Domestic players

Beijing resident Deng said that he and his wife’s expenditure on chronic disease treatment has increased in the past few years.

"The doctors usually recommend medicine made by foreign companies or joint ventures to us. I prefer domestic products, which are in general cheaper and have a similar effect," he said.

Compared with foreign companies, domestic drugmakers have the upper hand in terms of price, because their products are mainly generics.

Generic drugs are comparable to original drugs in terms of dosage, strength, quality and performance characteristics, and intended use. They can be marketed after the patent for the original drug expires, thus the prices of generics are much lower than the original medication.

In addition to price, domestic companies have their own advantages in various regions, said Wang Linhong, deputy director of the non-epidemic chronic disease control and prevention bureau affiliated to the Ministry of Health.

"Even with the same disease, the symptoms of patients in different areas may be somewhat different, so many local companies have their own products specifically tailored to local patients," she said, adding that companies with these kinds of medication are really competitive in regional markets.

According to Frank Guo, director of Ipsos Healthcare China, substantial investment will be made in different parts of the chronic disease management cycle — public education, health food products, and disease prevention.

Private companies are already playing quite an active role in chronic disease management. There are already many innovative Chinese private pharmaceutical companies that have a considerable presence in chronic disease therapy.

Private pharmaceutical companies and private medical device companies that develop and manufacture chronic disease related products such as testing equipment and therapeutic devices will benefit from this.

"We expect to see increased government funding for purchase of these types of devices, as well as a rising reimbursement level for patients which would make the tests and treatment more affordable," Guo said.

Reimbursement list

"The new initiative will probably lead to expanded reimbursement coverage for many of the drugs to treat chronic diseases, and will in turn lead to increased drug sales," said Guo.

Deng Mingliang, the son of Deng Jianping, said: "Some of the medicines I am using are not on the reimbursement list. But due to their quality, I choose the more effective, usually more expensive, ones. As a result, my expenditure is much higher than my parents’," he said.

China has a national essential drugs list, which was compiled by the National Development and Reform Commission. It focuses on common diseases, mainly chronic ones, and identifies drugs available to the public at all times, in appropriate dosages and at affordable prices.

In addition to the national list, regional governments can add medicines to their reimbursement lists in line with local medical and economic conditions.

So far, the national list covers 307 essential medicines, more than 90 percent of which are generics. The regional lists usually include more than 1,000 items, with original drugs only accounting for a small part.

"Price is the first consideration of the lists, then effect and quality are taken into account," said Wu Yiling, a scholar at the Chinese Academy of Engineering. "I believe the list should be expanded to offer more choices to patients."

Health Minister Chen Zhu said at this year’s session of the National People’s Congress in March that China will add about 400 Western drugs and 200 traditional Chinese medicines to the national essential drugs list this year. The local lists are expected to be expanded at a later date.

The ministry even considered putting medication to help people quit smoking on the list, but this attracted public criticism.

The critics said there are only three such kinds of medication available in China, all of which are developed and produced by international pharmaceutical giants and are very expensive.

"How to adjust the list — coordinating the interests of the public, the nation and businesses — is really a difficult problem to be resolved by the central government," said Wu.

liujie@chinadaily.com.cn