China Medical News

Beijing saw a year-on-year drop in new HIV/AIDS cases with a total of 1,462 new HIV/AIDS cases were reported in the city from January to October, down 11.61% year on year, the Beijing Municipal Health Commission said. Sexual transmission was blamed for 96.99% of the new cases in the 10-month period, the commission said. Beijing currently has 26,013 HIV carriers and AIDS patients. Since the first case in 1985, the capital city had reported a total of 39,018 HIV/AIDS cases as of the end of October, it added. (Source: Xinhua)

China will cut to 3% the value-added tax on the imports and the domestic production and circulation of more anti-cancer and rare-disease drugs. Starting on Dec. 1st, a total of 71 such drugs and active pharmaceutical ingredients will benefit from the tax reduction, according to a statement jointly issued by the Ministry of Finance and other government agencies. The move seeks to lower costs for patients and boost China's pharmaceutical industry. This is the third batch of anti-cancer and rare-disease drugs and active pharmaceutical ingredients to benefit from such a policy since 2018. (Source: Xinhua)

China will not lower its high blood pressure range as suggested by a recent clinical guideline, the top health authority said on Tuesday, handing the final verdict on a hotly-debated issue that sent jitters across a sizable population teetering on the brink of high blood pressure. However, experts have also recognized that in a country with over one-fifth of adults already living with the condition, expanding awareness of healthy lifestyles and early prevention among at-risk groups is vital to reduce related deaths.

Last week, the National Center for Cardiovascular Diseases and the Chinese Medical Doctor Association jointly released a clinical practice guideline for hypertension management, suggesting resetting the diagnosed threshold for high blood pressure to 130/80 millimeters of mercury, down from the current trigger of 140/90.

Han Yaling, an academician with the Chinese Academy of Engineering and a noted cardiology expert, said during an event marking the document's release that decreasing the threshold reflects an emphasis on stepping up early prevention, so as to avoid missing a key window of opportunity to rein in the occurrence of potentially deadly cardiovascular diseases.

The guideline said there is an estimated 243 million people with their blood pressure hovering around the contentious range of 130 to 139/80 to 89, and the majority are aged 18 to 54 years old. "Even though lowering the threshold will result in an increase in high blood pressure patients and incur expenses on early treatment, costly fees spent on much more serious comorbidities such as stroke, heart attack and poor kidney function will be much lower and the quality of patients' lives can be improved," said Han during the event.

In response to the heated discussion, the National Health Commission said on Tuesday evening that the definition of adult hypertension remains unchanged at having three blood pressure readings taken on different days that are higher than 140/90. It added that protocols or expert consensus released by institutions or industry associations are merely research outcomes, and will not be adopted as uniform diagnostic standards.

Most health experts have agreed with sticking to the current threshold for high blood pressure, for lack of robust evidence on the benefits of making adjustments and concerns over the capacity of grassroots medical systems.

Zhang Xinhua, president of the World Hypertension League, said that most high-quality clinical research shows that only patients with blood pressure of 140/90 or higher should take medication to reduce the risk of cardiovascular illnesses. "For individuals whose blood pressure reading is lower than the number, healthy lifestyles such as cutting back on salt, exercising, quitting smoking and limiting alcohol consumption, are the most effective ways to manage blood pressure," she said.

Zhang added that under the current rule, China already has a massive number of high blood pressure patients. At present, about 50% of patients are aware of their condition, only 40% are on treatment and 15% have their disease under control. "The healthcare system is already under immense pressure to detect patients who do not know their condition yet and provide effective therapies," she said. "If we allow groups who might not benefit from treatment to further strain limited healthcare resources, those with more severe symptoms might lose the opportunity to be diagnosed and treated." (Source: China Daily)

From improving early screening and diagnosis of rare diseases to lowering costly drug prices, China has strengthened comprehensive support and care for rare disease patients in recent years, according to health officials.　Yu Xuejun, vice-minister of the National Health Commission, said during an event that 323 hospitals across China have established a cooperation network for rare diseases, devoted to facilitating the referral of patients, online medical consultations as well as formulating diagnosis and treatment guidelines.

China has more than 20 million people living with rare diseases and 200,000 people get diagnosed with a rare disease annually, according to data from the China Alliance for Rare Diseases.　Since over 90% of rare diseases cannot be effectively treated, prevention is vital, Yu said during the opening ceremony of the 2022 China Conference on Rare Diseases held on Saturday.

Song Li, head of the commission's department of maternal and child health, said that the majority of the 8,000-plus types of birth defects are classified as rare diseases. China has set up more than 4,800 prenatal screening institutions, and nearly 500 facilities that can make confirmatory diagnoses. "Screening tests for genetic or metabolic diseases of newborns have been popularized in many provinces and cities," she said, adding that comprehensive efforts should be rolled out, covering premarital, preconception and newborn care to reduce risk factors of rare diseases.

Huang Guo, deputy director of the National Medical Products Administration, said that since 2018, China has approved 56 rare disease medications for the market. "In the future, we will continue to advance the research and development of innovative rare disease medications, and encourage the use of foreign novel drugs for R&D, clinical research and registration on the mainland at the same pace as they are performed overseas, to bring better drugs for rare disease patients in China more quickly," he said.

To incentivize drug development, Bi Jingquan, deputy director of the China Center for International Economic Exchanges, suggested extending market exclusivity periods for newly developed rare disease drugs from six to 10 years, which would make Chinese standards align with rules in Japan and the European Union.

Huang Huabo, an official with the National Healthcare Security Administration, said that 19 rare disease medications have been added to the national medical reimbursement list since 2018, leading to an average price cut of 52.6%. The list now contains 45 kinds of rare disease drugs, covering 26 types of diseases. "Through negotiations with drugmakers, the amount of out-of-pocket expenditures paid by rare disease patients from 2019 to 2021 has been lowered by 92.8 percent," Huang said.

A typical example is the list's inclusion last year of Nusinersen, a medication used to treat spinal muscular atrophy — a rare neuromuscular disorder. The price of the drug has been slashed by more than 90%. He said it is estimated that from January to September, the number of patients receiving the drug had increased by 2,000. The drugmaker also saw a threefold jump in its sales. "Bringing down the prices of these costly drugs through drug negotiations has not only alleviated financial burdens on patients and boosted their availability, but has also benefited enterprises," he said. (Source: China Daily)

Theanti-epilepsy drug, clobazam, was first thrust into the spotlight in November when thousands of parents pleaded for legal access to the then domestically unapproved medication that could provide a lifeline for their children. Less than a year later, the drug has again attracted widespread attention because it has not only become available in China, but is available at the world's lowest price thanks to concerted and prompt efforts from health authorities, drug developers and patient communities.

A generic version of clobazam, produced by Yichang Humanwell Pharmaceutical based in Hubei province, gained the country's first market approval for the medication on Sept 20. The company announced during a news briefing on Saturday that its clobazam will be sold at 84 yuan per package that contains 28 tablets of 10 milligrams each.

"The price is the world's lowest," said Du Wentao, president of the pharmaceutical company. "We are also planning to begin negotiations on getting our clobazam pills onto the national medical reimbursement list from 2023, and cooperate with nonprofit funds so as to provide medical aid for financially constrained families."

Hong Zhen, president of the China Association Against Epilepsy, said during an event held last week: "The speedy market authorization for a domestically made clobazam product resolves the critical shortage of epilepsy drugs. The approval also constitutes a milestone in China's anti-epilepsy cause and reflects the outcome of joint efforts."

Clobazam has been approved in over 100 countries and regions to treat epilepsy and is regarded as the last resort to tackle a few specific types of epilepsy that affect minors. However, the drug is listed as a second-category psychotropic drug in China, meaning that it is potentially addictive and must be strictly controlled. As a result, a number of patients used to purchase the medication from overseas via private agencies or foreign websites. But that avenue was cut off in September last year as local customs stepped up checks on imported clobazam and even detained sellers who brought these medications into China. The dilemma prompted families of children with epilepsy to send out a public letter in November, asking for help to gain adequate and stable access to the lifesaving pill.

The National Health Commission replied in December, saying that it is researching the medical needs of patients and coordinating with other government departments to organize bulk procurements and imports of clobazam. An official guideline aimed at facilitating temporary and legitimate imports of foreign-made clobazam for special groups was released in late June. The first prescription made possible under the new guideline was issued by Peking Union Medical College Hospital to a teenage patient in September. "We have managed to enable legal importation of clobazam, as well as achieve development and approval of domestic clobazam around the same time, which have completely addressed acute needs of patients suffering the difficult-to-treat kind of epilepsy," said Zhang Shuyang, president of the hospital. (Source: China Daily)

China's first central procurement program targeting equipment related to orthopedic spinal procedures has led to an average price cut of 84%, according to draft results released on the evening of Sept 27.

The price reduction, set to take effect in February, is expected to save patients around 26 billion yuan ($3.6 billion) annually, the National Healthcare Security Administration said. For instance, the price of medical equipment used for a procedure known as posterior fixation for the thoracolumbar spine, which makes up one-third of all spinal surgeries, will drop from 33,000 to 4,500 yuan per set on average. The price of equipment used for cutting-edge minimally invasive surgeries on the thoracolumbar spine will also decrease from nearly 40,000 to 5,600 yuan per set.

The administration said that 152 out of 171 companies participating in a tender held in Shanghai on Sept 26 won bidding. Both domestic and foreign enterprises took part.

Medical equipment has become the focus in China's latest efforts to reduce the financial burden of patients via national bulk-buy programs, which see manufacturers offer heavy discounts in exchange for large-volume contracts with public hospitals. Previously, bulk-buy programs for artificial joints and coronary stents had been rolled out. (Source: China Daily)

China spearheaded and published the world's first international standard on stem cell research on September 24th, signaling that the country has become a globally recognized front-runner in this cutting-edge field that may revolutionize medicine, experts said. The document, named ISO 24603, lists the various requirements and regulations for cultivating and using human and mouse pluripotent stem cells. It is also the first stem cell related standard for the International Organization for Standardization.

Pluripotent stem cells have the ability to differentiate into any cell types that make up the body. They are typically found during the earliest stages of cell division after fertilization. As a result, scientists are trying to harness the regenerative potential of stem cells to treat many challenging medical conditions, such as spinal cord injuries, leukemia, Type 1 diabetes, heart diseases, stroke, burns, Alzheimer's disease and Parkinson's disease, according to the Mayo Clinic.

However, stem cell therapy can be controversial due to it being poorly regulated, with unscrupulous providers hyping the technology and drawing patients seeking cures to illegal and potentially harmful treatments. Chen Yeguang, the president of the Chinese Society for Cell Biology, said stem cell and regenerative medicine is a rapidly developing field, and it is essential to build consensus and establish some ground rules for research and the industry. "ISO 24603 will play an extremely important role in setting standards for the whole industry and public health," he said.

George Dagher, convener of the ISO/TC276/WG2 committee, the organization responsible for reviewing biobanks and bio resource related standards, said ISO 24603 is based on expert consensus from ISO countries, and it represents a crucial and necessary step for expanding stem cell research.

Zheng Jian, deputy director of the Department of Basic Research of the Ministry of Science and Technology, said the standard not only provides crucial instructions to guide and support the development of the stem cell industry, but also showcased China's increased international recognition in stem cell research. "It has injected positive energy into China's science, technology, and innovation in life and health sciences," he said. (Source: China Daily)

China's National Health Commission has recently released a trial protocol on autism screening and intervention services for children under the age of six to improve related services and safeguard the health of young kids.

Due to the lack of efficacious medicine, the current major remedy for children with autism is rehabilitation training, according to experts with the commission. The optimal time for treatment is before six years old, and those who received science-based interventions before three years old are likely to have relieved symptoms and better prognosis, experts said.

The services will include health education, screening, diagnosis, and rehabilitation, aiming to raise parents' awareness of autism, enhance their activeness to receive screening, diagnosis, and intervention services, as well as to standardize the related services to improve the intervention effect, and reduce the occurrence of mental disability, according to the document.

It also stressed efforts to improve the capacity of community-level medical and health institutions, strengthen information security and privacy protection, while promoting the interconnectivity and sharing of screening and intervention information for children with autism, and improve the service quality.

Autism is a neurodevelopmental disorder characterized by varying degrees of impairment in communication skills and social interactions. Research shows that in China, the prevalence rate of autism among children has reached seven per 1,000 people. (Source: Xinhua)

The National Healthcare Security Administration recently announced a number of measures aimed at making dental implants more affordable, including capping medical service fees per tooth at tertiary public hospitals to under 4,500 yuan ($650).

Medical service expenditures for dental implantation, which currently stand around 6,000 to 9,000 yuan at public hospitals across the country, primarily contribute to the widespread impression that the procedure is expensive and overpriced, the administration said on Sept 8. "Based on suggestions solicited from the public, the majority agree that price regulation should be implemented to bring the fee into a reasonable range," it said, adding that some also advise taking into consideration the value of technical skills and risks involved in the process, as well as the scarcity of specialists.

While a general goal of lowering medical service fees to around 4,500 yuan has been set, the administration noted that more developed areas that see higher labor costs will be allowed to request a higher maximum limit based on local circumstances.

The administration is also planning provincial-level bulk procurement of medical consumables such as replacement teeth and crowns to reduce patients' financial burden. For instance, high-end replacement teeth cost around 4,000 to 6,000 yuan per tooth, while a less costly tooth is priced at around 2,000 to 3,500 yuan at public hospitals.

With improving living conditions and a quickly aging society, the demand for dental implants in China has registered double-digit growth in recent years, the administration said. It added that regional healthcare security authorities should also set up an alert system to detect irregular pricing of dental implants and expose institutions that stick to overpriced products or refuse to participate in bulk purchase programs.

The administration also said that these new pricing measures will be first and foremost enforced at public hospitals, but private institutions are also asked to charge reasonable prices that comply with market competition rules as well as expectations of the public. Misleading promotional tactics such as using fake subsidies to swindle customers are strictly prohibited, and those committing such sales strategies will be exposed to the public. (Source: China Daily)

The National Healthcare Security Administration has published the winning bids for its latest round of centralized drug procurement, adding 60 new types of medications including those used to treat high blood pressure, diabetes and lung cancer.　The average price cut during this round of procurement was 48%, and the medicines are expected to be available to patients by November.

This round will help patients collectively save 18.5 billion yuan ($2.73 billion) every year, the administration said. For example, the price of a targeted medicine used to treat lung cancer (Lenvima generics) has been reduced to 18 yuan per capsule from 108 yuan, which can save patients 8,100 yuan for every cycle of treatment.

Bidding took place in Nanjing, capital of Jiangsu province, and attracted 295 companies, and the administration released a draft list of 217 bid winners in the middle of July, among which only six are foreign companies. From late July, healthcare authorities in Tianjin and Guangdong province began to permit winners to promote their medications on official public healthcare platforms.

Since 2018, China has held seven rounds of centralized drug procurement covering 294 medications. Prices have been reduced by over 50% during the past six rounds, which has helped save patients over 260 billion yuan. (Source: China Daily)

China's pharmaceutical firms saw their combined business revenue climb 18.7% year on year in 2021, the highest growth rate in five years, official data showed Tuesday.
Companies in this sector together raked in 3.37 trillion yuan (about 502 billion U.S. dollars) in revenue last year, Zhou Jian, an official with the Ministry of Industry and Information Technology, told a press conference.
Their total profits stood at 708.75 billion yuan in 2021, up 67.3% from a year ago, Zhou said.
The industry's value-added output rose 23.1% year on year, 13.5% points higher than the overall growth rate, bringing its share in China's total industrial output to 4.1%.
Research and development also yielded solid results last year, Zhou noted, adding that the number of new drugs and medical equipment approved to enter the market was the highest in five years. (Source: Xinhua)

Starting from May, diabetes patients in China will enjoy an average 48% drop in their medicine costs. The price cut will be effective on about 40 commonly used insulin products selected by the country's centralized drug procurement program in November.
The bulk-buying mechanism has so far benefited patients with hypertension, diabetes, hyperlipidemia, chronic hepatitis B, and other chronic or common diseases, with an average drug price cut of 53%. It had saved an estimated 260 billion yuan (about 40.84 billion U.S. dollars) in medicine costs by the end of last year, and encouraged pharmaceutical enterprises to focus more on research and development, according to official data.
"Group-buying" will be institutionalized in the next few years and become the main purchasing channel for drugs and medical consumables, said the National Healthcare Security Administration. More high-value medical consumables will also be included in the program, it added. (Source: Xinhua)

China will gradually launch free human papillomavirus vaccinations nationwide to protect women and girls from cervical cancer, starting in pilot regions, the National Health Commission said.
Several provinces have rolled out efforts to promote free HPV vaccinations. Guangdong plans to gradually inoculate girls under 14 after they get into junior middle schools in September this year. A budget of 600 million yuan ($94.3 million) has been allocated for free vaccinations from 2022 to 2024. Cities such as Lianyungang in Jiangsu province and Jinan in Shandong province have already begun offering free HPV vaccines to school-age girls, the commission said.
It added that China backs the global strategy of accelerating the elimination of cervical cancer, which was initiated by the World Health Organization in November 2020. The strategy stipulated getting 90 percent of girls vaccinated with HPV vaccine before they turn 15 by 2030, and set the target of eliminating cervical cancer through vaccination, screening and treatment. "The primary target of HPV vaccination in China is girls from 13 to 15," the commission said.

With HPV vaccines, cervical cancer is expected to become the first malignant tumor to be completely eliminated. About 110,000 new cases of cervical cancer are diagnosed in China each year. Both the incidence and mortality rates have been increasing in the past 20 years and the cases have been diagnosed at a younger age. However, the HPV vaccination rate of school-age girls in China is less than 1%, China Central Television reported. Health experts suggested that women should get vaccinated as early as possible, and there is no need to wait for the nine-valent HPV vaccine, which may be temporarily out of stock.
China has approved four types of HPV vaccines for use, including two two-valent HPV vaccines, a four-valent one and a nine-valent kind, each signifying the number of virus strains it can protect against. Although higher-valent vaccines can protect against a wider range of viruses, "the two most common virus strains－Type 16 and Type 18－cause 84.5% of cervical cancer", said Qiao Youlin, a professor of epidemiology at the Chinese Academy of Medical Sciences' Cancer Hospital. "So you can be mainly protected by taking two-valent HPV vaccines," Qiao told CCTV. "The earlier and younger you get inoculated, the better it will be." (Source: China daily)

China will carry out centralized bulk-buying of drugs and high-value medical consumables on a regular and institutionalized basis, to further lower medical costs for patients, according to a decision made at the State Council's Executive Meeting chaired by Premier Li Keqiang on Monday. "The outcomes of the centralized bulk-buying program over the past few years should be fully recognized, as it has not only delivered real benefits to patients, but also motivated enterprises to step up product research and development and enhance quality," Li said.
The meeting noted the steady progress in the reform of centralized bulk-buying of drugs and high-value consumables in recent years, effectively curbing drug over-pricing through market-based mechanisms. By the end of last year, the program had helped save 260 billion yuan in medical insurance costs and patients' expenditures. Going forward, centralized bulk-buying need to be put on a regular and institutionalized footing to bring down the prices of medical services and drugs. "More drugs for chronic diseases and common illnesses as well as more high-value medical consumables should be incorporated into the bulk-buying program, as this is what people care much about," Li said.

The meeting decided to advance the national bulk-buying program, with focus on drugs for chronic diseases and common illnesses. Sub-national authorities will undertake provincial procurement or inter-provincial joint procurement of drugs that are not covered by the national-level bulk-buying. By the end of this year, the total number of drugs that each provincial region bulk-purchases at both national and provincial levels shall be no less than 350.
The coverage of bulk-buying regarding high-value medical consumables will be expanded in a well-paced manner, and the bulk-buying of orthopedic consumables and dental implants which are of high public concern will be rolled out at national and provincial levels respectively. "Quality is of utmost importance for drugs and medical consumables. We must make sure it is not compromised under any circumstance and work even harder to protect people's health," Li said.

The meeting stressed the need for long-term, stable supply of selected drugs and consumables. Medical institutions should use the selected products on a priority basis as appropriate. Oversight will be stepped up to ensure that price cuts will not come at the cost of the quality of selected products. "We must fully implement the policy for the use of medical insurance funds saved in the procurement, and advance the reform of the remuneration system to raise the salary of medical workers as appropriate and keep them better motivated." Li said. "COVID response and economic and social development should be advanced in parallel. People's normal access to medical services must be guaranteed during the pandemic." (Source: Xinhua)