China Medical News

News archive

2018

August: Cancer drug prices set to drop

Pharmaceutical companies are taking positive steps to reduce prices of cancer drugs in response to tariff exemptions and value added tax reductions to improve access to medicines and reduce the financial burden on patients. China removed import tariffs on cancer drugs from May 1 and lowered VAT from May 3. According to Voice of China, it is estimated that the moves will save patients about 1,000 yuan ($145) a year on average.

On July 25, domestic pharmaceutical enterprise Betta Pharmaceuticals Co Ltd announced that it has reached an agreement with the Ministry of Human Resources and Social Security to lower the price of its product, which combats lung cancer, from 1,399 yuan to 1,345.05 yuan per box.

"The nation has been promoting price cuts of anti-cancer drugs to make drugs more accessible and affordable to the public," Rong Di, deputy director of the Department of Pharmaceuticals at the China Chamber of Commerce for Import& Export of Medicines & Health Products, said during an interview with Securities Daily. "Enterprises - both foreign and domestic - have lowered the prices of products to answer the call from the government. Meanwhile, it is also part of the companies' development strategies."

Xian Janssen Pharmaceutical Ltd, one of the Janssen Pharmaceutical Companies of Johnson & Johnson, said it will cooperate with central and local authorities to adjust the prices of some of its innovative medicines in China, in response to the State Council's tariff exemption and VAT reduction policies. "We welcome and support the positive steps taken by the Chinese government to accelerate patients' access to innovative oncology medicines. Our commitment is to ensure cancer patients receive timely access to our treatments and we continue to work with external stakeholders to explore innovative solutions to improve access of those patients most in need," a company spokesperson told China Daily.

Regions in China are also actively responding to the nation's appeal. On July 30, the Health and Family Planning Commission of Hunan Province published a notice stating that enterprises are encouraged to actively submit applications for price adjustments of imported anti-cancer drugs. "Price cuts cannot be lower than the tariff cut," the notice said.

Guangdong Medicine Exchange also issued a guideline to urge pharmaceutical enterprises to submit declarations of anti-cancer drug prices, covering 646 types of medicine, among which 84 are imported.

To date, 15 provincial regions, including Shaanxi, Jiangxi, Hainan, Henan, have joined the action. (Source: China Daily)

August: China develops new diagnostic method for coronary heart disease

Chinese scientists have developed a new diagnostic method for coronary heart disease which has a 33% higher accuracy rate compared with conventional methods.

Developed by Shanghai Jiaotong University, the new technology is called Quantitative Flow Ratio (QFR) measurement system and has been approved by the China Food and Drug Administration.

A coronary angiography is the most conventional diagnostic method of coronary heart disease in China. However, the internationally recognized high-precision assessment technology is expensive and requires complex surgical procedures, which have not been popularized in China. Based on the computational analysis of an X-ray coronary angiography image, the system obtains the QFR, which can help identify coronary heart disease. The new method does not require additional surgeries or drugs.

A clinical study led by Fuwai Hospital of the Chinese Academy of Medical Sciences showed that the new method could assess coronary function within four minutes, and had a 33% higher accuracy rate compared with a coronary angiography.

"The new method will assist doctors in identifying coronary heart disease and assist in making treatment plans, such as whether the patient needs a heart stent implantation", said an expert from Shanghai Jiaotong University.

According to statistics from the National Cardiovascular Center, there were 290 million cardiovascular patients in China in 2017, including 11 million patients with coronary heart disease. (Source: Xinhua)

August: China to include more cancer drugs on medical insurance list

China will make more cancer drugs affordable, as a new round of negotiations between the country's state medical insurance administration and pharmaceutical companies to add such drugs to the medical insurance list is scheduled to finish by the end of September.

The administration said it has selected a range of drugs to be added and is confirming the producers' willingness to further negotiate. All of these drugs are of great clinical value and will bring huge benefits to patients with different blood cancers or solid tumors, including colorectal cancer, renal cell carcinoma, lymphoma, and chronic myelogenous leukemia, said the administration.

China has exempted import tariffs from all common drugs including cancer drugs, cancer alkaloid-based drugs, and imported traditional Chinese medicine since May 1.

Based on the new policy, 12 pharmaceutical companies have recalculated the prices of their products and will submit applications for price adjustments on the requirement of the administration.

A negotiation launched in 2017 has lowered the prices of 15 clinically-effective yet highly-priced cancer drugs such as Heceptin, Rituximab, and Bortezomib, as well as added them to the medical insurance reimbursement list. Prices of some medicines have dropped remarkably. In Hunan Province, the price of each vial of Herceptin decreased from 17,600 yuan to 7,600 yuan, and the price of each vial of Fulvestrant, also used to treat breast cancer, dropped from 11,500 yuan to 4,800 yuan.

The newly-formed State Medical Insurance Administration said it would further cut the price of cancer drugs on the list via public bidding and procurement. (Source: Xinhua)

August: China targets 45 drugs for priority approval

Aiming to speed new drugs to market, China just came up with a target list of 48 treatments greenlighted abroad, including some of the industry's biggest names. Some key new drugs are on this list, including Roche and Chugai’s ALK cancer drug Alecensa, psoriasis therapies Taltz by Eli Lilly and Cosentyx from Novartis, and Takeda’s anti-inflammatory treatment Entyvio. Even a few drugs just approved in the U.S. last year were ID'd as targets, including GlaxoSmithKline’s shingles vaccine Shingrix, Spark Therapeutics’ eye therapy Luxturna and Ultragenyx’s Mepsevii.

The list of "clinically urgently needed new drugs" was developed by experts convened by China’s State Drug Administration. The group mainly considered medications already approved in the U.S., EU and Japan, but not yet marketed in China. According to the agency’s Center for Drug Evaluation, the country is in urgent need of these drugs to fight rare diseases or life-threatening conditions, because no effective treatment exists in China or because they've shown clear advantages in clinical studies.

Some of the drugs on the list are already on their way to the Chinese market. Merck’s PD-1 star Keytruda, for example, was just waved through a few days ago to treat advanced melanoma patients. AstraZeneca, for one, has filed its PARP inhibitor Lynparza for approval. As for the others yet to make a bid for approval, the agency says drug developers can apply using foreign data and evidence that supports no racial or ethnic differences in efficacy or safety. Once accepted, their new drug applications will be put under priority review.

China has taken major steps to speed up its drug review process and reduce its backlog of applications. Lynparza, for example, was the first drug to be filed using data from multicenter trials that included China sites, without the usual application to waive a China-specific clinical trial. Keytruda was approved under an accelerated approval process.

The country’s drug regulator also started offering conditional marketing authorizations. Merck’s HPV vaccine Gardasil 9 was handed a conditional nod in May based on foreign clinical data. It took the agency only nine days to make the decision. (Source: FiercePharma)

July: China to complete standardizing urban, rural medical insurance by 2019

A unified national medical insurance service, from which both urban and rural residents enjoy equal benefits, will be in place by 2019, said the State Medical Insurance Administration on July 25.

In a notice jointly issued by the ministries of Finance, Human Resources and Social Security, the National Health Commission and the administration, local governments that have not started such service were urged to seize the moment and prepare themselves to put it into operation as soon as possible.

Rural residents in China used to have a medical insurance scheme with far inferior to their urban counterparts. The government started to standardize rural and urban schemes in 2017.

Each citizen receives the minimum 490 yuan (about $72) from the government in his or her medical insurance account a year on average and is required to deposit 220 yuan from his or her pocket.  Both figures are 40 yuan higher than 2017. (Source: Xinhua)

July: China's air pollution control brings health benefits

China's action plan on air pollution prevention and control has generated great health benefits, according to a recent research. China issued the Air Pollution Prevention and Control Action Plan in 2013 and accomplished all the major tasks set out in the action plan last year.

Researchers from Peking University's School of Public Health analyzed national air quality monitoring and mortality data to estimate the health impact of air pollution control in 74 Chinese cities from 2013 to 2017.

The result showed that annual average concentrations of PM2.5, PM 10 and sulfur dioxide dropped by 33.3%, 27.8%, and 54.1%, respectively, in the 74 cities between 2013 and 2017. In 2017, there were 47,000 fewer deaths and 710,000 fewer years of life lost attributable to air pollution in the 74 cities than those in 2013, a substantial improvement for public health.

China released a three-year action plan on air pollution control in July, solidifying a timetable and roadmap for improving air quality. According to the plan, China's air quality and people's satisfaction with it should significantly improve over the next three years. (Source: Xinhua)

July: Top Chinese rabies vaccine maker ordered to stop production over forged data

China’s drug regulator just pulled a manufacturing permit for the country’s second-largest maker of rabies vaccines over data falsification, marking the latest episode in China’s drug safety scandal.

During an inspection, China’s State Drug Administration found Changchun Changsheng Life Sciences forged production records for its Vero cell-based rabies vaccines. The agency immediately moved to revoke the company’s GMP license tied to the vaccine—just three months after its issuance—and dispatched a team to investigate the incident on site.

In its announcement filed to Shenzhen Stock Exchange, the Changchun, China-based company said it has started recalling all unexpired rabies vaccines, even though the batches under question weren’t released to the market, and it hasn’t received any adverse event report related to the quality of the vaccines through years of monitoring.

The company claims to be China’s second-largest rabies vaccine supplier, having delivered 3.55 million courses of the five-dose-per-course freeze-dried vaccine in 2017, making up about a quarter of the market, according to the firm’s annual report.

Changsheng’s recent scandal comes eight months after a batch, or 252,600 doses, of its diphtheria/tetanus/pertussis (DTP) combo shot was found below the potency requirement. It also comes shortly after the company became one of the first two companies to get Chinese approvals for quadrivalent flu vaccines. Besides rabies, DTP and flu vaccines, Changsheng also sells vaccines against chickenpox, hepatitis A and group ACYW meningococcal. A small proportion of its business comes from abroad, including India, Cambodia, Egypt and Belarus, among others. It’s not yet clear whether it sells its rabies vaccines outside of China.

China has taken a hardball policy to safeguard vaccine safety after a high-profile scandal in 2016. At that time, a ring led by a mother and daughter team in Shangdong province was found to have illegally sold millions of dollars’ worth of vaccines across the country without following proper storage and distribution requirements. Vaccines made by some of the country’s top makers were involved, over 100 people have since been handed criminal sentences, over 300 government officials were removed or punished, and most importantly, it hurt the public’s confidence in Chinese-made vaccines.

After that, China banned middlemen in vaccine distribution, asking provincial CDCs to buy vaccines directly from manufacturers, and established a better vaccines tracing system. (Source: FiercePharma)

July: Beijing's life expectancy rises to 82.15 years

A paper released by the Beijing Municipal Government on July 11th said that the premature death rate for major chronic diseases of people aged between 30 ~ 70 was 10.8% in 2017, a decrease of 0.92% from 2016. The paper also said that the average life expectancy of Beijing residents rose to 82.15 years in 2017, more than five years higher than the national average.

The main cause of death was chronic non-communicable diseases. Tumors, heart disease and cerebrovascular disease were the top three, accounting for 71.7%. In 2017, the mortality rate for Beijing residents with tumors increased to 183.8 cases per 100,000 people, accounting for 26.9% of total deaths, up 3.6% from 2016.

A deputy director of Beijing's Center for Disease Control and Prevention, said the rise of chronic diseases was attributed to an aging population, and changes in environment and people's lifestyle, such as lack of exercise, unhealthy diets and obesity.

The paper also reported progress in establishing a hierarchical medical system, saving 6.74 billion yuan (about one billion U.S. dollars) in medical expenses. This year, the municipal government plans to promote a health assessment service in the city and provide fitness guidance for residents. (Source: China Plus)

June: Survival rate of liver transplant recipients rises in China

According to a press conference held by the National Health Commission on June 22, the five-year survival rate of liver transplant recipients in China rose from around 59% in 2014 to 71% in 2017.  The one-year survival rate and three-year survival rate of liver transplant recipients in China reached 84% and 75% respectively, on a par with the international standard, said Guo Yanhong, an official with the commission.

Guo said China conducted 4,732 liver transplant operations in 2017, up over 26% year on year. Among them, 4,138 came from donations after cardiac deaths. The current average waiting time for a liver transplant in China is 27.5 days, compared with 120 days needed in the United States, according to Guo. (Source: Xinhua)

June: Over 600,000 Chinese went overseas for medical treatment last year

Science and Technology Daily reported that over 600,000 Chinese people sought medical treatment overseas last year. Statistics show that 80% of those people were cancer patients.

Figures released at this year's Cancer Awareness Week show a 5-year survival rate of 30% for patients in China, while it can reach 70%-80% in developed countries.

While cancer diagnosis in China is still in its primary stage, its cancer treatment is just as good as that in the United States; and Chinese doctors are usually more experienced than their American counterparts, according to Sun Yan with the Chinese Academy of Engineering.  However Sun does admit that China is lagging behind the United States in drug research and development.

He Jie with the Academy says whether it's necessary to go abroad for medical treatment depends on the illness. Common cancers such as lung cancer can be treated in China with a comparable prognosis.

Zheng Shanhai from China's Meitan General Hospital published an article warning Chinese patients about the risks of going abroad for cancer treatment. Most of them seek the help of a third party due to language barriers and the agencies are usually not certified to provide such services. (Source: China Plus)

June: More than 450 million Chinese are myopic

More than 450 million Chinese suffer from myopia (nearsightedness), according to statistics made public on the first week of June. "The myopia rates are around 30% for primary school students, 60% for junior middle-school students, 80% for senior high middle-school students, and 90% for college students," said Long Qin, professor of the ophthalmology department of Peking Union Medical College Hospital, at a press conference held by the National Health Commission.

"The Chinese are suffering myopia at an earlier age with higher diopters, and the population of myopia sufferers keeps growing," said Wang Ningli, director of the ophthalmology department of Beijing Tongren Hospital, at the conference.

According to Jiao Yahui, an official with the commission, myopia has become an increasingly severe problem among children and a major public health issue. "Relevant departments released guidelines for myopia prevention in 2016, proposing requirements for lighting, desks and blackboards in classrooms, for students using computers and their daily study time," Jiao said. "Since 2016, relevant departments have been strengthening monitoring of the eyesight of students of different ages in some cities, and the scale of the monitoring will be expanded this year."

The commission Tuesday released a new guideline for preventing and curing myopia, offering guidance for medical institutions and personnel to enhance their service and help students and parents raise awareness of using their eyes correctly.  Noting that many people had undergone laser surgery for curing myopia, Long said the effect of the surgery was good, but advised patients not to take the surgery until they were 18 years old and only if their diopters remained stable for over two years. (Source: Xinhua)

June: Beijing's smoking population drops by 200,000

According to the municipal health authority in Beijing, the number of smokers in Beijing has dropped by about 200,000, three years after the city adopted its strictest tobacco control regulation. The city's commission for health improvement said that the adult smoking rate in Beijing is now 22.3%, or 3.99 million smokers, which is 200,000 less than the figure in 2015.

A total of 61 hospitals have opened smoking cessation clinics. The number of tobacco control volunteers has approached 15,000 citywide. About 1,600 departments and over 7,300 individuals were punished over violations of tobacco control regulations.  Medical establishments, schools and hotels have a relatively high compliance rate for smoking control regulations, while small restaurants, office buildings and entertainment venues continue to pose difficulties for the regulators. (Source: Xinhua)

May: China overtakes U.S. for healthy lifespan: WHO data

China has overtaken the United States in healthy life expectancy at birth for the first time, according to World Health Organization data. Chinese newborns can look forward to 68.7 years of healthy life ahead of them, compared with 68.5 years for American babies, the data - which relates to 2016 - showed. American newborns can still expect to live longer overall - 78.5 years compared to China’s 76.4 - but the last 10 years of American lives are not expected to be healthy.

“The lost years of good health that are a factor in calculating healthy life expectancy at birth are lower for China, Japan, Korea and some other high income Asian countries than for high income ‘Western’ countries,” said WHO spokeswoman Alison Clements-Hunt.

The United States was one of only five countries, along with Somalia, Afghanistan, Georgia and Saint Vincent and the Grenadines, where healthy life expectancy at birth fell in 2016, according to a Reuters analysis of the WHO data, which was published without year-on-year comparisons in mid-May.

The best outlook was for Singaporean babies, who can count on 76.2 years of health on average, followed by those in Japan, Spain and Switzerland. The United States came 40th in the global rankings, while China was 37th. In terms of overall life expectancy China is also catching up with the United States, which Reuters calculations suggest it is on course to overtake around 2027.

“Chinese life expectancy has increased substantially and is now higher than for some high-income countries,” said Clements-Hunt. Meanwhile U.S. life expectancy is falling, having peaked at 79 years in 2014, the first such reversal for many years, Clements-Hunt said. That reflected increasing rates of drug overdose deaths, mainly from opioids, suicides, and some other major causes among younger middle-aged Americans, particularly in less affluent areas, she said.

The world’s longest life expectancy is in Japan, at 84.2 years, meaning that babies born there in 2016 were the first to be able to look forward to seeing the next century. (Source: Reuters)

May: China to further cut import tariffs for daily consumer goods

Further to import tariffs on imported drugs being exempted from May 1st, the State Council decided that China will further cut import tariffs for daily consumer goods starting July 1.

The average tariff rate for detergents, cosmetics such as skin care and hair care products, and some medicine and health products will be cut from 8.4% to 2.9%.  The average tariff rate for clothing, shoes and hats, kitchenware, and sports and fitness supplies will be reduced from 15.9% to 7.1%, and that for home appliances such as washing machines and refrigerators from 20.5% to 8%.  The average tariff rate for cultured and fished aquatic products and processed food such as mineral water will be cut from 15.2 percent to 6.9 percent, according to a statement released after the meeting.

The cabinet called the tariff cuts a move conducive to expanding opening-up, meeting the demands of the people and boosting quality and industrial upgrading.

China will roll out a series of measures to create a fairer, more transparent, and easier investment environment for foreign-funded companies, including relaxing market access, enhancing investment facilitation, and better protecting legitimate interests of foreign investors, said the statement. (Source: Xinhua)

April: New domestic lung cancer medicine offers hope

Late-stage lung cancer patients who have built up a tolerance to some drugs may have new hope thanks to a domestically developed medicine, doctors from Shanghai Chest Hospital said on April 19.

Clinical trials showed that by using a small molecular, multi-targeted drug called anlotinib hydrochloride, the lives of lung cancer patients could be prolonged an average of 50% over patients receiving placebos. They survived another 3.3 months on average, said Han Baohui, who led the clinical trials that involved 437 patients at 34 health centers and hospitals nationwide.

Han is director of respiratory medicine at the hospital, which carries out some of the country's most advanced lung cancer diagnoses and treatments. The treatment, which inhibits the growth of tumors and the development of surrounding blood vessels, will be available to the general public this year, he said.

"One headache for doctors around the world is that there is no guide for how to prescribe medicines for late-stage patients who build up tolerance to various medicines after taking them for long periods," Han said, adding that most doctors prescribe based on what's worked for them in the past. The new treatment "may become a standard in our country as a viable prescription for these patients", he said, adding that the cost of taking the medicine is estimated at around 10,000 yuan ($1,600) per month.

According to China's National Cancer Center, 4.29 million new cancer patients are diagnosed in the country annually, with lung cancer ranked first among all cancers in both rate of occurrence and mortality. (Source: China Daily)

April: Nearly 100 million Chinese have chronic pulmonary disease

A national study has found that China has nearly 100 million people with chronic obstructive pulmonary disease (COPD). The findings made the respiratory condition among the country's biggest public health concerns, said the report.

According to the study published recently in the international medical journal The Lancet, 8.6% of nearly 51,000 participants 20 years or older had the disease, with the elderly and smokers at higher risk. More than 40% of smokers over 60 have COPD.

People with COPD are more likely to develop heart disease, lung cancer and many other health conditions. "The study further alerts us to the severity of COPD, an underestimated health threat here, and one that is expected to rise further due to the heavy smoking epidemic and aging trend," said Wang Chen, a top Chinese respiratory disease expert who leads the study.

Numbers from China's National Health Commission showed that COPD killed more than 870,000 Chinese in 2016, about 9% of disease-related deaths. (Source: Xinhua)

April: Pharmaceuticals made overseas will be exempt from import taxes, which will ease burden for China's patients

According to the statement released after an executive meeting of the State Council on Thursday (April 12th), from May 1, import tariffs on all common drugs including cancer drugs, cancer alkaloid-based drugs, and imported traditional Chinese medicine will be exempted. Also, value added tax in the production and import of drugs will drop by a large margin, which experts believe will be more effective in easing the economic burden of patients.

With various measures taken into consideration, it is estimated that the policies will lower the drug prices by at least 20%, said Shi Luwen, director of the international research center on medicine management at Peking University. The measures will significantly enhance the availability and inclusiveness of the drugs, reduce the burden of patients' families, and will help prevent poverty caused by illness, he said.

Statistics indicate that many cancer patients in China have been struggling to acquire cheap, quality medicine. According to the national cancer institute, the market for antineoplastic drugs in China exceeds 120 billion yuan ($19.1 billion). However, they are usually too expensive for working class families.

"We are speeding up in making high-quality generic drugs available in the market, but most of the targeted anticancer drugs were still imported," said Liu Lihong, a doctor at the Beijing Chaoyang Hospital. Another doctor at the hospital, Chen Wenming, said that despite social insurance, patients in Beijing still have to pay 20% of the total price of the drugs. The percentage is even higher in less developed areas.

For this, the State Council put forward a solution at the meeting, asking for the timely inclusion of imported new drugs in the range of medical insurance, especially urgent cancer drugs. In addition, the import procedures of new medicine will be streamlined, as importing enterprises will take charge of the examination of the drugs, instead of compulsory examination by authorities. "It will make it easier for patients to access the drugs in terms of timing," said Shi Luwen. "It also adds to the enterprises' responsibilities to ensure the quality and safety of the drugs, while saving their time."

As for the long term, experts are expecting higher capabilities of medical institutions on the grassroots level, and the balance of the share of drugs in different areas, so that urgent medicine including anticancer drugs can more efficiently and accurately benefit the people. "More measures will soon be implemented to make sure those in urgent need of medicine can get sufficient, quality and cheaper drugs in time," the National Health Commission said. (Source: Xinhua)

April: China pushes generics over brands with another round of new pharma policies

On April 3rd, the Chinese government issued a new policy package—including tax breaks—to promote generics. This would allow certain qualified generics makers to be designated as high-tech enterprises, a label that comes with a 15% corporate tax rate, compared to 25% for other companies. The policy also makes clear that China considers compulsory patent licensing a bona fide option during public health emergencies or shortages of key drugs.

The government's health department and recently rebranded drug regulator will compile and actively update a drug list that encourages companies to produce generic versions. That list will include medications for rare diseases, major infectious diseases and pediatric treatments, as well as important drugs that are running scarce.

Except in special circumstances, physicians will not be allowed to write brand names on prescriptions, and even if they do, pharmacists will have the right to change to qualified generics. The decree, issued by the country’s State Council, also says it intellectual property protections will be tweaked to “strike a balance between the interests of patent holders and the public,” and will strengthen anti-monopoly enforcement.

China’s patent infringement situation has been under fire from countries like the U.S., and it’s one of the reasons cited by the Trump administration as justification for its recently proposed $50 billion tariff against China. In its 2016 Top Markets Report, the International Trade Administration under the U.S. Department of Commerce noted that in China, a company cannot bring a patent infringement case against a violator until the disputed product is launched on the market. Injunctions are rarely granted in pharma patent cases, the report said, and damages awarded are usually too low to cover lost revenue.

China has been relying largely on generics. Of about 170,000 drug approvals issued by the China FDA, over 95% are generics, according to the country’s National Health Commission. But many generics in China are poorly made and much less effective than their originals. To eliminate those low-cost, low-quality copycats, CFDA is in the process of a generics bioequivalence evaluation campaign.

Under this newly released set of guidelines, the Chinese government is also pushing for broad use of generic names instead of branded names. Copycats that pass the quality equivalence test will be labeled with the same generic name as the brand in a procurement catalog hospitals use to purchase drugs. The generics will also be covered by national insurance under the same standards.

All of these policies will further compress the breathing room for innovative drugs—currently mostly produced by foreign pharmas—especially those that already have generics on the market. (Source: FiercePharma)

March: 50~60 million people suffer from sleep disorders in China

A China sleep medicine survey report and a 2018 China white paper on Internet users' sleep were published on March 17, just four days ahead of this year's World Sleep Day. According to these two reports, around 50-60 million people in China suffer from sleep disorders. The reports have attributed the results to heavy work pressure and the habits of using smart phones before bedtime.

The white paper shows that 56% of those surveyed believe they have sleeping problems, including dreaming a lot, having light sleep and feeling sleepy after getting out of bed in the morning. Young people are the most sleep deprived group, especially those who work in first-tier cities. Beijing youth are found to sleep the least, with less than seven hours daily on average.

With regards to the causes of sleeping problems, 70% of surveyed netizens say their sleep has been affected by stress from work. People working in the financial and service sectors, as well as government agencies have the poorest sleep quality, according to the white paper.

In addition, nearly 90% of Internet users have a habit of playing with their mobile phones before going to bed. Experts note that luminous screens, such as those on mobile phones and computers, can increase peoples' alertness and excitability, impacting the time of falling asleep.

Sleep disorders are a dangerous factor in causing dementia, while adequate sleep is helpful in protecting the brain, according to Ye Jingying, director of the Sleep Medicine Specialized Committee with Chinese Medical Doctor Association.

Only less than 2% of those with sleep disorders get proper medical treatment, and on average, there are only 5.8 hospital beds for every one million patients in China's developed regions, the survey says. "We are seeing a lack of medical capacity and professional staff," said Han Fang, chair of the Chinese Sleep Research Society. (Source: China Plus)

March: China to give more support to patients with rare diseases

China has launched a program aiming at helping patients with rare disease in diagnosis and treatment and offering financial support to those in need. "The cost of treatment and care throws a lot of families into poverty. But what is more desperate yet, is that people often simply don't know what took their loved one's life," said Wang Yiou, head of the Illness Challenge Foundation, who lives with brittle-bone disease. The program, which was launched Wednesday, will be sponsored by the Illness Challenge and China Social Assistance foundations. It will help with diagnosis and treatment of up to 100 diseases.

With its enormous population, disparate geography and socioeconomic inequalities, China faces considerable obstacles in improving care for patients. "Patients in remote areas like the northwest often suffer years of physical and mental torture and have to bear with misdiagnosis or delayed diagnosis before they know what's wrong," said Wang.

At present, Chinese patients with rare diseases have very few options in terms of treatment. "For most of them, there is no effective treatment and when there is, patients cannot afford it," said Wang.

China is still in the early stages of making policy on rare diseases. "Diagnosis and availability of drugs remain significant challenges," said Zhang Xue, a member of the committee for rare disease treatment and support with the National Health and Family Planning Commission.

Some progress in licensing drugs and increasing reimbursement has been made and the first national list of rare diseases will be published this year. According to the Medical Insurance Directory, China currently has 119 new drugs at various stages of licensing and registration, of which 49 are covered by national medical insurance. "The support program will bridge the gaps between individual patients, medical resources and insurance. We hope misdiagnosis and delayed diagnosis will become less frequent. Patients and their families deserve a good living and should know they are supported," said Wang.  (Source: Xinhua)

March: Chinese scientists develop DNA nanorobots to treat cancer

Chinese scientists said they have successfully created and tested the world's first autonomous DNA nanorobots to combat cancer tumors, paving the way for revolutionary cancer therapy.

Scientists from China's National Center for Nanoscience and Technology (NCNST) led the research and cooperated with scientists from Arizona State University in upgrading the design of the nanorobots. The scientific study was published in Nature Biotechnology in February.

A nanorobot refers to a designed system that can perform a specific task at nanoscale dimensions. According to researcher Ding Baoquan, the DNA-based nanorobot has a tube-shaped structure with a diameter of about 19 nanometers and a length of about 90 nanometers.

"The nanorobot is exceptionally small and impossible to see with naked eyes. It is about 5,000 times smaller than the tip of a needle," Ding said. It can travel through the bloodstream searching for tumors. Once it detects a tumor, it will release its load of thrombin directly into the tumor to cut off its blood supply and "starve" the tumor to death. As the DNA nanorobot is a natural biocompatible and biodegradable material, it is cleared out of the body after it has finished its task.

Nanotechnology has provided new opportunities for medical industry. The research was started five years ago, when NCNST researchers first looked at cutting off the tumor blood supply by using DNA-based nanocarriers. Ding said although the concept of nanorobots for medical use has previously been introduced and experiments conducted in test tubes, this is the first time that experiments have been completed on living organisms with sophisticated biological environments.

The research evaluated the nanorobots in mice with tumors. The DNA nanorobots were injected into mice, and the results showed significant tumor shrinkage and often, complete tumor regression, within days or weeks. According to scientist Zhao Yuliang, the research team also conducted extensive safety studies of the nanorobots in two different mammals, including the Bama miniature pig, which is physiologically and anatomically similar to humans.

"Unlike chemotherapy and radiation, the DNA nanorobots are able to treat tumors without harming surrounding healthy tissue. The nanorobots do not accumulate in the brain and thus, do not pose the risk of causing a stroke," Zhao said.

Nie Guangjun, also part of the research team, believes this is a milestone in cancer research, a field that has been striving for decades to develop effective therapies. "Our research shows that DNA-based nanocarriers have been shown to be an effective and safe cancer therapy," Nie said. "We are currently working with a biotech firm to do pre-clinical studies and hope to translate this revolutionary technology into a viable anti-tumor therapeutic," Nie added. (Source: Xinhua)

February: Health program helps 4 million patients pay bills

A national program to aid impoverished villagers affected by serious diseases has benefited more than 4.2 million people, according to data released on Feb 12th by a leading health authority. Over 4.9 million rural families left in dire straits due to crippling medical expenses had been lifted out of poverty as of October, 46% of the total number, data from the State Council Medical Reform Office show.

The program, launched in June 2016, targets villagers registered with local authorities as surviving on just $1 a day and provides preferential medical insurance policies and other relief measures.

On average, those eligible for the program paid only 19% of their medical bills last year, compared with 43% in 2016, Wang Hesheng, head of the office and vice-minister of the National Health and Family Planning Commission, said.

Of the 4.2 million patients who benefited, 420,000 were cured as a result of the assistance they received, according to Liu Kui, the commission's deputy director of finance. "The program is aimed at ensuring basic medical care for the impoverished rural population and ensuring the basic life needs of someone affected by a major disease," he said.

Serious diseases including stomach cancer, terminal kidney disease and child leukemia are covered by the program.

Losing the ability to work and high medical bills are among the leading causes of poverty in China. Nearly 20 million people were living below the poverty line due to illness in 2015, accounting for 44% of the registered impoverished population, according to the commission. Included in this figure were 7.3 million people with serious diseases.

Authorities say these patients now receive family doctor services and greater reimbursements on the cost of medicines. In some areas, hospitals offer treatments in advance of payment - counter to standard policy - to allow poor patients time to receive government subsidies toward the costs.

More measures to alleviate poverty through improved health services are expected in the next few years, such as additional medical insurance programs and improved training for doctors at grassroots clinics, Liu said. (Source: China Daily)

February: 97% of Chinese netizens use mobile Internet

An industry report says that 753 million Chinese netizens accessed the Internet using their mobile phones in 2017, accounting for 97.5% of China's online population, the Beijing News reports.

The number of Chinese netizens reached 772 million at the end of last year, up 5.6% year-on-year, according to a report on China's Internet development released Wednesday from the China Internet Network Information Center (CNNIC). As mobile phones become the most widely used device for accessing the Internet in China, fewer people use desktops, laptops, or tablet computers to get online, said the report.

The number of mobile payment users in China has been steadily increasing. Mobile payments are now used by 68.3% of the online population for purchases ranging from personal shopping, public transportation, and medical services, according to Wang Tao, an analyst with the CNNIC. (Source: China Plus)

January: Beijing saved 6.7 billion yuan on medical costs in 2017

The Beijing Municipal Commission of Health and Family Planning said on Jan. 28 that Beijing saved about 6.7 billion yuan (US$1.06 billion) on medical expenses since the separation of clinic from pharmacy in April 2017. As hierarchical medical care advances, the outpatient visits in large hospitals have decreased by over 10%, and 20% less patients are seeking appointments with experts. In the meantime, the outpatient visits have increased by 16% in community hospitals.

The recent report on the work of the municipal government highlighted the establishment of hierarchical medical system as this year’s primary task. Each district will build a compact medical treatment unit that strengthens primary medical care. Meanwhile, the reservation service will be improved to facilitate patients and crack down on scalpers. The Beijing Municipal government has also announced that, by 2020, it will provide at least three general medical practitioners and five rehabilitation nursing beds for every 10,000 residents, and help to raise the average life expectancy to 82.4 years old. By the end of 2017, a total of 251 community medical centers, or 75% of the total, had changed the payment method to paying after diagnosis and treatment, instead of paying upfront.

Since April 2017, more than 3,700 hospitals have eliminated the margins in sales on medication, according to the commission. The separation of clinic from pharmacy has propelled the establishment of hierarchical medical care, rendering 12% and 3% less outpatient/emergency visits to tertiary and secondary hospitals respectively, as well as 16% and 25% more visits to primary hospitals and community healthcare institutions respectively. The number of outpatient and emergency visits to medical experts has also decreased, making it easier for patients with real needs to make such appointments.

From Jan. 1, the city merged urban and rural medical insurance policies to become an integrated insurance policy for both urban and rural residents in Beijing. This expanded the number of medical institutions under insurance coverage to over 3,000. The hospital hierarchy is also helped by the new reimbursement system, which provides higher coverage for primary hospitals and below (55%) and lower coverage for secondary hospitals and above (50%). In addition, the new system standardized the insured categories of medication, medical service and medical facility for all the urban and rural residents, and expanded the types of medicine under coverage from 2,510 to more than 3,000. (Source: China.org)

January: China's gender imbalance reduces further in 2017

At the end of 2017, China had 32.66 million more males than females, down from 33.59 million at the end of 2016, according to the National Bureau of Statistics. The gender imbalance has continued to decline over the last five years, dropping by around 1.2 million annually, with the largest reduction seen in 2017, official data showed.

Chen Jian, deputy head with China Society of Economic Reform, attributed the improvement in China's gender balance to the introduction of the "second-child policy," which has helped reduce the number of selective abortions performed in regions where boys are preferred over girls.

About 17.23 million babies were born in 2017, of which 51% have an older sibling, according to the National Health and Family Planning Commission. However, the total number of births fell by about 630,000 compared with 2016 while percentage of the population aged over 60 rose from 16.7% in 2016 to 17.3% in 2017.

China should roll out more supportive policies to encourage couples to have children in order to help the country deal with the aging society issue, said James Liang, a professor with Beijing University.

The government could reduce taxes or offer subsidies for families to help cover the costs for raising multiple children, Liang suggested. (Source: Xinhua)

January: Another Chinese city admits 'fake' economic data

A northern industrial city in China said its 2017 fiscal revenue was significantly less than it had earlier estimated partly due to “fake” additions, making a revision just days after reports of similar incidents fueled scepticism over official data.

Baotou in China’s Inner Mongolia Autonomous Region revised its estimated fiscal revenue in 2017 lower by nearly 50% in an annual work report, a copy of which was published on the Baotou government’s website on Jan. 13. The Baotou city government said in the report that the revision was due to factors including “fake additions”. It did not say how the additions came about or who was responsible.

Days earlier, the governments of Inner Mongolia and Tianjin, a large port city in northern China, said their fiscal and economic numbers for 2016 had been overstated. “We have been trying to change our mindset and change the course of our development model,” the Baotou government said, while pledging to tame government borrowings in part by halting debt-burdened public projects. Baotou was forced to halt an ambitious subway construction project earlier last year as the central government questioned its ability to finance the debt.

Inner Mongolia cut its industrial output figure for 2016 by 40%, according to the official Xinhua news agency on Jan. 3. It also said fiscal revenue for that year ought to be 26% less than initially stated. It did not give details.

The 2016 gross domestic product of Tianjin’s Binhai New Area - an economic zone once touted to become China’s Manhattan - was actually about a third smaller than previously announced, according to a commentary in the official People’s Daily on Jan. 15.

The incidents of data fraud coincided with a campaign led by Beijing to crackdown on risky lending, aimed partly at curbing runaway local government debt. The People’s Daily said that while inflated data may look good on paper, it would lead to more stress in the less developed hinterland as it would cause the central government to reduce funding.

In January last year, the northeastern province of Liaoning said it had faked fiscal data from 2011 to 2014, becoming the first province to make such an admission. Chinese provinces and cities have long been suspected of cooking up numbers, with the focus on local government officials, whose performance are often assessed based on how well their respective economies have performed.

China’s top leaders signaled a shift in priority as the country strives to be more quality driven. In an agenda-setting Communist Party congress in October, President Xi Jinping said China has now entered a “new era” where the country will prize quality growth over quantity.

China is set to release its 2017 GDP data on Thursday. Premier Li Keqiang has signaled that GDP growth should be around 6.9%, accelerating from a 26-year low of 6.7% in 2016. (Source: Reuters)

January: 17.5% of patients in China use TCM

About 17.5% of all patients in China are treated with traditional Chinese medicine (TCM), the State Administration of Traditional Chinese Medicine said on Jan 15. As of September 2017, 20.4 million patients had been discharged from TCM hospitals, accounting for 15% of all discharged patients in the country, the administration said.

Currently, 67% of the town-level and community health centers have TCM units, totaling over 30,000. By September 2017, there were 45,800 TCM clinics across China. Wang Guoqiang, head of the administration, said TCM services are still unbalanced and relatively weak at the grassroots level. "The needs of the public for TCM cannot yet be met," Wang said. The administration plans to support medical institutions with specialties on TCM and build at least one public TCM hospital in each county. (Source: Xinhua)

January: Chinese researchers make breakthrough in lupus diagnosis

Chinese researchers have developed a new testing method for the diagnosis of lupus, which could improve the accuracy rate to over 90%. The new method uses DNA methylation detection to find lupus-specific information in genes, the first time researchers are able to elevate the diagnosis of lupus to the genetic level, according to Lu Qianjin, a professor with Central South University.

Lupus, technically known as systemic lupus erythematosus or SLE, is an autoimmune disorder that can damage joints, kidneys, hearts, lungs, brain and blood. It affects 1 million Chinese, and 40 to 70 of every 100,000 people worldwide.

"Early symptoms of lupus are often too general to be distinguishable, making accurate diagnosis difficult and depriving patients of timely treatment," Lu said. "The new method can accurately discriminate lupus from other dermatoses, with an accuracy rate of above 90%."

The breakthrough, made by Lu and his team after 20 years of research, was awarded at the National Science and Technology Award Conference in Beijing. The new testing method has been adopted by 23 hospitals in China, Lu said, adding that he had applied for patents for the technique both at home and abroad in hopes of benefiting more patients. (Source: Xinhua)

2017

December: More young people suffering from colorectal cancer in China

Chinese doctors said incidence of colorectal cancer has been rising among young white-collar workers due to unhealthy lifestyles and eating habits.

Colorectal cancer usually occurs in people around 60 in developed countries, but in China, the average age to contract the disease is 45, said Professor Kong Dalu from Tianjin Cancer Hospital. "The number of white collars under 30 diagnosed with colon cancer has been rising steadily in recent years, accounting for 10 percent of all inpatients of the disease," he said.

The disturbing rise is in part due to their sedentary lifestyle and an unhealthy diet, said Kong. China has seen a rapid improvement in living standards in recent decades, which results in a diet rich in fat, calories and protein but low in fiber. Oncologists recommend that young adults engage in regular physical activity, and stick to a diet rich of whole grains, vegetables and fruit and low in red and processed meats to prevent the disease. (Source: Xinhua)

December: System of family doctors developing

China's top health authority is standing by its statement that more than 500 million people had been assigned family doctors as of the end of November, despite a barrage of questions raised by netizens. The National Health and Family Planning Commission said on Wednesday (Dec. 20th) that the figure was based on data reported by local governments since May. It reiterated that the number of people who accessed family doctor services met the target for the year.

According to a circular from the commission in May last year, more than 30% of China's population was supposed to be covered by family doctors by the end of this year.  On Sunday, the commission said residents in more than 95% of China's cities can now access family doctors, with the total number exceeding 500 million people, more than 35% of the population. However, the announcement was met with disbelief by some netizens, who said the number was too high, Science and Technology Daily reported.

While the commission said on Wednesday that the number of people covered by family doctors had met the target, it added that coverage varies by area, and quality of service in general needs improvement.

A system of family doctors has been promoted nationwide since May and is in its infancy. Many difficulties exist, including a lack of general practitioners and customized grassroots services, the commission said. It said it will focus on improving family doctor services next year, so that residents are more satisfied with the services they receive. Measures include more intense training of healthcare workers at the grassroots.

Currently, family doctors comprise physicians mainly working at grassroots medical institutions, such as community health centers and village health facilities. It is expected that family doctors who serve as health gatekeepers for residents will help solve health challenges such as the increasing number of patients with chronic diseases and soaring medical costs resulting from too many patients going to big hospitals while grassroots medical institutions are ignored, the commission said.

Wang Xin, a family doctor at the Zhongliang Community Health Service Center in Beijing's Shunyi district, said that of all 1,200 residents in the community, about half have signed up with him, the sole family practitioner in the center. "The biggest difficulty in promoting family doctors in Beijing is lack of enough qualified doctors," Wang said. "In some areas a family doctor may not even have a bachelor's degree and cannot provide medical services; they can only provide public health services or prescribe drugs, so local residents lack trust and still prefer to go to big hospitals for treatment."

The number of people covered by family doctor services reached 7.6 million as of May, accounting for 35% of permanent residents in Beijing, according to the city's health commission. Beijing residents can sign up with family doctors in their communities for free because of subsidies from the city government. (Source: China Daily)

December: New program launched to address poverty caused by illness

China launched a new program Friday to help address poverty caused by illness. The program, which will last until February, aims to use the slack farming season and the Spring Festival holiday when migrant workers return home, to figure out how many poor people have diseases and keep them updated with new policies, according to Xia Gengsheng from the State Council Leading Group Office of Poverty Alleviation and Development.

Xia said that more than 50% of impoverished residents in 10 Chinese provinces fell into poverty due to illnesses, at the end of 2016.

China aims to lift all people above the poverty line -- per capita annual income of 2,300 yuan (USD 348) -- in rural areas by 2020. Strong efforts have been made in helping the rural poor suffering from illnesses.

More than 4.2 million poor patients with serious or chronic diseases have been treated since last year. The family doctor system has expanded to include around 80% of those living under the poverty line.

Meanwhile, more than 900 top hospitals have dispatched doctors to over 1,000 hospitals in poor counties, and developed a network of distance health care. (Source: Xinhua)

December: Hospitals not responsible if families refuse to give consent

Hospitals will be exempted from responsibility if doctors perform emergency surgery before they are able to secure consent from patients’ relatives.

The ruling, issued by the Supreme People’s Court on Wednesday (13th), clarifies responsibilities of hospitals when they have to perform medical emergencies but do not have agreements from patients’ families.

Doctors often face this dilemma when they are not able to find patients' families or the relatives do not reach an agreement or refuse to sign before the hospital starts the procedure. But after the surgery, sometimes families disagree and demand the doctors to pay, an official with the national top court’s research office said in a statement.

Now doctors can perform emergency treatment after securing approval from the person in charge of the hospital, the court said. “The courts will support the doctors and the hospitals will not have to compensate under this ruling,” said the official, whose name was not disclosed.

“The move is to encourage doctors to save patients in emergency and consider rescue as the priority.” But if hospitals neglect or are late to take medical actions, they will be held responsible and would have to pay compensation , the ruling added.

The interpretation, which will come into effect on Thursday, can also help regulate hospitals as they handle emergencies, the official added. (Source: China Daily)

December: China's clinical illness insurance covers 1 billion people

China's critical illness insurance (大病医保) now covers more than one billion people, according to the National Health and Family Planning Commission.

Improving the system of critical illness insurance has been a major task for the health sector during the 13th Five Year Plan period (2016-2020). While expanding the coverage of the insurance to all urban and rural residents, health authorities also lowered the threshold for payment by insurers, raised the ratio of payment by insurers and expanded the scope of services covered by insurance.

Wang Hesheng, vice head of the commission, said that insurance for critical illnesses now covers more than 50% of patients' medical costs, and in some rural areas a basic medical insurance system for the impoverished covers 80 to 90% of medical fees. The commission said it would work to ensure families with low incomes, senior citizens, juveniles and those with severe disabilities or severe diseases will receive proper medical treatment. (Source: Xinhua)

December: China opens first mobile poisoning emergency center in Guizhou

China opened its first emergency mobile center for cases of poisoning in Guiyang, capital of southwestern China’s Guizhou province on Dec 6. The center is stationed at the Guizhou People's Hospital and is expected to increase the local capacity of dealing with emergent cases of poisoning.

The center in Guizhou will offer professional treatment, including on-the-spot surveys, tests, individual protection and medical security. Cases of poisoning emergencies in recent years from around the world will be analyzed to improve the training and exercise of health emergency staff.

During the 13th Five-Year Plan (2016-20), China will open 11 emergency mobile centers all around the country. (Source: National Health and Family Planning Commission)

December: Boom in HPV vaccinations shows Chinese women's growing health consciousness

Fan Lei, 32, cannot wait to get her first human papilloma virus (HPV) vaccine, after a fretful three-month wait. "I asked for leave immediately after the call from the community health service center," she said. The HPV vaccine Fan received in the city of Yinchuan in northwest China's Ningxia Hui Autonomous Region, was developed by U.S.- based Merck & Co, and approved by the China Food and Drug Administration to enter the market in May. The first batch reached Chinese consumers a month ago.

The introduction of the new vaccine came after a good response from Chinese women to GlaxoSmithKline's Cervarix, the first HPV vaccine licensed for use in China, earlier in the year. But Cervarix has an age cap of 25, while the Merck product is available for anyone from 20 to 45. "In fact, I intended to get the Cervarix vaccination, but was told I was too old," Fan told Xinhua.

The younger generation in China, especially middle-class women of Fan's age or younger, now have a much greater health consciousness. In just a month, the center Fan visited received more than 910 reservations for the new HPV vaccination, but only 280 vaccines were available, according to Gao Xiaoyan of the center.

The popularity of HPV vaccines in Yinchuan mirrors the strong demand nationwide. According to the report "Cancer Statistics in China 2015" published by CA: A Cancer Journal for Clinicians, more than 30,000 patients died of cervical cancers, and over 98,900 new cervical cancer cases were reported in China in 2015. In other words, three Chinese women were killed by cervical cancer every hour.

But cervical cancer, by far the most common HPV-related disease, can largely be prevented. According to the WHO, nearly all cases of cervical cancer, the fourth most frequent cancer in women, can be attributed to HPV. It can take 15 to 20 years for cervical cancer to develop in women with normal immune systems, and the symptoms tend to appear only after the cancer has reached an advanced stage, making it important to take precautions in advance.

The two HPV vaccines currently available on the market can protect against both HPV 16 and 18, which cause at least 70 percent of cervical cancers, according to the WHO. The vaccines may also offer cross-protection against other less common HPV types that cause cervical cancer. But for some time, HPV vaccines were not greenlit on the Chinese mainland due to safety concerns, and many had to travel to Hong Kong to get a shot.

A complete HPV vaccination requires three shots in six months, which meant patients had to travel to Hong Kong three times during this period, at high cost. "Some of my friends went to Hong Kong to get the vaccination, but it's too troublesome to go from Yinchuan. Now we have it at home, it's much easier," Fan said. Though one shot of the vaccine costs over 800 yuan (121 U.S. dollars), Fan and her friends believe it is worth the money. "It is pricey. But compared with the economic and mental burden of the disease, it is nothing," she said.

China is also developing its own HPV vaccine. Clinical testing of a second-generation HPV vaccine, led by the National Institute of Diagnostics and Vaccine Development in Infectious Diseases, was approved by the China Food and Drug Administration in late November. It is expected to enter the market in 2022.

"HPV vaccination can prevent most types of cervical cancer, but a regular health check is still necessary," said Zhou Liwei, vice chairman of the Center for Disease Prevention and Control in Ningxia. "Cervical cancer patients are getting younger. We should care more about our health through regular health checkups and proper vaccinations," Fan said. (Source: Xinhua)

December: Chinese-made ventricular assist device enters clinical testing

On Dec. 8th, several Chinese hospitals started a clinical test for a ventricular assist device (VAD), which is believed to be the first such test conducted on the Chinese mainland. A VAD is an electromechanical device for assisting cardiac circulation, which is used either to partially or completely replace the function of a failing heart. It is expected to benefit hundreds of thousands of Chinese patients with severe heart failure.

The VAD was developed by Chongqing Yongrenxin Medical Devices Co. Ltd., a Sino-Japanese joint venture. The device entered a period of clinical testing in Japan in 2005. In November, the Chongqing-based company officially obtained approval for the clinical test from the China Food and Drug Administration.

According to Hu Shengshou, president of Fuwai Hospital, heart failure caused more than 40% deaths due to diseases in China annually. Hu said that China has at least 600,000 patients with severe heart failure. However, due to a severe donor shortage, the country only conducts around 300 heart transplant surgeries each year.

VAD is known globally as one of the most effective measures to treat patients with severe heart failure. Domestically-made devices are not yet ready to be put into commercial use, while foreign-made devices are often unaffordable. The device will be put into use in 2018 after the clinical test concludes. (Source: Xinhua)

December: China’s elderly population to account for 40% of Asia’s total by 2050

China’s elderly population is estimated to hit 480 million by 2050, accounting for two-fifths of the total figure in Asia, said Zhu Yaoyin, vice-president of China National Committee on Aging on Dec 6.

China is currently the only country in the world with an elderly population of over 200 million, and that percentage is expected to increase by 24% from 2000 to 2050, twice that of the estimated world average, Zhu said.

In addition, Zhu noted, China has turned into an aging society as a developing economy, which constitutes a serious issue. As a result, the country is faced with a huge task, especially with ongoing urbanization and a low-birth rate trend.

Zhu promised that the country will further enhance the social security system and basic public services for senior citizens, and find solutions to tackle major difficulties. Meanwhile, the country will take measures based on comprehensive evaluations to improve the elderly care system, such as community-based and smart care services. (Source: People’s Daily Online)

December: Tuberculosis Diagnosis and Care in China: A Lesson for All

A new study provides data on the “know-do” and “policy-practice” gaps found in tuberculosis diagnosis and care across three levels of China’s health system.

Tuberculosis Diagnosis in China

In China, tuberculosis remains a high health burden and the rate of accurate tuberculosis diagnosis is low. There may be several factors influencing the low rate of diagnosis, particularly in rural areas. So far, health care research has focused on those already diagnosed, but research into those who are undiagnosed in rural areas remains scarce. Healthcare providers and policymakers need to understand the reasons for the low rate of diagnosis in urban areas in order to implement effective policies to eliminate TB.

In a recent study published in PLOS Medicine, researchers from the University of North Carolina trained and sent standardized “test” patients to present with classical TB symptoms for 274 healthcare providers at village clinics, township health centers, and county hospitals in China.

The results showed that the county hospitals managed the patients’ visits correctly 90% of the time, compared to only 38% in township health centers and 28% in village clinics.  While antibiotics were prescribed in 61% of the consultations, incorrect antibiotic use was high at all levels of care.  Only 28% of village doctors and 18% of township providers correctly referred the case onward.

 

The “Know-Do” Gap

Although patients presenting with symptoms typical of TB were generally not properly managed, the deficits were not due to a lack of provider knowledge.  These same doctors managed according to TB recommendations 81% of the time when these same symptoms were described in clinical vignettes.  In other words, the providers seemed to know the medical guidelines for TB management but, in practice, do not follow them.  This “know-do” gap can be seen in hospitals worldwide.

The “Policy-Practice” Gap

Although sputum testing is recommended for tuberculosis diagnosis, this study found that when the healthcare providers ordered tests, they were most likely to order chest X-rays. Despite the availability of sputum testing, their focus was to establish what might be wrong with these individuals who were unwell rather than on diagnosing TB.

Despite incorrect testing practices, their actions may not be indicative of poor medical care.  Primary healthcare providers may see several patients each week whose symptoms could be associated with TB, but could also be caused by a chest infection.  They may not want to worry patients unnecessarily or add to patient and/or clinic costs.  In understaffed centers, healthcare providers may practice under the assumption that individuals with persistent conditions such as TB will return to be seen again.

This study highlights that the elimination of tuberculosis should not rely upon the development of better tests or pills.  The disconnect between medical guidelines and medical practice, particularly in poorly resourced and rural areas, will require interventions targeting integrated healthcare training in real-world situations so that they feel empowered to properly diagnose and refer tuberculosis patients. (Written by Debra A. Kellen, PhD; Source: Medical News Bulletin)

November: Shanghai Pharma buys Cardinal Health China business

China's leading drug maker and distributor, Shanghai Pharmaceuticals Holding Co. Ltd., said Wednesday it will take over Cardinal Health Inc's China business. Shanghai Pharma's subsidiary Century Global and Cardinal Health's subsidiary Cardinal Health Cayman Islands Ltd. signed a contract Wednesday to buy the Cardinal Health Co., Ltd. for 557 million U.S.-dollar acquisition. Century Global thus holds Cardinal Health China business through the acquisition.

U.S. pharmaceutical distribution giant Cardinal Health Inc's China business is the eighth largest drug distributor in the country, with a network covering 322 Chinese cities. The acquisition will enable Shanghai Pharma to enter the market in Tianjin and Chongqing municipalities and Guizhou Province, expanding its distribution network to 24 provincial-level areas, and the company will become one of the biggest imported drugs agents in China, said Liu Dawei, board secretary of Shanghai Pharma. (Source: Xinhua)

November: China's TCM industry grows 20%

The traditional Chinese medicine (TCM) industry in China grew by 20% in the past year, according to the State Administration of Traditional Chinese Medicine (SATCM). The sector earned more than 860 billion yuan (about US$130 billion) last year, one third of the country's total medical industrial output, said Wang Guoqiang, head of the SATCM.

The Law on Traditional Chinese Medicine went into effect on July 1,to regulate and support the development of the industry. With a history of more than 2,000 years, TCM has unique theories and practices in herbal medicine, acupuncture, massage and dietetics. There are 482,000 TCM practitioners in China now. (Source: Xinhua)

October: China records increase in medical resources in 5 years

Li Bin, minister of the National Health and Family Planning Commission held a news conference on the sidelines of the 19th National Congress of the Communist Party of China on October 22nd, and said that the availability of medical resources in China has increased in the past five years, with people at grassroots having better access to healthcare facilities.

Li mentioned that by the end of last year, the number of medical institutions in China reached 980,000, and the number of health workers exceeded 11 million. She added that the number of registered physicians per 1,000 people in China reached 2.3 last year, compared with 1.8 five years ago, the number of registered nurses per 1,000 people in China reached 2.5 last year, compared with 1.5 five years ago, and the number of hospital beds for every 1,000 people reached 5.4 last year, compared with 3.6 five years ago.

Of all 7.9 billion diagnostic and treatment services provided by hospitals and clinics in China last year, more than 55% were provided by institutions at grassroots. And to help medical institutions at grassroots improve abilities, more than 6,800 public hospitals have established partnership with such institutions through internet to provide guidance and training, Li said.

To control medical expenditure, all public hospitals, the primary provider of healthcare services in China, banned price markup for the drugs they sold to patients at the end of September, a practice carried out for decades by many public hospitals as a major source of income, Li said. Besides drugs, fees for medical services and checkups and tests, such as CT scanning, were also reduced as part of the ongoing healthcare reform. For example, in Beijing, which abolished drug price markup in all the city's public hospitals in April, patients saved 4.4 billion yuan ($665 million) in medical expenditure between April and September, Li said. (Source: China Daily)

October: Better test developed in China to detect liver cancer

Scientists in China have identified DNA markers specific to liver cancer, which is expected to greatly improve accuracy in diagnosis of one of the most common cancers in China.

Using the new technology, doctors can provide a diagnosis and prognosis to patients with liver cancer through simple blood tests. That could decrease the chances of a misdiagnosis by more than half, according to Xu Ruihua, director of the Sun Yat-sen University Cancer Center in Guangzhou, Guangdong province, who has led the research.

After five years of research, involving over 100 researchers from different institutes, the scientists identified methylation in DNA circulating in the blood that is related to liver cancer. Methylation, like genetic mutation, is an abnormal genetic change that can cause cancer, Xu said.

Using samples of circulatory system DNA from a large group of 1,098 liver cancer patients and 835 healthy people for comparison, they constructed a diagnostic prediction model that showed high diagnostic specificity and sensitivity, Xu said in the study, which was published in Nature Materials, a science journal, on Oct 9.

Liver cancer is one of the most common cancers in China. The number of new cases reached 466,000 in 2015, and the cancer caused 422,000 deaths that year, according to the center, accounting for more than half of the world’s liver cancer cases and deaths. (Source: China Daily)

September: Spread of resistant bacteria reduced

Health authorities have been emphasizing the control of bacterial drug resistance and the rational use of antibiotics, and efforts made in the past 10 years have yielded noticeable results, said Xiao Yonghong, a member of the National Health and Family Planning Commission’s expert committee for rational use of drugs and a professor at Zhejiang University’s First Affiliated Hospital.

Last year, antibiotics dispensed at medical institutions across China accounted for 11.2% of the total value of all drugs sold at those institutions, compared with 19.7% in 2010, he said. According to Xiao, in 2010, more than 67% of inpatients in China used antibiotics, and nearly 20% of outpatients used antibiotics. By the end of last year, the percentages decreased to 37.5% and 8.7%, respectively. The quantity and frequency of antibiotics used on patients also saw a decrease of about 41% from 2010 to 2016.

With the reduced use of antibiotics, the proportion of cases of major multidrug-resistant bacteria at medical institutions in China have been controlled, according to Xiao. “Gaps still remain between China and countries that have taken the lead in the control of bacterial drug resistance, but China is close to the US and major countries in Europe in certain aspects,” Xiao said. For example, the proportion of cases of methicillin-resistant Staphylococcus aureus, a type of multidrug resistant bacteria prevalent in many countries, was lowered from about 52% in 2011 in China to about 30% last year. In comparison, the proportion of cases in the United States is 44% and in India, 48%, Xiao said. (Source: China Daily)

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