China Medical News

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May: Anti-cancer drugs more accessible for clinical use in China

Hospitals in China saw a 15% increase in 2020 in the variety of medical insurance covered anti-cancer drugs with negotiated price cuts compared with 2019. The data was based on results from a monitoring network that covers more than 1,400 hospitals across China, Guo Yanhong, an official with the National Health Commission, told a press conference on May 10.

In 2018, 17 anti-cancer drugs were included in China's medical insurance reimbursement list, with their prices cut by 56.7 percent on average after a round of price negotiations between the National Healthcare Security Administration and pharmaceutical companies. The hospitals under the monitoring network purchased 450.8 percent more of the 17 anti-cancer drugs on average in 2020 than in 2018, Guo said, adding that the accessibility of anti-cancer drugs for clinical use has increased. (Source: Xinhua)

May: China expands access to insurance-covered drugs

China has expanded the channels for patients to buy medicine under the country's medical insurance programs, a healthcare security official said on May 10.

For medicines covered under the healthcare security system's price negotiation program, patients can purchase their medicines either at hospitals or in qualified drug stores, and both channels enjoy the same reimbursement terms, said Huang Huabo, an official with the National Healthcare Security Administration (NHSA), at a press conference. Huang said such measures are intended to ensure the supplies of relevant drugs and meet patients' needs.

The NHSA and the National Health Commission recently issued a joint circular on the move to include relevant drug stores into the healthcare security system's supply chain and insurance payment system. (Source: Xinhua)

May: China to launch pilot program to promote HPV vaccination

China will introduce a pilot program to promote the inoculation of the human papillomavirus (HPV) vaccine and improve the rate and quality of cervical cancer screening nationwide this year, according to a health official.

The National Health Commission (NHC) is working to enhance measures for the tertiary prevention of cervical cancer to protect women's health, said NHC official Song Li.

Song said that China implemented a cervical cancer screening program in major national public health services in 2009. More than 120 million cervical cancer examinations have been conducted free of charge across the nation, Song added. (Source: Xinhua)

April: China's maternal mortality rate continues to decrease

China's nationwide maternal mortality rate was 16.9 per 100,000 in 2020, down 15.9% than 2015, said a health official on April 29.

The infant mortality rate was 5.4 per 1,000 in 2020, a decrease of 33.3% compared with 2015, said Song Li, head of the division of women and children of the National Health Commission at a news briefing. The mortality rate of children under five years old is 7.5 per 1,000 in 2020, down 30% compared with 2015, she said.

The maternal mortality rate is well below the median of 43 per 100,000 in middle- and upper-income countries. China's core indicators of maternal and child health also rank top among middle- and upper-income countries in the world, she added.
In the last five years, the commission has improved policies and measures related to the health of women and children, optimized the allocation of resources, and effectively strengthened medical service related to childbirth, Song said. (Source: Xinhua)

April: Cervical cancer screening program benefiting Chinese women

More than 120 million cervical cancer screenings were conducted free in China as part of the country's efforts to protect women's health.

The mortality rate of cervical cancer among Chinese women is 5.5 per 100,000, lower than the global average of 9.7 per 100,000, Song Li, an official of the National Health Commission (NHC), said at a press conference here on April 29, citing data from an annual report on tumor registry in China.

The disease is preventable and also curable if detected early and treated adequately, yet it is the fourth most common cancer among women globally. Without additional measures, the annual number of new cases of cervical cancer is expected to increase from 570,000 to 700,000 between 2018 and 2030, while the yearly number of deaths is projected to rise from 311,000 to 400,000, according to statistics released by the World Health Organization.

The NHC is playing an active role in promoting inoculation against cervical cancer, as well as its screening among Chinese women, Song said. (Source Xinhua)

April: China's malignant tumor survival rate climbs to 40%

The five-year survival rate for people diagnosed with malignant tumors in China has increased to over 40%, up from 30.9% 10 years ago, according to a senior health official.

The rise has been attributed to the improvement of the country's medical care quality and diagnosis and treatment capabilities, said Jiao Yahui, head of the Bureau of the Medical Administration of the National Health Commission, at a press conference on April 27. (Source: Xinhua)

April: National program to improve lymphoma treatment launched

A national program dedicated to improving the medical treatment capacity and capability of lymphoma, a type of cancer that begins in immune system cells, was established on April 24. The launch ceremony of the program initiated by the National Health Commission Capacity Building and Continuing Education Center was held in Beijing.

The center said that the program, which is supported by Roche Pharma China, will integrate relevant resources to form a lymphoma specialist alliance consisting of a pathology center, a clinical center, and a whole-process management center. Through capacity building, specialized talent training, and the construction of a quality control system, the program aims to comprehensively promote the country's overall medical strength in treating the disease and establish a standard, patient-oriented disease diagnosis and treatment path, according to the center.

Yang Aiping, director of the National Health Commission Capacity Building and Continuing Education Center, said that the program, which will include multiple medical disciplines and cover the full span of disease development, will focus on the grassroots level and help medical education in this field achieve better standards in a more systematic manner.

Dozens of experts from across the country were hired to be on the expert team for the program. Ma Jun, director of the Harbin Blood Disease and Tumor Institute of Harbin First Hospital, was appointed the leader of the expert team. "With the innovations regarding therapies and the coverage of medical insurance policies continuing to grow in recent years, the accessibility and affordability of treatments for lymphoma patients in China have greatly improved. However, there are still various unsatisfied needs from the patients throughout the diagnosis and treatment process. A lot can be done," Ma said.

Lymphoma is a common malignant tumor with relatively high control and recovery rates. The five-year survival rate of such patients is 38.3% in China, which is far lower than developed countries. Experts said that factors, including unclear diagnosis, non-standardized self-care of the patients and not adhering to instructions for regular follow-up treatments, have affected the overall treatment effect and prognosis. (Source: China Daily)

March: Diagnosis-related groups-based medical payment in simulation run

A pilot program of diagnosis-related groups (DRGs), which classifies different groups of patients to streamline medical insurance payment, has been put in a simulation run in 30 Chinese cities, the National Healthcare Security Administration said on March 9.

All the cities in the simulation run program, including Beijing, Tianjin, Shanghai, Qingdao and Urumqi, have passed an examination and evaluation, the administration said in a statement. In the program, patients will be classified into DRGs on the basis of factors such as their clinical diagnosis, age, complications and treatment methods. Medical fees and insurance payments will thus be based on DRG classification instead of specific cases.

The program is expected to ensure more accurate management of medical institutions and patients, standardize hospitals' diagnosis and treatment, improve services for the patients and make more efficient use of the healthcare insurance funds, according to the administration. (Source: Xinhua)

March: New drug list eases patients' burdens

A new national reimbursement drug list took effect on March 1 in a major boost to relieving the financial burden on Chinese patients and increasing accessibility to innovative, lifesaving drugs. The updated list of 2,800 medicines covered by basic medical insurance was released in late December. It includes 119 newly added drugs with an average price cut of 51%, the National Healthcare Administration Bureau said. The considerable price reduction is largely due to price negotiations between the administration and drug manufacturers in November and December, it said.

Patients are projected to save about 28 billion yuan ($4.3 billion) this year, thanks to price reductions and medical reimbursement, it said. The administration said that compared to previous adjustments to the list, the latest additions cover a wider range of conditions, from cancer and rare diseases to COVID-19, in a bid to bring concrete benefits to more people.

At Beijing Tsinghua Changgung Hospital, Nie Guangmeng, head of the healthcare insurance department, said "the latest list will markedly ease the burdens of patients," he said. "For instance, the price of lenvatinib (a medication for treatment of thyroid cancer and some other cancers) has dropped from 16,800 yuan to 3,240 yuan, and more people are eligible to claim reimbursement under the new policy."

Yin Rutie, a gynecologist at West China Second University Hospital in Chengdu, Sichuan province, said the inclusion of olaparib, an innovative therapy against ovarian cancer, will slash out-of-pocket payments shouldered by patients by as much as 90%. "For years, treatment targeting advanced stages of ovarian cancer mainly centered on surgeries and chemotherapy, but about 70% of patients are likely to relapse within two to three years following these standard procedures," she told, an online news portal. Yin said based on available research, the promising drug is projected to raise the five-year survival rate of ovarian cancer patients to 70%, representing a "breakthrough and milestone" for patients. She said the new drug list is expected to enable more patients to access the lifesaving medication.

The administration said the list includes 17 new cancer drugs. Through negotiations, the prices of 14 oncology medications already covered by medical insurance also dropped by an average of nearly 15%. (Source: China Daily)

February: Chongqing approved as port of entry for imported drugs

China's Chongqing municipality has been approved as a port of entry for imported drugs, making it the only such entry port in west China and the fourth in the Chinese mainland following Beijing, Shanghai and Guangzhou. The permission for entry was granted by China's National Medical Products Administration, a city official told a press conference.

Previously, imported drugs had to pass through China's eastern ports to arrive in western regions, and it could take up to 40 days or more for the consignments to arrive in Chongqing, said Luo Li, deputy director of the municipal drug administration. However, after the approval, the time is expected to shorten to around 15 days through the China-Europe freight train service, Luo added.

The approval will bring more imports of novel drugs through Chongqing and strengthen the competitiveness of the city's pharmaceutical industry, said Yuan Quan, president of Chongqing Pharmaceutical (Group) Co., Ltd. It will also prompt foreign pharmaceutical magnates to set up projects involving pharmaceutical research and development and clinical trial of drugs in Chongqing to fast-track the development of pharmaceutical industry clusters, Luo said. (Source: Xinhua)

February: Bulk drug buys make healthcare affordable

The national drug bulk-buy program initiated in late 2018 is estimated to have saved patients 106 billion yuan ($16.6 billion) by the end of last year, and the country is planning to implement the system on a regular basis, officials said on Jan 29.

After three rounds of price negotiations with drug manufacturers and centralized procurement campaigns, 112 types of drugs were selected and their prices fell by an average of 54%, said Chen Jinfu, deputy head of the National Healthcare Security Administration. "The average price of these drugs used to be two to three times higher than global levels. Now, it has dropped to roughly the same level," Chen told a news conference. In addition to the nationwide program, local authorities have launched 20 rounds of provincial-level bulk-buy programs, covering nearly 260 types of medications. Regional combined procurements are expected to yield savings of 24 billion yuan a year, he added.

According to a circular released this month by the State Council, the country's Cabinet, the drug bulk-buy program will become a regular and institutionalized practice to help lower medical costs for the general public. Chen said a fourth round of drug procurements is underway, with the move projected to lead to price cuts in May. "The long-term goal is to gradually cover a wider range of medications through national channels. Local authorities will be guided to target more high-demand and costly drugs as an additional boost to driving down pharmaceutical prices," he said. To ensure the program brings concrete benefits to the public, officials said more incentives will be rolled out to encourage medical workers to prescribe selected drugs on a priority basis.

Wang Xuetao, an official at the National Health Commission's department of drug policy and essential medicine, said that medical institutions are being encouraged to regularly and appropriately upgrade their budgetary systems to make use of amounts saved through the bulk-buy program. To make sure patients benefit from the new measures, he said, the use of selected drugs with price cuts will be taken into account when appraising the performance of hospital heads. Chen said a certain amount of the 100 billion yuan-plus savings has been reserved for medical institutions to allow them to increase incomes of health workers. "Some hospitals in Beijing have given more than 1 million yuan to medical workers as an incentive to choose centrally procured drugs for patients," he said.

The outcome of these incentives is evident as the use of drugs made by successful bidders has increased exponentially, Chen said. "The demand spike shows that the program has already expanded public access to medications," he added. (Source: China Daily)

January: Ordos announces free HPV vaccination program

Starting in 2021, Ordos city in the Inner Mongolia autonomous region is offering offer free vaccinations against human papilloma virus for female residents from ages 13 to 18, the local government said recently. Ordos became the first city in China to promote such a free vaccination policy. It covers all female residents between 13 and 18 with local household registry, and is designed to help prevent cervical cancer. Cervical cancer, which can be caused by HPV, is one of the most common tumor diseases for women in China and is highly fatal. According to the policy, girls will be offered two-valent HPV vaccines in appointed medical institutions and only need to pay for the cost of vaccine transportation, storage and disposal.

Last August, during a public well-being project launched by Juungar Banner in the city, nearly 10,000 girls from 13 to 18 in the region received free HPV vaccines. Over the past five years, the Ordos government has provided free cervical and breast cancer examinations for more than 190,000 women from 35 to 64. The local government has put over 30 million yuan ($4.67 million) into the project and will continue the free examinations for local female residents. (Source: National Health Commission)


December: China adds 119 drugs to reimbursement list

China has included 119 more kinds of drugs in its national medical insurance reimbursement list, delivering greater price cuts and benefiting more people, the National Healthcare Security Administration (NHSA) said at a press conference on Dec 28.

96 of the new additions to the list are exclusive drugs that offer lower prices through negotiation and 16 were newly put on the market this year, the NHSA said. Altogether, a record number of 162 drugs on the list were negotiated for price reduction. A deal was reached for 119 of the drugs, with their prices dropping an average of 50.64%.

The inclusions also helped expand the scope of reimbursement to cover more diseases including COVID-19. So far, all the medicines listed in China's latest diagnosis and treatment scheme for COVID-19 have been added to the reimbursement list, the NHSA said.

China currently has 2,800 kinds of medicines on the national reimbursement list, including 1,374 traditional Chinese patent medicines. (Source: Xinhua)

December: One in five Chinese suffer from high blood pressure

Hypertension, affects one in five Chinese people and kills more people than any other disease in the country, a leading cardiologist has warned. An estimated 300 million Chinese live with high blood pressure, with annual medical bills totaling 31.89 billion yuan (around 4.88 billion U.S. dollars), said Hu Shengshou, head of China's National Center for Cardiovascular Diseases. "The chronic condition has become a leading cause of death and disability in China," he said at a national conference on hypertension prevention and control over the weekend.

A recent report on Chinese residents' chronic diseases and nutrition showed that the prevalence rates of hypertension, diabetes and high cholesterol among Chinese aged 18 and above have respectively climbed to 27.5%, 11.9% and 8.2%. China plans to launch a pilot program in its communities in January to synergize the fights against high blood pressure, high blood sugar and hyperlipidemia, aiming to improve the management, treatment and control of the conditions. The program is expected to cover 200,000 people and expand to 34 districts and counties by 2022, said Cai Jun, the official in charge of the program. (Source: Xinhua)

December: Drug offers new way to limit spread of HIV

The market launch of a drug that prevents HIV infection, the first of its kind in China, will contribute to the fight against the AIDS disease the virus can cause. Users take a pill each day and must test negative for the virus before they start, according to the United States-based biopharmaceutical company Gilead Sciences, which is the developer of the drug Truvada.

While AIDS has become a preventable and controllable chronic disease with the development and popularization of treatment therapies during recent years, the number of new infections has been rising, experts said at the drug's market launch in China.

The Chinese Center for Disease Control and Prevention published annual data in late November that says 95% of new HIV infections were contracted through sexual activity. Experts believe such preventative medicine will help bring down the risk of infection among the high-risk groups. Wang Ning, an expert of infectious diseases with the national CDC, said the drug functions through limiting the replication of the virus in the human body and thus prevents individuals from becoming infected with HIV. "The efficacy of the prevention drug can reach 90 percent or above under good medication compliance," he said.

Zhang Fujie, director of the Clinical and Research Center of Infectious Diseases at Beijing Ditan Hospital Affiliated with the Capital Medical University, said the medication has addressed an area of unmet need in the field of HIV prevention medicine in the country. He also pointed out that the drug is not able to prevent other sexually transmitted diseases, and those among high-risk groups should take comprehensive strategies, including taking treatment medications, prevention drugs, and using condoms. "Recent surveys also showed that high-risk groups hoped that such preventative drugs can be available to them through the internet or homosexual communities, rather than designated hospitals. The parties involved will discuss methods to ultimately improve drug availability and compliance," Zhang said.

In total, 1.04 million AIDS infections had been reported in China by October, which means the infectious disease has been kept at a low epidemic level for several consecutive years, according to the National Health Commission. (Source: China Daily)

December: Premature mortality from chronic diseases drops in China, but challenges remain huge

The premature mortality rate from major chronic diseases has declined in China, but health challenges caused by the increasingly ageing population and unhealthy lifestyle remain tremendous, health officials and experts said on Dec 23.

The premature mortality rate among Chinese residents due to four major chronic diseases -- cardiovascular and cerebrovascular diseases, cancers, chronic respiratory diseases and diabetes -- was 16.5% in 2019, two percentage points lower than the 2015 figure, said Li Bin, vice-minister of the National Health Commission (NHC).

China has also seen a significant decrease in the loss of labor caused by such diseases, Li said at a press conference, citing the 2020 Report on Chinese Residents' Chronic Diseases and Nutrition. The report was based on the results of a national survey among nearly 600 million Chinese people between 2015 and 2019. The survey was organized by the NHC and carried out by the Chinese Center for Disease Control and Prevention, the National Cancer Center (NCC) and the National Center for Cardiovascular Diseases.

In 2019, 88.5% of all deaths were caused by chronic diseases, with deaths resulting from cardiovascular and cerebrovascular diseases, cancers and chronic respiratory diseases accounting for 80.7%, Li said, adding that the proportion of deaths caused by chronic diseases is expected to continue to rise. He noted that one of the challenges for chronic disease prevention and control is the unhealthy lifestyles of Chinese residents. Problems such as high levels of salt and oil in food, children and teenagers' frequent drinking of sugary beverages and insufficient physical activity are widespread.

Another challenge is obesity. With more than half of Chinese adults overweight or obese, the incidence rates of hypertension, diabetes, hypercholesterolemia, chronic obstructive pulmonary disease and cancer have increased from 2015.

But the good news is that the five-year cancer survival rate in China has risen from 30.9% to 40.5% over the past decade, an increase of nearly 10 percentage points, said He Jie, director of the NCC.

The NHC plans to work with relevant departments to promote the early and comprehensive prevention and control of chronic diseases, while raising public awareness of healthy lifestyles, said Li. (Source: Xinhua)

December: Depression prevalence rate in China reaches 2.1%

The prevalence rate of depression in China reached 2.1% last year, and that of anxiety disorders reached 4.98%, said an official with the National Health Commission (NHC) at a press conference on Dec 23.

The number of people with psychological problems and mental disorders in China is gradually increasing, said Chang Jile, head of the disease prevention and control bureau under the NHC, adding that the mental health problems of the public have become increasingly prominent. The country set up a national prevention and control center on mental health earlier this year to address related problems, said Chang. China will strengthen the education of professionals in related areas, increase mental health awareness among the public, and pay more attention to vulnerable groups of people, Chang noted. (Source: Xinhua)

December: China's centralized drug-procurement program provides cheaper medicines

Fifty-five types of medicine listed in China's third-round centralized drug-procurement program have become available in public hospitals across the country at much lower prices, the National Healthcare Security Administration said Thursday. The medicines, with an average price cut of 53%, include those widely prescribed for diabetes, high blood pressure, infections and cancers, the administration said.

China initiated a trial of the centralized drug procurement in 2019. Since then, three rounds of the procurement have covered 112 varieties of medicine, with their average price down 54%. Based on the reimbursement rate of 60%, the program is estimated to save 21.6 billion yuan (about 3.34 billion U.S. dollars) for public hospital patients and 32.3 billion yuan for the medical insurance fund annually, the administration said.

According to Prof. Hu Shanlian at the School of Public Health of Fudan University, the program will lead to reduction in prices of drugs not yet included in the program. This will have a ripple effect and could see pharmacies and private medical institutions lower drug prices, Hu said. More medicines with large demands and high prices are expected to be covered by the centralized drug-procurement program, Hu added. (Source: Xinhua)

December: More HIV infections found among elderly

Elderly people have become the group that saw the fastest growth in reported HIV infections in China, with a 500% increase in the number of newly reported HIV/AIDS cases among men aged 60 or above between 2010 and last year, the World Health Organization said on Tuesday, World AIDS Day.

Around 37,000 people aged 60 or above in China were diagnosed with HIV/AIDS last year-77% of them being men-accounting for 25% of the total number of reported new HIV cases, the WHO said. Unsafe sex was the major cause of HIV infections among elderly men, with 60% of them claiming to have got infected via commercial sex activities, and 30% saying they got infected via non-commercial sex, such as extramarital sex, the WHO said in a report.

In all, 150,000 people in China were diagnosed with HIV/AIDS last year, and the total reported number of people living with HIV/AIDS reached 960,000 by the end of last year, the WHO said.

Although the number of newly reported HIV/AIDS cases in China has been rising in recent years, the prevalence of HIV/AIDS in China remains at a low level, compared with most other countries, according to the National Health Commission. However, the infection rate among elderly people, especially elderly men, has increased at a much faster rate over the past 10 years compared with the general increase among the whole population.

Tao Lin, a researcher at Peking University's Sexology Research Center, said that compared with younger groups such as college students, the increase in HIV infections among elderly people has not received equal attention from the public. "Most elderly people who got infected with HIV are males, because in general males are more sexually active at an older age and tend to seek extramarital sex for satisfaction," he said. "Due to rising living standards, more elderly people have more money and free time, but some of them do not have adequate awareness of safe sex." Compared with young people, many retired people may show less restraint in their sexual behavior, which may make them more vulnerable to HIV infection, Tao said.

Xu Duo, an HIV/AIDS control and prevention campaigner in Pu'er, in Yunnan province, said the rising number of HIV/AIDS cases among elderly people is a reflection of inadequate psychological care from society. "Elderly people also have the right to seek happiness through sex, and the whole of society, including government, should provide more services, including sexual health education, for the growing number of elderly people, as China is rapidly becoming an aging society," she said. (Source: China Daily)

November: Project highlights risk of chronic obstructive pulmonary disease

More than a fifth of people in China may have a high risk of developing chronic obstructive pulmonary disease based on a national pilot project carried out over the past three years.

More than 1.5 million screenings for the disease have been conducted since the project was launched in November 2017, covering 28 cities in 24 provincial-level regions in China, Yang Ting, a respiratory disease doctor at Beijing's China-Japan Friendship Hospital, which led the project, said at a conference on the diagnosis and treatment of the disease on Wednesday.

Through the project, more than 26,000 people with the disease have received standardized management over the past three years, she said. Medical professionals also provided more than 1,600 training sessions to respiratory physicians working in grassroots medical institutions and helped improve their ability to provide diagnosis and treatment, she said.

The project will be expanded to cover more cities across China, and more research will be conducted over the next three years, including improving the identification of groups more prone to develop the disease and providing better follow-up services for patients, Yang said.

Chronic obstructive pulmonary disease is one of the most common chronic diseases in China, with about 100 million patients. However, a lack of proper medical equipment and qualified medical workers has hindered prevention and control of the disease at the grassroots level in China, she said. (Source: China Daily)

November: Hepatitis C program to standardize diagnosis and treatment kicks off in Beijing

A program to promote standardization of diagnosis and treatment of hepatitis C kicked off in Beijing recently, to help patients suffering from the infectious disease, which may cause liver cirrhosis, liver cancer and in some cases, death.

Unlike hepatitis B, awareness of hepatitis C among the public in China is low, so that a massive number of patients are not aware of their status. Their condition will deteriorate gradually and they may infect others, said Wang Guiqiang, head of the department of infectious diseases at Peking University First Hospital, at a news conference on Saturday.

The number of hepatitis C patients in China is estimated to be about 10 million, but only about 200,000 new cases are reported every year. That is because the virus will not cause obvious symptoms in its early stages, and many patients may live with it for two or three decades, until it's too late for treatment, he said.

The program, initiated by the Chinese Foundation for Hepatitis Prevention and Control, plans to establish an experts' guiding network and chronic hepatitis C diagnosis and treatment centers across the nation, optimize transfer treatment systems and enhance training of grassroots medical workers under a unified and scientific guideline. A total of 116 medical institutions — 15 central hospitals and 101 county-level hospitals — will participate in the program.

Wang added the disease is mainly transmitted by blood or body fluids, and screening should be strengthened among high-risk groups, including Chinese who received blood from donators or organ transplantation before 1992, and who had an abortion, eyebrow tattooing, ear piercing or a pedicure in unregulated institutions. He said most grassroots medical institutions became able to conduct nucleic acid testing during the fight against the COVID-19 pandemic, which will help with the diagnosis of hepatitis C at such facilities.

The World Health Organization proposed eliminating hepatitis C as a public health threat in 2030. Although there is no vaccine for hepatitis C, the disease can be treated by anti-virus drugs, experts said. Three drugs against hepatitis C have been enrolled in China's medical insurance list. (Source: China Daily)

November: Telemedicine expanded to rural areas

A policy document, issued by the Ministry of Industry and Information Technology and the National Health Commission on Nov 3, said the level of internet coverage at grassroots healthcare institutions will be raised by expanding the scale of broadband services and 4G networks in remote and impoverished areas. The coverage of 5G networks will be expanded to more healthcare institutions to offer better internet connectivity. The blueprint is the central government's latest move to promote telemedicine and bridge the urban-rural healthcare gap.

Last year, China's telemedicine network saw 21.72 million patient visits, and more than 24,000 medical institutions nationwide were connected to the network, according to the NHC. "The document is a key step toward the establishment of an ideal telemedicine system in China," said Cui Yong, vice-president of the China-Japan Friendship Hospital in Beijing and chairman of an expert panel at the department of dermatology at the National Telemedicine and Connected Health Center. He noted that the disparity in healthcare between hospitals in first-and second-tier cities and those at the grassroots has seen people flowing to big cities, leaving small hospitals with fewer patients. Cui added that the gap in the level of medical services between hospitals in different parts of the country could be reduced by telemedicine, which offers remote clinical services and exchanges between practitioners.

One of the major challenges facing the telemedicine system is a lack of application of new technologies, such as 5G and artificial intelligence, with technological levels also varying between hospitals. Those factors are the driving forces behind the document, he said. He highlighted the need for stronger guidance from the central government and the rolling out of more support policies to integrate telemedicine with the medical insurance system and cutting-edge technologies.

Meanwhile, as hospitals have developed a range of systems for telemedicine, it is important for authorities to push forward the restructuring and unification of such systems to boost connectivity between hospitals and improve efficiency, he said. "A nationally unified telemedicine system, a key step toward making the system more efficient and diagnoses more accurate, will help raise the level of trust and acceptance among patients," he added.

Cui gave the example of the China-Japan Friendship Hospital, which undertakes functions for the National Telemedicine and Connected Health Center. It provided long-distance diagnoses for severe COVID-19 cases in Wuhan, capital of Hubei province, earlier this year and played a key role in patients' treatment and recovery. The document also pledged to fully utilize new-generation information technology to improve access to healthcare in poor areas and help impoverished groups.

Diagnostic services

The government will extend telemedicine coverage to all poor counties, connect long-distance diagnostic services to villages equipped to handle them and offer individuals and households access to online lessons about basic healthcare and home management of chronic disease, it added. Wang Hang, founder and CEO of Haodf, one of China's largest online healthcare companies, said telemedicine has made the services of high-ranking clinicians much more accessible to rural residents and helped reduce their healthcare costs.

Local authorities have employed Wang's company to provide telemedicine services to residents in the country's western areas, including the Ningxia Hui autonomous region. He noted that internet access is still lacking in some rural areas and many residents do not own smartphones, while awareness of the help available through telemedicine systems is low. These are major obstacles to the promotion of telemedicine in remote areas. "It is important to extend the reach of telemedicine so people in the rural areas can understand that the services are helpful. Only in this way can we gain more people's trust and promote the development of such services at the grassroots level," Wang said. (Source: China Daily)

November: Multinational enterprises ink flurry of agreements

Multinational pharmaceutical companies at the ongoing third China International Import Expo are signing a flurry of collaboration agreements with Chinese digital health giants as part of their efforts to ride the country's smart medical development wave. Some of these collaborations are designed to provide full-cycle digital healthcare solutions for patients with multiple types of chronic diseases during the diagnosis, treatment and long-term disease management process, while others are intended to create innovative models of getting vaccinations.

Novartis Oncology, a unit of Swiss healthcare major Novartis, Servier China, a unit of the French pharmaceutical company Servier, and Pfizer, a US-based multinational pharmaceutical firm, inked collaboration agreements with Alibaba Health, a unit of e-commerce giant Alibaba, at the CIIE over the weekend. The United States-based Bristol-Myers Squibb also signed a collaboration agreement with JD Health to establish a comprehensive, technology-driven platform for liver disease patients, from early diagnosis to long-term disease management.

The strategic cooperation between Novartis Oncology and Alibaba Health is aimed to build an innovative digital healthcare model that combines the former's strength in precision medicine and the latter's in digital technology, providing patient-centric, one-stop services to cancer patients from online prescription, online drug purchase, medication compliance and payment, said Novartis Oncology officials.

"With shared vision and goals, we hope our strategic partnership will enable more convenient access to high-quality medical services for cancer patients through digital solutions, thereby improving their quality of life and alleviating the disease burden," said Zhu Shunyan, chairman and CEO of Alibaba Health.

Servier China hopes to rely on the Alibaba Health Pharmacy Platform to carry out online education about chronic diseases to improve awareness about diseases and standard treatment, and to rely on Alibaba Health Online Hospital for follow-up medical services through the internet. The company said that in the next three years, both sides will continue to optimize processes and replicate online education and treatment programs for chronic diseases to more disease areas. The partnership may also explore e-commerce models, including debuting a therapy through the internet, to deliver medical products to a wider range of patients.

Pfizer's cooperation with Alibaba Health focuses on building complete and full-chain vaccination service online. Pfizer will use the Alibaba Health platform to publicize information about vaccines and promote online closed-loop services. This includes education, consultation and making an appointment, said Pfizer officials. (Source: China Daily)

November: Stent prices to fall at least 90%

Centralized procurement of coronary stents is expected to see prices in China fall by at least 90% and save patients billions of yuan a year. But while some have welcomed the move, others have expressed concerns it could affect product safety.

The bulk-buy program, launched at the start of this year, will benefit heart disease patients and promote the high-quality development of the medical device sector, the National Healthcare Security Administration said on Nov 5. It is expected to make coronary stents, once priced at more than 10,000 yuan (about $1,500) each, available to patients in Chinese hospitals for roughly 1,000 yuan for the treatment of coronary heart disease. It is estimated that the price reduction due to centralized purchasing will save patients some 10.9 billion yuan in related expenses a year.

The 10 varieties of coronary stents in the program are from eight enterprises in China and abroad that submitted successful bids. It is hoped that the average price hospitals pay for stents will fall from about 13,000 yuan to 700 yuan.

On China's popular WeChat social media platform, about 480,000 people had commented on the topic "coronary stents prices will fall" by Nov 6. The top-ranked news on the topic received more than 176,000 likes, with many people expressing strong support for the move. However, some questioned whether the stents would be safe and whether those produced by different winning brands would cause any adverse reactions.

"It is unbelievable that such a shocking price decline can be achieved," said Yang Guangfu, a heart disease patient who has paid nearly 40,000 yuan to have three stents placed in the past 10 years. "Although it's good for patients, I'm worried more about the stents' quality at such amazingly low prices."

A report by China Central Television on Nov 6 cited the National Healthcare Security Administration as confirming that all the winning bids had passed the country's quality tests, and that the quality of the stents could be traced to ensure their safety. The administration said 80 to 90% of the stents from different companies are interchangeable and capable of meeting 80% of demand. The other 20% differ due to the special size requirements of certain patients.

China has more than 330 million patients with heart diseases, according to a report by the National Center for Cardiovascular Diseases last year. It said the number of patients receiving percutaneous coronary intervention — which uses stents to open narrowed arteries that supply heart muscle with blood — soared dramatically from 230,000 in 2009 to more than 1 million last year.

The centralized procurement of coronary stents is part of government-led efforts to address inflated prices and other ills in the distribution of pricey medical supplies and a key link in deepening such reform. Stents from the eight winning bids cover mainstream products now commonly used in health institutions, with quantities accounting for more than 70% of the intended purchase volumes of such institutions.

Thanks to the bulk-buy program, the average price for the same products from the same enterprises has decreased by 93% compared with last year. The average price reduction for domestically made products is 92%, and it is 95% for imported products.

More than 2,400 health institutions across China have participated in the centralized procurement, including those who usually purchase more than 500 coronary stents a year. The first year of centralized procurement will see institutions purchase 1.07 million coronary stents, equivalent to 65% of their total purchase volumes last year. The coronary stents purchased during the first year of the centralized procurement program are expected to be made available to patients from the start of next year. (Source: China Daily)

October: China embraces internet hospitals, with 900 now operational

Internet-powered health services are playing an increasingly important role in China's health system, with 900 internet hospitals now operational in the country, Mao Qun'an, a department head at the National Health Commission, said Wednesday at a press conference on the reform and development of China's health sector during the 13th Five-Year Plan period (2016-2020).

Internet hospitals represent a new approach to outpatient service delivery, allowing patients to attend a local medical consultation facility and seek a consultation through the internet from a doctor based at a major urban hospital. A remote medical collaboration network has been put in place covering more than 24,000 prefecture-based health institutions across the country, Mao said.

Since the start of the COVID-19 epidemic, Chinese hospitals have rolled out a number of internet-based services, from sharing knowledge on virus control, health consultation and psychological counseling, to follow-up treatment for chronic diseases and drug delivery, he noted, adding that such services have met people's health needs well, while reducing the risks of infection caused by offline meetings. (source: Xinhua)

August: Eli Lilly, Pfizer, Merck among Big Pharma losers in China's latest round of procurement bidding

Several pharma giants—including Merck, Novartis, Eli Lilly and Pfizer—have just lost procurement deals in China under the country's new bidding system. The drugmakers lost out to domestic producers, which in some cases undercut prices for established medicines by more than 90%, according to Jiemian. Among the drugs to lose contracts were Eli Lilly schizophrenia medicine Zyprexa and Pfizer’s Viagra, the publication said.

This week's bidding in Shanghai was the third round under a procurement program launched in 2018 aimed at saving billions of dollars. On Thursday, domestic and global companies bid for contracts on 56 medicines.  Initially, the program focused on purchasing medicines for 11 cities in China. It has since expanded nationwide, threatening an important market for many Big Pharma players.  Companies such as AstraZeneca, Sanofi and Eli Lilly have managed to keep business under the aggressive procurement program, but they had to live with major discounts.

The latest results underscore that large pharma companies are making a “strategic retreat from some of their older drugs,” in China, ICBC International Research analyst Zhang Jialin said, as quoted by Bloomberg; instead, they’re focusing on growing market share for newer medicines.

It’s not a completely unforeseen shift, though. Pfizer’s established drugs business started showing a decline in China back in April 2019. At the time, Wolfe Research analyst Tim Anderson wondered whether the decline was the “canary in the coalmine” for the rest of the industry, which has been relying on the lucrative China market for revenue growth. (Source: Fierce Pharma)

August: China releases treatment guideline for advanced breast cancer

China has recently released a new guideline for the diagnosis and treatment of advanced-stage breast cancer, hoping to extend the survival time of patients.

Breast cancer has the highest incidence rate among women. At present, the five-year survival rate of breast cancer patients in the country has reached 83.2%, whereas that of advanced breast cancer patients only accounts for 20%. The complicated treatment calls for urgently improving diagnosis and treatment standards, especially to narrow the gap between different regions of the country, said Ma Fei, an expert with the National Cancer Center. Ma, also a professor at the Cancer Hospital of the Chinese Academy of Medical Sciences, explained that about 20 percent of HR-positive breast cancer patients in China never receive endocrine therapy, an essential treatment for this cancer, even in its advanced stage. It is not a standard practice based on due procedures, Ma added.

The new guideline has combined the latest international and domestic research to update the 2018 version of expert consensus. It is more in line with the needs of clinical practice and lays a foundation for the standardization of diagnosis and treatment of advanced breast cancer. The fresh guideline is jointly compiled by the national cancer diagnosis and treatment-quality control center and the China Anti-Cancer Association. Treatment protocols for a variety of breast cancers have also been updated, including inoperable locally advanced breast cancer, HR-positive/HER2-negative advanced breast cancer, HER2-positive advanced breast cancer, hereditary breast cancer and advanced male breast cancer.

In the new guideline, CDK4/6 inhibitors combined with endocrine drugs are recommended as the first-line treatment for HR-positive/HER2-negative advanced breast cancer, said Xu Binghe with the Cancer Hospital. Xu added that the new guideline offers suggestions for the second-line treatment in accordance with the progress in targeted therapies in recent years and drug accessibility in China. Compared with the previous version, the new guideline defines the order of priorities of the first-line and second-line treatments and their recommendation levels, enabling doctors to choose a more appropriate treatment for patients, Xu said.

Besides, new anti-HER2 drugs from the past two years, including the country's own innovative medicines, are added into the guideline for the treatment of HER2-positive advanced breast cancer. In recent years, China has been striving to accelerate the registration and approval of both foreign and domestically-developed cancer drugs. Several innovative breast cancer drugs have been approved successively. In June, a locally-developed injection for metastatic HER2-positive breast cancer patients, named inetetamab, was approved for clinical use. After 12 days, several Chinese cities, including Beijing, saw their first prescriptions of the drug. Considering the speed of approval of new drugs, the guideline fully takes into account drug accessibility, Xu said. It includes drugs already available in the market and those having the potential to enter the market in the next one to two years, Xu added.

The new guideline also stresses multidisciplinary treatment, Ma noted, adding that it offers separate treatment suggestions for problems encountered by advanced cancer patients, such as bone metastases and brain metastases. The experts will now look to introduce and popularize the new guideline in the country's 200 pilot hospitals, and then expand it to the local hospitals so as to standardize the treatment of advanced breast cancer at the grassroots level, Ma added. (Source: Xinhua)

August: 8 hospitals in Beijing launch online diagnoses and treatment

Eight hospitals in Beijing have launched online diagnosis, treatment and drug delivery services to provide convenience to patients with chronic diseases and reduce the risks of cross infections from repeatedly visiting hospitals. The hospitals, including Xuanwu Hospital, Beijing Anzhen Hospital and Beijing Chaoyang Hospital, have begun internet diagnosis and treatment and home delivery of prescription medicine.

Patients can make an appointment after registering through the hospital app or mini-programs on WeChat, China's leading messaging service. The consultation sessions are held in video chatrooms, before doctors issue prescriptions, which are then transmitted to the hospital's prescription platform for review. After the review is completed, the prescription is forwarded to the hospital's pharmacist to issue a formal electronic prescription.

The National Health Commission issued a circular in May calling on hospitals to advance the development of online diagnosis and treatment as well as internet-based hospitals in efforts to ease the pressure of outpatients and help fight COVID-19. (Source: Xinhua)

July: China launches study on liver cancer in hepatitis B patients

A research project aimed at lowering the incidence of liver cancer among patients with hepatitis B was launched in China on Tuesday, which was World Hepatitis Day. The project, sponsored by the Chinese Foundation for Hepatitis Prevention and Control, will observe and study the five-year incidence of liver cancer among 20,000 chronic hepatitis B patients in 99 hospitals across the country. It aims to optimize the clinical treatment path of hepatitis B antiviral therapy and explore ways of reducing the incidence of liver cancer linked to hepatitis B.

"We hope long-term treatment and observation can answer questions that traditional clinical trials cannot, like what's the difference in liver cancer incidence between different therapies," said Zhang Wenhong, a leading expert working on the project.

According to data from 2019, primary liver cancer is the fourth most common malignant tumor and the second leading cause of death among all kinds of tumors in China. It is estimated that 85% of China's liver cancer patients have been infected with the hepatitis B virus.  (Source: Xinhua)

July: Imported shingles vaccine available in Beijing and Shanghai

An imported vaccine against shingles for people aged 50 and above has been available in Beijing and Shanghai from the beginning of this month, the Science and Technology Daily reported.

The vaccine, Shingrix, was developed by British pharmaceutical giant GlaxoSmithKline. China's National Medical Products Administration approved it for the market in May. It is on a list of 48 "clinically urgently needed new drugs" for fast-track approval by the administration and is currently the only recombinant shingles vaccine to hit China's market.

Shingles is caused by the varicella zoster virus. It is characterized by a painful rash with blisters that wrap around either side of the torso. "The disease also causes nerve pain, which can be more severe than labor pain or cancer pain. In some cases, it may lead to mental disorders and depression," said Xu Jinhua, a skin disease expert at Huashan Hospital in Shanghai.

Shingles affects nearly 3 million adults in China every year, with 1.56 million new cases. According to scientists, people over 50 are at higher risk of shingles. With limited therapies available, vaccination is the most effective way to contain the viral disease. The newly-available vaccine requires two shots over two months.  (Source: Xinhua)

July: Home-developed breast cancer drug first prescribed in China

Chinese doctors have given their patients the first sheets of prescriptions of a new, home-developed breast cancer drug.

In Beijing, Inetetamab, a targeted injection drug for metastatic HER2-positive breast cancer patients, was first prescribed in the cancer hospital of the Chinese Academy of Medical Sciences on Wednesday, 12 days after the drug was approved for clinical use. Meanwhile, Jiangsu, Anhui, Shandong, and Zhejiang provinces also witnessed their first prescriptions of the drug, given at local medical institutions. Developed by Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd., a subsidiary of 3SBio, inetetamab was approved for clinical use by the National Medical Products Administration on June 19.

In recent years, China has been striving to speed up the registration and approval of both foreign and home-made new cancer drugs, and to promote the replacement of imported drugs that are costly, but urgently and essentially needed with domestic ones. According to a report released by the National Cancer Center in 2019, breast cancer is the cancer with the highest incidence rate among women. In 2015, the number of new breast cancer cases in China reached 304,000, of which 20 to 25% were HER2-positive patients. HER2, or human epidermal growth factor receptor 2, is a type of protein in the breast tissue, helping to control breast cells dividing, growing, and repairing. When the HER2 gene is abnormal, it encourages the rapid growth of cancer cells. The HER2-positive breast cancer tends to grow faster, spreads more easily, and is more likely to recur.

Earlier studies show that inetetamab has a stronger effect on antibody-dependent cell-mediated cytotoxicity (ADCC). ADCC is an immune response, in which antibodies, by coating target tumor cells, make them vulnerable to attacks from immune cells. The new drug has broken the monopoly on the anti-HER2 monoclonal antibody by imported drugs, and brought more choices to breast cancer patients, said Lou Jing, chairman of 3SBio. (Source: Xinhua)

June: Life expectancy of Chinese rises to 77.3 years

The average life expectancy of Chinese citizens rose from 77 years in 2018 to 77.3 years in 2019, according to statistics released by the Chinese National Health Commission on June 6.

China saw a falling maternal mortality rate which dropped from 18.3 per 100,000 in 2018 to 17.8 per 100,000 in 2019, said the commission in an annual communique on China's health development. The infant mortality rate decreased from 6.1 per 1,000 in 2018 to 5.6 per 1,000 in 2019, the commission noted.

According to the communique, more medical care services are available across the country. By the end of 2019, the total number of healthcare institutions nationwide reached 1.01 million, providing over 8.8 million beds for patients. Compared with the previous year, there were 1,345 more hospitals and 10,751 more community-level healthcare institutions in 2019, it added.

By the end of 2019, the number of medical professionals in China had totaled nearly 13 million, an increase of 5.1 percent year-on-year, it noted. (Source: Xinhua)

June: China approves new self-developed cancer drug zanubrutinib

China has granted market access to a self-developed cancer drug, according to the National Medical Products Administration. The drug, known as Brukinsa (zanubrutinib) in capsule form, was developed by the biotechnology company BeiGene. It is for the treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy, and also for adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

The drug was approved through a priority review procedure and its marketing authorization holder should continue with the confirmatory clinical trials, according to the administration. The approval of the drug will provide an important treatment option for Chinese patients with lymphoma.

Wu Xiaobin, president of BeiGene said the development of the drug has taken more than eight years and around 25 clinical trials have been carried out in more than 20 countries, involving more than 500 international clinical experts. More than 1,700 patients have joined the clinical trials globally. The approval of the drug also underlines China's progress in developing innovative drugs, Wu said.

In November last year, the drug received approval from the U.S. Food and Drug Administration as a treatment for MCL in adult patients who have received at least one prior therapy.

Wang Zhiwei, vice president of BeiGene said the company's production line in the city of Suzhou, east China's Jiangsu Province has an annual output of 100 million capsules, which can ensure the demand of the domestic market as well as the international market. (Source: Xinhua)

May: China sees higher rate of premarital health checkups

More than 61% of Chinese newlywed couples went for premarital health checkups in 2018, significantly higher than the figure of 2.7% in 2004, said the National Health Commission (NHC).

Multiple measures have been taken in recent years, such as introducing relevant legislation, offering free premarital health checks, and setting up more institutions providing relevant services, to encourage more people to undergo such checkups, according to a document released by the NHC on May 19.

A total of 22 provincial-level regions are providing free premarital checkups for all newlyweds in their regions by incorporating the service into their government-backed public health service systems. More than 102 million people went for the checkups across the country between 2004 and 2018.

A total of 3,502 institutions and about 25,000 personnel have been approved to provide relevant services and a survey of 2,699 county-level maternal and child health care institutions in China showed that such checkups are available at over 86 percent of such sites.

Thanks to such check-ups, infectious and genetic diseases among relevant groups are better under control, said the NHC, adding that from 2004 to 2018, 8.73 million people have been diagnosed with certain diseases during the checkups.

The incidence of fetus edema syndrome, a genetic disease, has decreased by over 90% in some provincial-level regions like South China's Guangdong and Guangxi. (Source: Xinhua)

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