SSRI, along with SSRI China and SSRI Asia Pacific held a seminar “Inside China 2018” on August 3rd, 2018 in Tokyo to approx. 40 people from 23 pharmaceutical and medical device companies. The seminar consisted of presentations about the 2nd largest pharmaceutical market in the world, China, from the point of view of physicians, patients and the research agency. In addition, Qing-Kun Song, an associate professor at Beijing Shijitan Hospital (affiliated to Capital Medical University, Department of Science and Technology, Cancer Epidemiology division) gave a special presentation on China’s cancer epidemiology and the social background surrounding the Chinese healthcare system. The summary of each presentation as follows:
Cancer epidemiology in China – special presentation by Qing-Kun Song of Beijing Shijitan Hospital
~ Innovative new medicine – opportunity for Japanese manufacturers ~
The results from 10 years of various cancer screening projects in China showed that the current cancer prevention and treatment systems in China are insufficient. Compared to the cancer prevention and treatment situations in Japan, early detection of cancer is insufficient and the treatments are non-standardized. In addition, there are issues of lower survival rates and side effects because conventional chemotherapy and radiation therapy are still widely used due to the fact that many new therapies are not available in China.
For this reason, the Chinese authority is in a “welcoming” mood for importing/ approving innovative new medicines from overseas, and has stated that they are willing to accept oversea clinical data upon approving new medicines. Since Asian (Japanese) clinical data is likely to work more favorable (easier acceptance) compared to Western clinical data, now may be a good time for Japanese manufacturers to consider entering into the Chinese cancer market.
Basic information on the Chinese pharmaceutical market (by Jane)
~ Patients are highly concentrated in tier 3 hospitals ~
The land mass of China is approx. 25 times of Japan with significant regional differences. Of the approx. 980,000 healthcare institutions in China, the vast majority are institutions at the grassroots level such as village clinics that can only administer vaccines and treat very mild sicknesses. Hospitals that offer more comprehensive care only occupy 3% of the entire healthcare institutions in China. These hospitals are categorized into 3 tiers based on hospital infrastructure, level of care, the number of specialists etc. Of these hospitals, the top ranked tier 3 hospitals only occupy 8% of all hospitals, but see more than half of the outpatients who visit hospitals. While China operates under a universal health insurance system, the unique characteristic is that there is a maximum ceiling on the reimbursable amount.
Market research in China (by Kio)
~ Need to consider the unique cultural / social characteristics ~
Upon conducting market research in China, it is important to consider the influence of Confucianism and the “face” culture. Focus groups will often not give you the truth and tendency of high average scores etc. are characteristics to be considered upon designing the study and analyzing the results in China. Also, it is important to know that doctors are very keen on the cost of medicine since new products will not be reimbursable in China, and there is a ceiling on health insurance coverage. Lastly, it is important to remember that the doctor-patient relationship in China is very poor. Violence against doctors in China is quite common and doctors may select treatments and tests in order to “protect” themselves rather than for the benefit of the patient. Knowing and not knowing these unique characteristics of China will have a big difference upon comprehending the market research results from China.
Disease management and new Tx needs (from Chinese physician research data; PatientsMap)
~ Significant market size for respiratory, chronic diseases and cancer ~
SSRI and M3 recently launched PatientMap 2018 China with research data from over 10,000 Chinese physicians. According to this database, respiratory conditions such as upper and lower respiratory infections, COPD and pneumonia, and lifestyle diseases such as hypertension, type 2 diabetes and dyslipidemia occupied the top estimated number of patients in China. The data suggested that there are 61 million hypertension patients currently being treated in China. For the estimated number of cancer patients, stomach cancer and NSCLC each showed 2.1 million in China vs. 0.3 and 0.19 million respectively in Japan, followed by colorectal cancer at 1.8 million (0.34 million for Japan). For diseases/conditions in which physicians wish for new products (unmet needs), hematological malignancies such as AML and ALL, and psychiatric conditions such as schizophrenia and bipolar disorder were amongst the top diseases/conditions. PatientsMap is a large-scale database product developed by SSRI and M3 in collaboration which contains physician research data on the number of patients they see for around 400 diseases/conditions (including rare diseases).
Characteristics of general population and patients in China (from NHWS data)
~Increase of OCT/TCM usage under government promotion, but still high demands for branded Rx ~
According to NHWS, a patient-reported outcomes (PRO) data, the migraine market in the urban cities, including undiagnosed patients, exceeds 60 million. Of these 60 million, more than half are undiagnosed, which is double or more the number of Japan and the US. Comparing the migraine/pain data from 2010/2011 and 2017, while the overall treatment rate has increased more compared to Japan and the US, the usage of OTC including TCM has increased to around 70%, which is quite unique to China. However, when comparing the disease severity, treatment usage and satisfaction, it showed that Rx was more preferred than OTC, and there was a tendency of preferring branded medications over generics. NHWS is a patient database product developed by Kantar Health covering over 165 diseases/conditions in 10 different countries. (NHWS is being sold in Japan by SSRI)
■ Contact information
Regarding the seminar: Jane Zhang (firstname.lastname@example.org)
Regarding market research in China:
Pharma clients: Ryusuke Shinozaki (email@example.com)
Agency clients: Kio Tsuzaki (firstname.lastname@example.org)
Regarding PatientsMap: Ryuichi Kayano (email@example.com)
Regarding NHWS： Sachiko Funabashi (firstname.lastname@example.org)
■ Social Survey Research Information Co., Ltd
Established: April 1982
Capital: 27 million yen
Executive: President & CEO Takashi Makita
Address NMF Shinjuku EAST Bldg. 10-5 Tomihisacho, Shinjuku-ku, Tokyo 162-0067 Japan
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Affiliate companies: SSRI China Co., Ltd. (Dalian)
SSRI Asia Pacific Co., Ltd. (Hong Kong)
HIMA Research (Shanghai)
PD Research Co., Ltd. (Japan)