system; public hospital reform; and measures for encouraging and channeling private investments in hospitals, among others.
  • The city will also be launching a number of pilot programs on the reform of institution-funded healthcare, reform of the medical insurance payment system, and others.
  • Link to full Chinese text

……However, a commentator likens measures to encourage specialists to voluntarily serve in Beijing community hospitals to using missiles for killing mosquitoes:

  • The shortage of qualified community doctors is due to the prolonged failure of the government to invest in grassroots health facilities. A competitive compensation structure is also critical for developing community doctors.
  • Until these issues are addressed, relying on specialists to address the needs of community hospitals would be a waste of valuable resources and risks using “missiles to kill mosquitoes.”
  • Link to full Chinese text

On the issue of doctor-patient relations, Cutian Golden News (Wuhan) reported on the netizen-initiated action to rank good and bad doctors:

  • Commentary from a newspaper in Wuhan calling for the creation of lists of “good and bad doctors” has set off a media frenzy. A popular news program on CCTV has organized an online discussion. The Business Herald also wrote a commentary. Other netizens in other cities, including Beijing, Shanghai, and Jinan have initiated a campaign to “learn from Wuhan” by posting local “good and bad doctor” rankings.
  • Most believe that the news and activities show that doctors and patients have yet to establish mutual trust. Some experts believe that a breakthrough on this issue would be an important area to be addressed in the medical reforms.
  • An expert of hospital administration commented that the best way to address the strained doctor-patient relationship is by encouraging patients to seek initial diagnosis in community hospitals. However, in his view, the goal remains elusive.
  • Link to full Chinese text

…….Against this background, a training program is launched for hospital chief press officers:

  • The China Hospital Chief News Officer (CNO) Training Plan was officially launched recently. The training plan is organized jointly by the School of Journalism of China Renmin University and China Hospital Management University. The objective of the plan is to assist hospitals in building a constructive doctor-patient communications system, a system for positively guiding public opinion, and to build harmonious doctor-patient relations.
  • The program has received guidance and support from the Press Office of the MOH, China Medical Association, the Center for Medical Dispute Mediation of the Beijing Medical Education Association, and the China Health and Medical Development Foundation.
  • Link to full Chinese text

Minister of Health Chen Zhu reported that the medical reform has already made significant impact, while citing other issues to be further studied:

  • The minister noted that the reform has received a high level of consensus from the public.
  • Issues to be further explored include how to realize fair and efficient healthcare resource allocation and how to further improve policies for grassroots medical staff while investments in medical infrastructure continue.
  • Link to full Chinese text

……..In the meantime, Li Ling, professor of Beijing University’s China Economic Research Center, wrote on the public welfare nature of medical reforms:

  • This round of medical reform confirmed public welfare as the guiding ideology of the reform. Public welfare is determined on the idea that health is a basic right. The key difference between health and other commercial products is that health and survival are basic human rights. Globally, many countries have already followed the principle of inclusivity and public welfare for allocating medical and healthcare resources.
  • How would the new medical reform achieve the mission of public welfare? The first is by ensuring that everyone can afford care. The second is by ensuring that everyone can have healthcare. Lastly, medical workers are the key force for realizing the public welfare nature of healthcare.
  • The critical key is for the government to fulfill its function. It is the people, through the political processes, who have entrusted the responsibility for implementing public welfare work. The government needs to increase financing, provide supervision, and plan for realizing the public welfare nature of healthcare.
  • Link to full Chinese text

…….Separately, a review of the new book by Hu Suli, founder and ex-managing director of Caijing, cited Hu’s relatively more market-based solution for reforming healthcare:

  • The Nanfang Metropolitant News published a book review titled “Is She Really the Most Dangerous Woman in China?”
  • Many of the problems she wrote about over a 10-year period continue to grow today. On the issue of medical reform, Suli predicted that “allowing those doctors who possess business talents to enter the market, give them free reign to start businesses, and become the core force in driving medical business sytem innovations, would bring about a solution of multiple wins.”
  • Link to full Chinese text.

Shanghai announced that an electronic health record will be established for every resident in the city:

  • The system will allow every Shanghai resident to seek care in any hospital. Such a system would be effective against repeat prescriptions and examinations. Moreover, the system will promote utilization of best resources for patients.
  • For example, biopsy results of breast cancer patients will all be transmitted to Shanghai Oncology Hospital, which has the most advanced diagnostic capability. This will significantly improve the quality of healthcare services and volume.
  • Link to full Chinese text

Business Initiative

A research company reported that competition is intensifying among multinationals for the world’s largest diabetic market with over 92 million patients:

  • Nova Nordisk, the current market leader with over 60% of the market, is expected to expand its staff size by 50% to reach 3,000.
  • Sanofi Aventis recently revealed that the company will provide 20 million yuan to sponsor a “China Type II Diabetes Research Project” under the China Diabetic Medical Association.
  • Since 2007, Eli Lilly has invested 1.8 million euro in research on diabetes in China. In 2009, Eli Lilly announced the launch of Byetta in China.
  • Bayer Schering has bought the exclusive right to market SciLin insulin in China. Currently, Acarbose is one of the key products for treating type II diabetes and the reason for Bayer’s growth in China. With SciLin, Bayer will be able expand its therapy offerings and consolidate its positioning in the market.
  • Recently, MSD announced that the SFDA in China has approved sitagliptin (Januvia) for launch in China. The therapy is the first type of DPP-4 inhibitor available in China.
  • Link to full Chinese text

Another article reported on similar strategies by multinationals for the markets in Asia but titled the piece differently—Price Reductions by Leading Multinationals Are Only for Gaining Market Share in Developing Markets:

  • According to IMS data, 87% of global pharmaceutical sales came from the U.S., Europe, and Japan in 2008. However, sales growth in these markets has stagnated. Asia, excluding Japan, represents the potential growth market for the multinational pharmaceutical companies. For most tens of millions of Asians, however, the biggest problem is that many cannot afford the cost of healthcare.
  • Eisai, GSK, Sanofi Aventis, and others have already lowered their posture and lowered prices in order to stimulate demands in these markets.
  • However, a coordinator of the WHO’s non-infectious disease prevention program said these measures are negligible for ensuring public health because the impact of price reduction only affects a small portion of people.
  • Link to full Chinese text

Public Health

MOH: Preventive Vaccines Most Effective Disease Control Measure

  • The MOH published a notification on its website requesting offices throughout the nation to implement the vaccination work in 2010. The notification pointed out that preventive vaccines are the most effective measure for disease control and have enjoyed a widespread public foundation.
  • Link to full Chinese text

Shanghai Ranks Highest for Incidence of Lung Cancer

  • According to Shanghai Disease Control and Prevention Center, in recent years, incidences and mortality for cardiovascular diseases and cancer have exceeded the national average. Lung cancer in particular represents 30% of all cancer incidences, ranking Shanghai a municipality with the highest rate of lung cancer.
  • During the launch of GE CT and the 10th CT Summit, the director of radiology at Ruijing Hospital revealed that cardiovascular diseases and cancer have become the most serious threats to Shanghai public health. He urges early diagnosis as a way to promote better health, lower medical costs, and improve medical quality.
  • Link to full Chinese text

A media reports that the “66 Articles of Health” provide residents with standards for evaluating information accuracy

  • The spokesperson for the Ministry of Health and director of the China Health Education Center, Mao Anqun, spoke during the 2010 Chinese Medical Association’s Health Lecture held at the Great Hall of the People.
  • Mao reported on key findings from the 2009 Health Literacy Survey and talked about specific details of the 66 Articles of Health, which are part of the government’s effort to promote health literacy.
  • He said emphatically that each person is the first responsible party for his or her health.
  • Link to full Chinese text

…….Separately, an online media portal launches a “Public Health Information Literacy Education” program

  • In response to the low health literacy rating for Chinese residents, Wanfang Med Online, an online medical portal, has launched a “Public Health Information Literacy Education Program.”
  • The program will include a series of health information literacy education activities, including feature stories on health, monitoring of information literacy, and a literacy development plan.
  • According to the news report, a 2007 study revealed that 84.7% of the public are most interested in medical and health information. However, according to the first survey on health literacy in China, the health literacy level of residents is only 6.48%. The survey showed that residents scored especially low on the question concerning “knowing how to acquire health information and knowledge.”
  • Link to full Chinese text

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