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Pharmaceutical Pricing and Reimbursement in China


Description: With a growth rate of more than 20% per year, the Chinese pharmaceutical market is set to become the third largest in the world in 2011. A radical healthcare reform package recently unveiled by the government will more than double public healthcare expenditures from 2009 to 2011. For biopharmaceutical companies competing in China, future success will depend on a clear understanding of the implications of these reforms.

Questions Answered in This Report

- More than 1 billion of China’s 1.3 billion residents now have some form of government-sponsored health insurance. Which are the most important public health insurance programs? What level of benefi ts do these programs offer? What changes are planned for the near future?

- Prices for international branded drugs in China are generally comparable to prices in some European markets. How do Chinese prices compare with prices in the United States? Which kinds of drugs have prices close to, or higher than, U.S. prices?

- Hospitals are the dominant distribution channel for prescription drugs in China. Why do hospitals play such an important role in the healthcare system and the pharmaceutical market? How does the government plan to exercise stricter control over hospital prescribing in the future?

- In the future, a drug’s reimbursement prospects are likely to depend heavily on inclusion in a new national essential medicines list. How extensive is this list likely to be? How will the healthcare system procure and use drugs on this list?

Scope

- Regulatory structure: key policy decision makers in the Chinese healthcare system.

- Organization and funding of the healthcare system: historical perspective, health insurance, organization of healthcare provision.

- Pharmaceutical pricing: historical pricing procedures, standard pricing procedures, premium pricing, centralized drug tenders, international price comparison.

- Reimbursement and cost containment: drug reimbursement, price cuts.

- Outlook and implications for the pharmaceutical industry: changes to the health insurance system, investment in healthcare facilities and professionals, improved quality and range of healthcare services for patients, new system of hospital funding, overhaul of the pharmaceutical supply system, challenges and opportunities for drug manufacturers.

“Multinational pharmaceutical companies seeking to do business in China must adapt to market conditions that are profoundly different from those found in the traditionally dominant markets of North America, Europe, and Japan. The challenges may appear daunting, but manufacturers cannot afford to ignore a market of 1.3 billion potential customers. At a time when most mature pharmaceutical markets are stagnating, or even declining, the Chinese market continues to grow by more than 20% per year and is forecast to become the third-largest prescription drug market in the world in 2011. A massive health reform program recently unveiled by the central government will give a further boost to the pharmaceutical market in coming years. However, to capitalize on the potentially lucrative opportunities, foreign companies will need to know how to navigate China’s complex healthcare system.”

- Neil Grubert, M.A., Director of Pricing and Reimbursement Research


Contents: Executive Summary
Strategic Considerations
Stakeholder Implications

Introduction

Regulatory Structure
Ministry of Health
State Food and Drug Administration
Ministry of Human Resources and Social Security
National Development and Reform Commission
State Administration of Traditional Chinese Medicine

Organization and Funding of the Healthcare System
Historical Perspective
Central Planning Era (1949-1978)
Market-Based Era (1978-2002)
Current Organization of Healthcare
Health Insurance
Organization of Healthcare Provision

Pharmaceutical Market Trends

Pharmaceutical Pricing
Historical Pricing Procedures
Standard Pricing Procedures
Premium Pricing
Centralized Drug Tenders
International Price Comparison

Reimbursement and Cost Containment
Drug Reimbursement
Price Cuts
Generic Prescribing

Intellectual Property Protection

Outlook and Implications for the Pharmaceutical Industry
Radical Healthcare Reform Program
Changes to the Health Insurance System
Investment in Healthcare Facilities and Professionals
Improved Quality and Range of Healthcare Services for Patients
New System of Hospital Funding
Overhaul of the Pharmaceutical Supply System
Challenges and Opportunities for Drug Manufacturers

Tables

1. Organization of Healthcare Provision in Urban and Rural Areas
2. Average Sources of Income and Expenditure for General Hospitals in the Public Health System, 2007
3. Average Outpatient and Inpatient Drug Expenditures Per Patient by Type of General Hospital in the Public Health System in Select Years, 1995-2007
4. Maximum Markups Permitted on Ex-Manufacturer Prices of Fully Reimbursed Drugs Included in the National Reimbursement Drug List
5. Ex-Manufacturer Prices of Select Drugs in China and Other Major Markets as a Percentage of U.S. Prices, 2008
6. Pharmaceutical Price Cuts Imposed by the Chinese Government, October 1997-May

Figures

1. Sources of Healthcare Funding in China, 1995-2006
2. Ex-Manufacturer Prices of Select Drugs in China as a Percentage of U.S. Prices,


Products Mentioned - Anastrazole - Atazanavir - Bicalutamide - Bortezomib - Capecitabine - Celecoxib - Cetuximab - Diclofenac - Docetaxel - Erlotinib - Filgrastim - Gemcitabine - Infl iximab - Interferon-beta-1a (Rebif) - Letrozole - Leuprolide - Lopinavir plus ritonavir - Meloxicam - Mycophenolate mofetil - Oseltamivir - Oxaliplatin - Peg-interferon alpha 2a - Peg-interferon alpha 2b - Pemetrexed - Pioglitazone - Rituximab - Rosiglitazone - Sorafenib - Sunitinib - Tacrolimus - Temozolomide - Trastuzumab


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